Health Care

Who Wants Moar Medicaid?

Washington Post
At Wonkblog, Sarah Kliff has a revealing map of the states that have agreed to the Obamacare Medicaid expansion, are undecided, or have rejected it. Take a look: Eighteen states will accept the Affordable Care Act's Medicaid expansion—or are leaning towards it—17 are undecided, 7 are leaning "no," and 9 will not expand it. It's worth emphasizing how important this is: Of the 32 million people slated to receive health-care coverage under the ACA, just over 21 million will receive it by way of the Medicaid expansion. If states like Texas, Florida, Georgia, and Virginia decide to reject it, millions of people will go uninsured for no reason other than political pique. My hunch is that conservative states will be able to avoid the Medicaid expansion in the short run, but that longer-term pressure will force them to yield. Remember, the federal government is offering to cover 90 percent of the cost of the expansion, meaning—in effect—that states are receiving a huge award of free money...

Getting Away with Wage Theft

The 1938 Fair Labor Standards Act (FLSA), which ushered in many of the worker protections we enjoy today, was a major progressive victory. But as the century that followed it shows, it was by no means the end of the struggle to get workers treated fairly. Employers, aided by conservatives in the executive and judicial branches, have often found ways of ensuring these laws are not fully enforced. Symczyk v. Genesis Healthcare Corp. , which the Supreme Court considered yesterday at oral argument, presents another case in which conservatives on the Supreme Court might erect a barrier making FLSA harder to enforce. The case involves a lawsuit filed by Laura Symczyk, who alleged that Genesis Healthcare had committed wage theft against her and her co-workers. According to Symczyk, Genesis routinely docked the pay of workers (including herself) for lunch breaks that were not taken. Reflecting the strength of her claim, Genesis offered her $7,500 plus associated fees to settle. Symczyk,...

Will the Contraception Mandate Survive Judicial Review?

Yesterday's court order blocking the Obama administration's ruling on health-care plans is by no means the end of the road.

Yesterday, the Eighth Circuit Court of Appeals issued a stay blocking the Obama administration's requirement that employer health-insurance plans cover contraception. The related suit was filed by Frank O'Brien, a Roman Catholic business owner who claimed that the mandate violated his rights under the free exercise clause of the First Amendment. It's not clear whether the stay indicates a real chance that the mandate will ultimately be ruled unconstitutional. It was granted in a one-line order , with one of the judges in a three-judge panel dissenting. The stay order indicates that the two other judges consider the suit non-frivolous, but this does not necessarily mean that O'Brien will ultimately prevail. Still, the appeals court would have been better not to issue the stay, because the free exercise argument being made against the contraception mandate is i ndeed frivolous. The key precedent, Oregon v Smith , makes it clear that generally applicable laws do not violate the First...

The Great Society's Next Frontier

(AP Photo/Susan Walsh)
(AP Photo/Susan Walsh) A copy of H.R. 3200, America Affordable Health Choices Act of 2009, sits on the desk of House Energy and Commerce Committee Chairman Henry Waxman, a Democrat from California. A s The Washington Post ’s Ezra Klein declared shortly after voters re-elected President Barack Obama, one of the major winners last week was health-care reform. With Democrats holding on to the Senate and the White House, Republicans will be unable to repeal the law before all of its provisions go into effect in 2014—after which, the theory goes, the public will come to accept that government has the responsibility to ensure health care is available for all. This is the end of a long battle for progressives: Health care has been the major missing piece of our welfare state for nearly a century, and for decades making it part of our system of social insurance has been a primary goal of politicians, think tanks, and activists. With this piece of the progressive puzzle in place, the natural...

The Moral Question of the Medicaid Expansion

Uninsured people getting medical care at an event in Los Angeles earlier this year. (Flickr/Neon Tommy)
In the last four years, we've seen a lot of reflexive, frankly dickish anti-Obamaism from Republicans at all levels. Much of it is relatively harmless; when some knuckle-dragging congressman goes on talk radio to air his suspicions that Obama's birth certificate is a forgery, there may be some chipping away at the President's legitimacy, but no one's life is affected directly. But there are some cases where Republicans are willing to do direct, substantial, even life-threatening harm to thousands or even millions of people, for no other reason than to demonstrate their unflagging hatred for the man in the Oval Office. I'm talking here about the coming expansion of Medicaid, which didn't get discussed much during the campaign, but which is the most profound effect of the passage of the Affordable Care Act. As you'll recall, when the Supreme Court upheld the individual mandate, it gave a gift to Republicans too, saying states could opt out of the law's expansion of Medicaid, under which...

Defending the Right to Treat Your Employees Like Dirt

Papa Johns? More like Papa Jerk's! Thank you, I'll be here all week. (Flickr/jumbledpile)
Getting tired of eating at Chick-Fil-A every day to express your hatred of liberals? Well, now you have a couple more options. You can chow down at Applebee's, where the CEO of their New York franchises went on TV to declare that he won't be doing more hiring because of the costs Obamacare would impose. Or you can head over to Papa John's, whose CEO, John Schnatter, has said that Obamacare could add as much as—brace yourself—10 cents to the cost of a pizza, and since obviously customers would never tolerate such price gouging, he'll just have to cut back employees' hours. In our new era of corporate political activism, we're goin to be seeing a lot more of this kind of thing. So let's make sure we all understand exactly what it is these chieftains are complaining about: They don't want to give their employees health insurance . That's it. They'd prefer to talk about "regulation" in some general sense, so you might get the impression that Obamacare is making them needlessly remodel...

Nancy Pelosi, Same Job, Different Coalition

(Flickr/Talk Radio News Service)
(AP Photo/Pablo Martinez Monsivais) House Minority Leader Nancy Pelosi holds a news conference with newly elected Democratic House members on Capitol Hill. N ancy Pelosi has confounded expectation before. Following the 2010 midterm elections, when Republicans recaptured the House on a wave of Tea Party indignation, Pelosi was widely, and unjustly, criticized for leading House Democrats to debacle. She had played a key role in enacting Obamacare, a program that the Obama administration chose not to defend as Election Day drew nigh. She had not paid enough attention to solving the recession, critics argued, though in fact House Democrats had passed additional stimulus measures that failed to surmount Senate filibusters. It was time, the critics said, for her to go. But Pelosi disagreed, and her House colleagues turned out to be in no mood to challenge her decision. Now, once again, she has surprised the Washington conventional wisdom by signing on for another two years atop the House...

When It Comes to Lady Politicians, We've Got a Long Way to Go

(Flickr/Leader Nancy Pelosi)
(AP Photo/Michael Dwyer) Democrat Elizabeth Warren takes the stage after defeating incumbent GOP Senator Scott Brown in the Massachusetts Senate race, during an election night rally at the Fairmont Copley Plaza hotel in Boston, Tuesday, November 6, 2012. I t's made for a great narrative: Tuesday night, female candidates prevailed in nearly all the tightest, most-watched Senate races around the country. A historic number of women will now serve in the upper chamber, once the boysiest of boys' clubs. If that wasn't enough to prompt some girl-power cheering, there was the news out of New Hampshire that, with the election of Maggie Hassan to the state's top executive spot, the governor, senators, and congressional representatives now all carry XX chromosomes. Several commentators have noted there's still a long way to go. But perhaps, more notably, there's little evidence that these wins are part of a wider trend for female candidates. The political gains were most notable in the Senate,...

Will Massachusetts Voters Legalize Assisted Suicide?

This is the ninth in the Prospect's series on the 174 measures on state ballots this year. Six years ago, Mesfin Nega was attacked outside a nightclub. He suffered a broken neck and a damaged spinal cord that transformed the previously healthy 32-year-old into a quadriplegic. As The Washington Post later reported , Nega had made a pact with his friend Shimelis Yegazu: If one were ever to suffer an injury that required him to be connected to life-sustaining equipment, the other would take it upon himself to disconnect the equipment. Nega and Yegazu made the news last week when Yegazu followed through with this pact, administering a lethal dose of phenobarbital to Nega, and then taking a fatal dose himself. Nega’s story raises a question that has been off the political radar for some time: Should a patient who wants to end his or her own life have the right to receive a physician’s assistance doing so? Debate here doesn't fall along usual partisan lines—there is no party orthodoxy for...

Anti-Obamacare Ballot Measures: Purely Symbolic, Sometimes Ironic

(Flickr/Fibonacci Blue)
This is the seventh in the Prospect's series on the 174 measures on state ballots this year. Ever since the Affordable Care Act (ACA) passed, Republicans have been desperate for ways to gut it. They hoped the Supreme Court might do the dirty work, but the Court ruled this summer that the law was constitutional. They hoped to pass new legislation, but as long as Democrats have the White House and the Senate, that's a non-starter. So instead, for the time being, they are turning to purely symbolic acts of defiance. Four states have ballot measures on November 6 that, if passed, would directly conflict with the ACA. In Alabama, Florida, Montana, and Wyoming, voters can ostensibly decide to ban any and all mandates that residents get health insurance. But these "bans" would exist in name only. That's because the measures would violate Obamacare, which requires that the state's residents get health insurance or pay a fine (which the Supreme Court calls a tax). These measures will have no...

A Bumper Crop of Pot Referenda

(Flickr/Torben Bjørn Hansen)
In the halls of state legislatures, few folks laugh at the exploits of Cheech and Chong or Harold and Kumar. There is a bipartisan consensus that marijuana laws are political kryptonite, as if touching the topic of drug legalization, even medicinally, might prompt immediate backlash. The lack of mainstream support is surprising, given that sizeable groups in both parties have long clamored for an end to the “War on Drugs.” Some drug war critics point to the costs, both societal and budgetary, associated with imprisoning millions of people for a crime that doesn’t seem to hurt anyone. Others like the fiscal possibilities for marijuana legalization: If pot is legal, it will be taxable, and at a time when state governments are starved for cash, any possibility for new revenue is an opportunity. Though mainstream lawmakers remain reluctant, citizens seem to be warming to the idea of marijuana as something other than an illegal substance. (Maybe stoner movies have had some success.) A 2011...

Arlen Specter: A Poor Man's Richard Nixon

From Democrat to Republican to Democrat again, from his fierce opposition of Robert Bork to his cutthroat cross examination of Anita Hill, Specter was always, above all, a politician.

(Flickr/ProgressOhio)
Flickr/musicFIRSTcoalition W hen Arlen Specter, the former Pennsylvania Senator who died Sunday at the age of 82, was negotiating to become a Democrat in 2009, he believed that he would retain his GOP-acquired seniority on the Senate committees in which he served. Specter thought he’d gotten a commitment from Majority Leader Harry Reid—Specter’s switch would not only help him avoid a primary challenge from the right, but would give the Democrats 60 votes in the Senate. However, the Democratic caucus resented the idea that Specter could jump ahead of lifelong Dems on the seniority list. Reid was thus unable to keep the agreement with Specter. Losing the committee seniority, Specter said, according to Politico , “was the worst moment of my life.” The worst moment of a then-79-year-old man’s life? Think about that. Specter had, by then, lost his parents. He had gone through several bouts of cancer, a benign brain tumor, and cardiac bypass surgery in the previous decade. He had two...

Medicaid Is the Real Target

Since August, when Mitt Romney chose Paul Ryan as his running mate, the two campaigns have fought a fierce battle over who is the most stalwart protector of Medicare. In the first presidential debate, Romney assailed President Obama for his $716 billion in Medicare cuts, and Ryan did the same in last week’s vice presidential face-off. Likewise, the Obama campaign has hit Team Romney for the Ryan plan and its Medicare “premium support”—which, if implemented, would gradually replace traditional Medicare with subsidized, regulated private insurance. The irony is that—in the short term, at least—Medicare will stay unchanged, regardless of who wins the election. Seniors are among the most mobilized voters in the electorate, and there’s too much political risk involved in making big, immediate changes to Medicare. For that reason, Medicare reform plans on both sides are backloaded and will take time to unfold. The same isn’t true of Medicaid, the other major federal health-care program. The...

Are Women Better Off Than We Were Four Years Ago: Take Two

The story so far. Last week I objected to the question “Are you better off now than you were four years ago?” I object to the idea that my well-being can be reduced purely to economics, or to few things that the president can affect. (One colleague wrote: My 90-year-old mother would certainly say she’s not better off than she was four years ago, but that’s more about her health than about her wallet!) So I’m going to hijack that question for my own purposes and ask: Are women better off than we were four years ago—not just financially, and not just in ways affected by President Barack Obama’s administration, but overall? Last week we checked in on our financial well-being, given that finances are indeed important. But there’s more to life than our checkbooks and retirement plans. So welcome to Episode Two: Our Bodies, Our Well-Being. There’s some good news and some bad news. As you know, this past year, some prominent menfolk have been deeply distressed to learn that we believe that...

Obama: Giving Away Social Security

(AP/Rex Features)
Here is Mitt Romney’s proposal to cut Social Security benefits, from the Romney campaign website : First, for future generations of seniors, Mitt believes that the retirement age should be slowly increased to account for increases in longevity. Second, for future generations of seniors, Mitt believes that benefits should continue to grow but that the growth rate should be lower for those with higher incomes. In other words, cuts in benefits. In the first debate, I was waiting for President Obama to go to town on this. Instead, Obama had this to say: LEHRER: "Mr. President. Do you see a major difference between the two of you on Social Security?" OBAMA: "You know, I suspect that, on Social Security, we’ve got a somewhat similar position. Social Security is structurally sound. It’s going to have to be tweaked the way it was by Ronald Reagan and Speaker — Democratic Speaker Tip O’Neill." He’s got a similar position to Mitt Romney’s? On Social Security? Does this man just want to hand the...

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