Health Care

The Obamacare Is Falling! The Obamacare Is Falling!

AP Photo/Charles Dharapak
AP Photo/Steve Browne, Valley City Times-Record As we approach the full implementation of the Affordable Care Act at the end of the year, confusion still reigns. Most Americans don't understand what the ACA does or how it works, which is perhaps understandable. It is, after all, an exceedingly complex law, and from even before it passed there was an aggressive and well-funded campaign of misinformation meant to confuse and deceive Americans about it, a campaign that continues to this day and shows no sign of abating. To undo uncertainty and banish befuddlement, we offer answers to a few questions you might have about Obamacare. What's happening when? The next important date is October 1, when open enrollment for insurance plans on the new exchanges begins. Those who sign up will begin their new insurance on January 1, when the rest of the high-profile components of the law take effect. The individual mandate, requiring everyone to carry insurance or pay a fine, takes effect, as does...

Could Conservatives Help Obamacare Implementation Work?

She only wants to help, really. (Flickr/American Life League)
Supporters of the Affordable Care Act, up to and including President Obama, have been at pains to point out to anyone who'd listen that as with any large and complex piece of legislation, implementation is going to be imperfect. There are going to be hiccups. Hurdles. Stumbles. Stops and starts, ups and downs, potholes and roadblocks and detours. They've been saying it because it's true, because they want to prepare the media and the public, and because they know that conservatives will be squawking loudly every time it becomes apparent that some feature of the law needs to be adjusted, trying to convince everyone that even the most minor of difficulties is proof the law should never have been enacted in the first place. But let me make a counter-intuitive suggestion: Perhaps all the inevitable overblown carping from the right will prove to be a good thing, making the law work better in the long run. Not because the conservatives' motives aren't bad (they are), and separate from the...

The Sum of Its Parts

Flickr/Will O'Neill
We're just two weeks away from the start of open enrollment for the new state health care exchanges established as part of the Affordable Care Act, and it's safe to say that Republicans will not be able to repeal the law between now and then. It's equally safe to say that they won't be able to repeal it by January 1, which is when the people who sign up for insurance through those exchanges start on their new plans. That's also the date when a whole bunch of other components of the law take effect. When that day comes, will Republicans have to abandon all hope of ever repealing it? The ones who don't understand the law (and let's be honest, that's probably most of them) might answer yes. Once it goes into effect and begins destroying lives, sapping us of our precious bodily fluids, and generally turning America into a socialist hellhole where all hope has died and the flickering flame of freedom has been snuffed out, people will quickly realize what a disaster it is and support repeal...

Anti-Choicers' New Mexico Experiment

The American Prospect/Chloe Hall; AP Photo
AP Photo/ The Albuquerque Journal, Kitty Clark Fritz; homepage photo by Chloe Hall/The American Prospect Abortion-rights supporters and opponents demonstrate at the University of New Mexico in Albuquerque. I n early August, several dozen teenagers and a few adult supervisors descended on the Holocaust and Intolerance Museum in Albuquerque, New Mexico, with a request: They wanted the curators to add an exhibit on abortion. When their demand was rebuffed, the teens—who were spending the week in the city as part of a pro-life training camp sponsored by Survivors of the Abortion Holocaust—unfurled a banner outside the building calling Albuquerque “America’s Auschwitz.” The protest catapulted Albuquerque into the national media, but the demonstration is just part of a larger experiment by the recent wave of pro-life activists flocking in from out of state: Can they transform New Mexico—a moderate state with liberal abortion laws—into another reproductive-rights battleground? After a number...

The Republican Team Effort on Obamacare Obstruction

AP Photo/J. Scott Applewhite
When it comes to the Affordable Care Act, you have to give Republicans credit for sheer sticktoitiveness. They tried to defeat the law, but it passed. They tried to get the Supreme Court to declare it unconstitutional, but that didn't work. So now, as the open-enrollment period for the exchanges approaches on October 1, they're thinking creatively to find new ways to sabotage the law. Sure, at this point that means screwing over people who need insurance , but sometimes there's unavoidable collateral damage when you're fighting a war. Their latest target is the Obamacare "navigators." Because not just the law but the insurance market itself can be pretty complicated, the ACA included money to train and support people whose job it would be to help people get through this new system, answering consumers' questions and guiding them through the process. Grants have been given to hospitals, community groups, charities like the United Way, churches, and the like in the 34 states that are...

The Law That Must Not Be Named

This is not actually a skit from "Portlandia."
Talking Points Memo has done a service and rounded up a bunch of the ads states will be airing to promote the health-insurance exchanges created under the Affordable Care Act, and they provide an interesting window into how the exchanges in particular, and the ACA in general, is going to look to the public. The first thing you notice is that none of ads mentions the words "Affordable Care Act, let alone "Obamacare." A couple of them use words like "official" to denote that this is sponsored by the state, but others just make it seem like a consumer marketplace that might not have anything to do with government at all. And many of the spots look like they were produced by the state tourism board, with quick cuts between picturesque scenes from all around the state and poetic words about how our state is awesome and we're all terrific people. For instance, this one from Oregon barely mentions healthcare at all; it's just a friendly Portland hipster musician bounding around the state...

Total Eclipse of the Fetal Heart

AP Images/Rogelio V. Solis
B y the end of July, it was clear opponents of abortion were going to have a banner year. In the first half of 2013, state legislatures across the country enacted dozens of restrictions on abortion clinics that will slim their hours or shutter them completely. States like Wisconsin and Indiana added requirements like ultrasounds and waiting periods for women seeking the procedure. After a high-profile debate , Texas passed a law that bars abortion after 20 weeks, bringing the total number of states with similar bans to 11. The show’s far from over. Earlier this month, at a press conference that featured the Duggar family of 19 Kids and Counting fame, two Ohio state legislators announced they were restarting the fight for one of the most restrictive abortion laws in the country. House Bill 248, generally known as the “Fetal Heartbeat Bill,” was introduced on August 22 in the House Committee on Health and Aging, chaired by the bill’s co-sponsor, state representative Lynn Wachtmann. This...

Why the Republican Obamacare Strategy Fell Apart

News flash: these guys never knew what they were doing. (Flickr/Speaker Boehner)
After President Obama signed the Affordable Care Act, conservative writer David Frum, who had been a speechwriter for George W. Bush, chided his compatriots for the strategy they had employed in opposing it. Had they worked with Obama on a compromise, he argued, the result could have been a more conservative version of the law; by simply opposing it in its entirety, they wound up with nothing once the law passed. For raising this criticism, Frum was declared a traitor and banished from the conservative movement; these days his (still conservative) ideas get a better hearing on the left than the right. And what has been the Republican strategy on health-care reform since the ACA's passage? Well, first they tried to kill it through the courts. That didn't work, though they won for Republican governors the right to refuse the Medicaid dollars that would enable them to offer insurance to their states' poor (congrats on that), though many of them are coming around to accept the money. In...

Washington's Weed Whackers

For most of Stephanie Kahn’s life, medical marijuana was a tempting remedy that remained just out of reach. Her father, who suffered from multiple sclerosis, was told by doctors as early as the 1970s that medical marijuana could alleviate his symptoms. At first, he was repelled by the idea of using an illegal drug. But as the pain and muscle spasms grew worse, he eventually tried marijuana and found that, as the doctors said, it provided almost-miraculous relief. Decades later, when her mother was undergoing chemotherapy for lung cancer, Kahn, a nurse, heard the same refrain. “She lost 45 pounds in a month and a half,” she recalls. “And the doctor kept saying, marijuana could help her handle the chemo, could help her get her appetite back.” Months after her mother’s death in 2009, Kahn’s husband of 37 years, Jeffrey, a Reform Jewish rabbi who had retired from congregational ministry a few years earlier, floated an unorthodox idea: What if they opened a medical marijuana dispensary? “...

A Bold Obamacare Prediction

An ad from Organizing For America
Love may not mean never having to say you're sorry (what a dumb idea, anyway), but being a blogger means being able to make predictions and not really worrying about whether you turn out to be right or wrong. Oh sure, if you're spectacularly wrong, and wrong on television (see Kristol, Bill ), people might make fun of you. But usually, nobody remembers. And if you're right, you can remind everyone of how clever you were. In that spirit, let me offer a prediction. The implementation of the Affordable Care Act, a.k.a. Obamacare, begins with open enrollment for the state exchanges on October 1, with coverage beginning on January 1. Sarah Kliff, who knows as much about the law as pretty much any reporter, returned from a cruise to report that the regular folks she encountered, when they heard what she does for a living, all wanted to know whether Obamacare was going to work. This was true of supporters and opponents alike. Not that the people Sarah met on the Lido Deck are a...

How Long Do You Want to Live?

Flickr/Yann Gourvennec
Attentive readers will recall that I'm rather interested , as a human whose body stubbornly continues to age, in the prospect that science will one day enable us to extend our lives far beyond what is possible today. Throwing the "immortality" word around tends to turn people off, since it sounds so absurd (after all, nothing lives forever, not even our sun), but what about just living a whole lot longer than most of us expect to even when we're being optimistic? Is that something you'd want? My answer has always been, "Of course—are you kidding?" If advancements in medicine and technology can dramatically extend our lives—and assuming that we don't end up like Tithonus, the figure from Greek mythology who was granted eternal life but not eternal youth, so lived forever in a tortuous ever-increasing decrepitude—then I'm all for it. There are strong arguments that living for an extra 50 or 100 years (or more) might be great for you as an individual, but bad for society as a whole, but...

Big Pharma's Private War on Drugs

Pharmacy robberies have spiked in large part thanks to illegal demand for OxyContin. A look inside the drugmaker's efforts to protect its product and the pharmacists at the front lines.

AP Images/Graeme Roy
AP Images/Graeme Roy O n a Wednesday afternoon this spring, with overcast skies and gas-slicked puddles on Utopia Parkway, some two hundred pharmacists gathered on the fourth floor of St. John’s University in Jamaica, Queens, for the Fifty-Fourth Annual Dr. Andrew J. Bartilucci Pharmacy Congress. The plainclothes professionals sat around tables draped with red tablecloths, sipping plastic cups of coffee and occasionally glancing at their phones. At approximately two o’clock that afternoon, John P. Gilbride, Caucasian male, five foot six, medium build, clean-shaven, wearing a dark suit and glasses, entered a rear door of the room carrying a leather satchel. He stood with his head down before walking to the lectern and opening a PowerPoint presentation. Four massive bulls-eyes were splayed out on the conference room walls. “Pharmacy robberies and burglaries are taking place across the country at an alarming rate,” he said. “Do you talk about it? Do you prepare for it? We all had fire...

On Abortion, a Tale of Two Countries

Texas state senator Wendy Davis, whose unsuccessful attempt to stop a restrictive abortion law drew national attention. (Flickr/Texas Tribune/Todd Wiseman)
Conservatives may be in retreat on many different fronts these days, but in one area, they're having smashing success: restricting the ability of women—particularly non-wealthy women—from accessing abortion services. And they're doing it with a new tool: the 20-week abortion ban, offered as cover for a raft of restrictions that aren't about stopping later-term abortions but about stopping all abortions. They're succeeding not because of some change in Americans' views on the subject, but because of the exercise of raw political power. As you may have heard, opinions on abortion, unlike those on many other subjects, have been remarkably stable for decades. But that stability masks some stark differences on abortion, differences that create just enough space for Republicans in parts of the country to make abortion all but illegal. Yesterday the Pew Research Center came out with a new poll , showing some rather dramatic gaps by region on what people think about abortion. Check out this...

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...

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