Health Care

Iowa's High-Tech Abortion Battle

Free Verse Photography (http://www.flickr.com/photos/ennuipoet/5479828006/sizes/l/in/photostream/)
O ne night in 2007, Jill June, CEO of Planned Parenthood of the Heartland, couldn’t sleep. She was grappling with a problem that vexes rural pro-choice advocates everywhere: the lack of access to abortion. At the time, Planned Parenthood of the Heartland, which performs most of the abortions in Iowa, had 17 clinics in its network but only three with an on-site physician. Doctors would travel, sometimes as far as 200 miles, to three other clinics in the state to perform intermittent care. The remaining 11 clinics did not offer abortion services. In all, 91 percent of Iowa’s counties, the more sparsely populated regions that are home to more than half the state's women, lacked an abortion provider . For June, providing access to medical abortion—the termination of an early pregnancy using a pill, rather than a surgical procedure—was especially challenging. In a few states, nurse practitioners or other midlevel medical staffers are allowed to dispense medical abortion pills, widening the...

Is Obamacare a Republican Job Creator?

flickr/divaknevil
AP Photo A lmost 50 years ago, Congress passed and Lyndon B. Johnson signed the law establishing Medicare. It was, soon, wildly popular—so much so that to this day Republican opposition to the program can only be expressed in terms of “saving” Medicare from supposed instability. In the next congressional elections, liberals took a beating—and the Democrats lost the White House in 1968. Scratch that—Democrats lost five of the next six presidential elections. That’s not the only story I could tell like that. Social Security? It passed in 1935, during what turned out to be a very good election cycle for the Democrats. Implementation began after the 1936 election, and the 1938 election began a string of conservative coalition control in Congress that lasted 20 years. Want another one? Let’s try foreign policy. The Cold War was over time a bipartisan policy, but it was the Republicans who were in office when the Cold War ended and the Soviet Union dissolved … a policy outcome universally...

The Next Phase of the Obamacare Battle Begins

President Obama speaking yesterday on health care. (White House photo by Chuck Kennedy)
We're beginning a new phase of the battle over Obamacare—and the fact that we can continue to refer to it as a "battle" tells you something—one that in some ways takes on the appearance of an electoral campaign, with television ads, media events, PR stunts, and a universal assumption that the whole thing is zero-sum. If anything related to Obamacare goes well—like, say, people getting health insurance at affordable prices—then that's bad for Republicans and something they'll do what they can to stop. What we have here is something truly unprecedented: an opposition party not just insisting that a significant government program was a bad idea, not even just hoping that in its implementation it doesn't work, but committing itself to actively working to make sure the program fails and that as much human misery as possible can be created along the way, so that eventual repeal of the program will become possible. The Obama administration is facing a huge administrative task, laid on top of...

Rhode Island’s Small Victory

AP Photo/Susan E. Bouchard, File
AP Photo/Mel Evans W hen Governor Lincoln Chaffee signed the Temporary Care Giver’s Insurance law last week, Rhode Island became the third state—along with California and New Jersey—to grant paid time off to care for a sick loved one or a new baby. Rhode Island’s law, which goes into effect in 2014, will not only provide most workers with up to four weeks off with about two-thirds of their salaries (up to $752 a week), it will protect employees from being fired and losing their health insurance while they’re out. Workers will be able to use the time to care for a broad range of people, including children, spouses, domestic partners, parents, parent-in-laws, grandparents, and foster children. And, though the maximum single leave is four weeks, each parent can take four weeks off to bond with a new baby. A mother recovering from birth could combine that with an additional six weeks paid through an existing state program, bringing her total paid time off to ten weeks. An entire family...

Under Obamacare, Millions Will Die

Barack Obama may be trying to kill this woman's son.
I have questions. For instance, are Charles and David Koch aliens from the planet Fnerzblax 6, come here to feast on the entrails of Earth humans to give them strength for their coming war with the barbarians of Fnerzblax 4? We don't know, and that's what has me so concerned. I ask because Americans for Prosperity, the group through which the Kochs channel much of their political activism, is initiating a new television campaign to get people afraid of and angry about Obamacare, and this seems to be the method of the campaign. The first ad, called "Questions," asks whether Obamacare is going to take money from a worried-looking young mother and deprive her sick child of the care he needs to survive. Not that it would truly do these things, but hey, she's just asking: Beyond the just-asking format, there's a preview here of something else we'll be seeing as Obamacare gets implemented over the next couple of years. Every problem that anyone has with anything related to health care will...

The Part-Timer Problem

The Obama Administration’s decision to delay for a year the penalty that employers (in firms of 50 or more employees) must pay if they don’t provide health insurance to their workers shines a light on a problem that may be even more profound than getting health coverage for every American: that is, the decline of the American job. The employer mandate was designed for an economy in which American workers were employed in what had been normal jobs. In firms of 50 or more, all workers who put in at least 30 hours a week were either to receive coverage from the firm or else the firm would have to pay the government a $2,000 yearly penalty. Problem is, fewer and fewer workers are putting in 30 hours a week. To begin with, labor-force participation is at its lowest level since women increased their work-force participation in the 1970s. It has declined even during the past four years of so-called recovery. The past four years have also seen a rise in the percentage of workers who are part-...

Should the Employer Mandate Be Eliminated Altogether?

President Obama signing the Affordable Care Act.
This week the Obama administration announced that it was delaying implementation of the "employer mandate" part of Obamacare, so companies won't be required to cover their workers until the beginning of 2015 instead of the beginning of 2014. Their stated reason is that they need more time to work with employers to implement the somewhat complex reporting requirements, and they're trying to be flexible and respond to employers' concerns. Which is probably true, but it's also true that the issue has become something of a political headache, with lots of news stories profiling employers saying the mandate is going to destroy their businesses or lead them to lay off workers and cut back their hours so they don't have to comply. We'll get to what's true and false about those news stories in a moment, but it's important to understand that the "mandate" isn't really a mandate at all. First, it only applies to businesses with 50 employees or more. And second, if employers still don't want to...

Progressives' Post-DOMA To-Do List

AP Photo/Alex Brandon, file
AP Photo/The Columbus Dispatch, Fred Squillante T wo of my favorite writers on legal subjects, Dahlia Lithwick and Barry Friedman, wrote a piece for Slate earlier this week wondering if the progressive agenda hasn't been exhausted by the victories on same-sex marriage. "While progressives were devoting deserved attention to gay rights," they argue, "they simultaneously turned their backs on much of what they once believed." I share their sense of frustration, but I interpret the landscape differently. To me, the problem isn't the lack of a robust progressive agenda. The problem is that progressives generally lack power. Last week, I saw strong defenses of progressive values at every level of politics—from ordinary citizens to the highest offices in the country. In a brief window of time, you saw heroic opposition to barbaric attacks on the welfare state in North Carolina and reproductive freedom in Texas, President Obama's climate change speech , and eloquent defenses of equality by...

Christian Employers Claim Their Religion Puts Them Above the Law

Sacred ground, where worldly laws don't apply. (Flickr/prariedogking)
Ready for the next court fight over Obamacare? Get to know Hobby Lobby, the chain of stores fighting the Affordable Care Act's requirement that the health insurance employers offer their employees cover contraception, and the next Christian martyr to the unholy scourge of health coverage for employees. Hobby Lobby's owners are conservative Christians, and though their company isn't a church, they'd like to choose which laws they approve of and which they don't, and follow only the laws they like. And a federal appeals court just ruled that not only can their suit go forward, but they're likely to win. Because apparently, "This law violates my religious beliefs" is now a get-out-of-jail-free card. The decision is simply mind-blowing, essentially finding that private business are just like religious institutions, and therefore they can decide which laws they have to obey: "Hobby Lobby and Mardel have drawn a line at providing coverage for drugs or devices they consider to induce...

The ACA's Obamacare Problem

The law is going to make health care better for many Americans. A lot of them just won't realize it's the same thing as the Obamacare they hate. 

AP Images/Evan Vucci
AP Images/Evan Vucci Obamacare is well on its way to being permanently unpopular. A problem for supporters of health-care reform? Not really—because the Affordable Care Act (ACA) could become just as untouchable as Medicare or Social Security. That’s right—get ready for “keep your Obamacare away from my Affordable Care Act!” Okay, not literally; they won’t actually know that the ACA exists. But that’s what they’ll be saying, in effect. From the very beginning, and certainly before Democrats also adopted “Obamacare” as the shorthand name for health-care reform, Republicans have strongly opposed a fantasy version of the landmark legislation. Whether it was “death panels,” or “government takeover,” or any number of wacky claims in chain emails, Republican opposition has rarely been focused on what’s actually in the ACA. And no matter how successful reform turns out to be, that’s unlikely to change. See, the funny thing about the Affordable Care Act is that a whole lot of it will either...

If Pot Becomes Legal

What will become of its secretive California hometown?

AP Photo
AP Photo/Ben Margot Humboldt Cannabis Center horticulturist Steve Tuck gestures beside both mature and baby marijuana plants he is growing for medical users of the drug. A t one point in Humboldt: Life on America’s Marijuana Frontier , Emily Brady’s account of her year in a remote Northern California county where pot is the cash crop that drives the local economy, one of the book’s subjects—a native of the area named Emma Worldpeace—talks to a new friend about the pictures of deceased classmates that hang on tackboard on Emma’s dorm room wall. “Did you know all these people who died?” she asked. “Yeah, I grew up with all of them,” Emma replied. “Oh my god, that seems so tragic.” The kicker was that Emma’s friend was the one who came from a “rough part of the Bay Area.” “Well sure, maybe every year someone from my school died,” her friend said. “But I went to high school with five or six thousand people.” In a large city, the fallout from youth violence represents an awful loss. In...

When Republican Governors Do the Right Thing

Flickr/Gage Skidmore
One of the oddest political turnarounds in recent days has been the emergence of Governor Jan Brewer of Arizona as an Obamacare hero. Up until now, Brewer was known primarily for her forceful advocacy of the notorious anti-immigrant measure S.B. 1070, for supposedly wagging her finger at the president of the United States on an airport tarmac, for claiming weirdly that headless bodies were showing up in the Arizona desert, and for perhaps the most epic brain freeze in the history of televised debates. Yet despite being a fervent opponent of the Affordable Care Act, Brewer not only decided to accept the expansion of Medicaid that is being rejected by many of her fellow GOP governors, she campaigned aggressively for it over the objection of many Arizona Republicans, and yesterday she won the battle when the expansion passed the Arizona Legislature. So will other Republican governors follow her lead? Perhaps, but it's going to depend a lot on their own personal political calendars. Let's...

A Quiet Blockbuster

(AP Photo/J. David Ake) A s we near the end of this Supreme Court term, a number of cases of substantial interest to politically-aware people who aren't court specialists remain to be decided. Landmark rulings involving the constitutionality of affirmative action, crucial provisions of the Voting Rights Act, and laws discriminating against gays and lesbians are still up in the air. People without access to the physical opinions handed out at the Supreme Court building used to have to wait for media reports about the outcome of cases to trickle out. Today, opinions are released almost instantaneously in PDF form, transforming late-term opinion days into a minor event. According to Kali Borkoski of the indispensable SCOTUSBlog , more than 60,000 readers have viewed its live-blogging of yesterday's opinions, with more than 12,000 simultaneous viewers a little after 10 a.m, when the decisions are announced. However, the vast majority of these onlookers did not get rulings in the cases...

What Will Republicans Do if Obamacare Turns Out OK?

Flickr/Fibonacci Blue
Ramesh Ponnuru has a long piece at National Review imploring conservatives to come up with a health-care plan they can swiftly put in place when Obamacare inevitably collapses under the weight of its disastrous big-government delusions. Though I disagree with almost every point Ponnuru makes along the way, from his analysis of what will happen with Obamacare to his recommendations of what a conservative health-insurance system should look like (the fact that anyone, even a free-market dogmatist, thinks catastrophic coverage plus high-risk pools would work out great is just incredible), I'll give him credit for trying to get his ideological brethren to come up with a proposal to solve what they themselves keep saying is a terrible problem. But alas, his effort is doomed to fail. Why? Because when it comes to health care, conservatives just don't care . I'll elaborate in a moment, but here's the crux of Ponnuru's argument: Opponents of Obamacare should plan instead for the likelihood...

Our Bodies, Their Cells?

AP Images/Axel Heimkin
AP Images/Axel Heimkin Editor's note: On June 13, 2013, the Supreme Court, delivered its long-anticipated ruling in Association for Molecular Pathology v. Myriad Genetics. In a victory for the American Civil Liberties Union, the Court ruled that genes cannot be patented. The ruling invalidated Myriad’s key ownership claims over BRCA1 and BRCA2, two of the most important (and often deadly) players in hereditary breast cancer, and effectively overturned 30 years of patent practice. “A naturally occurring DNA segment is a product of nature and not patent eligible merely because it has been isolated,” wrote Justice Clarence Thomas in the unanimous decision. “It is undisputed that Myriad did not create or alter any of the genetic information encoded in the BRCA1 and BRCA2 genes." L ately I have been thinking a lot about breasts. Well, not exactly breasts, but about two of the handful of genes that influence whether breasts develop cancer. These genes are called BRCA1 and BRCA2, and among...

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