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Red States seek to gut the Affordable Care Act and make Blue States more like them.

Red States seek to gut the Affordable Care Act and make Blue States more like them.

In this timely piece from the LA Times we learn about two working mothers, one in California and one in Texas, and their very different health care experiences thanks to the Affordable Care Act’s expansion of Medicaid to low-income adults, or lack thereof, in their states. The California mum (Jenny) whose state enthusiastically embraced the ACA, has health coverage which kicked in last year when she was hospitalized from a severe infection. Texas on the other hand opted out of the Medicaid expansion and the Texan mum’s (Courtney) experience reflects that fact; without health coverage she’s not able to afford asthma inhalers nor dental treatment for a broken molar she received in a domestic dispute. Courtney’s been living on Orajel, she says.

In fact recent research has concluded that the Red States who refused Medicaid expansion suffered a higher mortality rate among near elderly low-income adults compared to states that expanded the program. The result is that the states who opted out likely sustained almost 16,000 avoidable deaths during the period studied. 

The fate of the ACA now rests in the hands of an ideologically extreme right-wing Supreme Court (SCOTUS) in California v Texas stemming from an effort by Texas and 17 other Red States joined now by the Trump administration to overturn the ACA. (The result will not be known until next year). It’s difficult not to see this as anything other than a continuation of an expanding war on Blue States who typically provide their citizens with more and better services. It’s bad enough that Texas and the others demonstrate such a studied unconcern for the health and well-being of their own residents, but it’s truly reprehensible that they’re driven to seriously damage that of low-income people in the rest of America. Apparently, Texas politicians will not rest until Jenny’s experience in California mirrors that of Courtney. Misery really does love company it seems.

And if Republicans win the November election, we can be assured that any chance of a meaningful replacement for the ACA in the event that SCOTUS throws it out will be just as dead as those 16,000 people who died prematurely. Nor should we forget that if the law falls, all who enjoy private health insurance will once again be subject to caps on their coverage, prohibitions on pre-existing conditions and the other means of victimization in the tool bags of the insurance companies. 

All of which is a strong reminder that the sooner we crush the GOP at the ballot box, the better it will be for our collective welfare.

The GOP Has Become a Malevolent Force in American Life

The GOP Has Become a Malevolent Force in American Life

Consider these words written in 2012 by non-partisan political scientists Thomas Mann and Norm Ornstein:

The GOP has become an insurgent outlier in American politics. It is ideologically extreme; scornful of compromise; unmoved by conventional understanding of facts, evidence and science; and dismissive of the legitimacy of its political opposition.

Eight years on things have got demonstrably worse. Republicans continue efforts to repeal the Affordable Care Act both legislatively (in 2017, which failed) or in court as GOP states led by Texas pursue a lawsuit currently pending before the Supreme Court that may see the ACA overturned next spring. The consequences to millions of Americans would be devastating.
This in the face of a virulent pandemic with more millions of Americans losing their jobs and their health care who will likely need the ACA. In the current health crisis, the Republicans’ rush to open up the economy before infection rates have decreased or we have adequate testing and contact tracing capabilities promises to cause thousands of unnecessary deaths – particularly among the elderly.

Meanwhile the GOP’s stubborn and obtuse denial of climate change threatens the future of our children and grandchildren. The depressing litany of destructive policies the GOP has embraced over the years whether its unravelling environmental protections and workplace safety regulations, beating up on the poor in America, suppressing voting rights of minorities to name but a handful, do enormous harm to the American people. The reality is of a political party and conservative movement that rejects the worth and role of government to do good and runs it incompetently to prove its point, while doing everything possible to impede the other party from governing effectively.

In this the GOP is robustly supported by its perpetually angry base, and a right-wing media machine that pushes both to the extremes. Negative partisanship is bipartisan but at least most Democrats get their news from reliable mainstream media as opposed to Republicans who are far more likely to be misinformed thanks to conservative media even on something as critical as the coronavirus. The latest conservative conspiracy theory, for example, is that the COVID-19 death rate is vastly exaggerated, a dangerous illusion that promotes a lethal complacency.

In short, Republican governance at every level is severely hazardous to our health and well being. In the present emergency, a GOP administration first weakened the federal government’s ability to combat a theoretical pandemic then thoroughly botched its response to a real one. And while a pragmatic Democratic House has tried gamely to bring some sanity to the government’s response to the economic and health calamities, it’s an uphill struggle against an ideologically driven, boneheaded GOP majority in the Senate. For example, an obvious need to support states with an infusion of federal funding as their economies tank and their revenues plummet is being blocked by a hatefully partisan GOP leadership that sees it as disproportionately (and erroneously) benefitting Democratic states.

When this catastrophe is finally over, Americans need to have a serious conversation on the future of our democracy in light of the bitter divisions that are unlikely to ameliorate even without the vile and divisive presence of either Trump or Senator “Moscow” Mitch McConnell. I don’t pretend to know the answer but I do know that we can never move forward as a country while this extreme polarization, without parallel in any other democratic nation, persists.

Democrats Successfully Force their Hand During Coronavirus Stimulus Bill Negotiations

Democrats Successfully Force their Hand During Coronavirus Stimulus Bill Negotiations

Just a quick update on the outcome of the coronavirus stimulus bill negotiations.

Mitch McConnell attempted to ram through $2T spending bill that focused more on boosting big business than providing care for thousands of Americans suffering and dying from severe cases of COVID-19 (and thousands more to come) and alleviating the financial stress put on millions of Americans who suddenly became unemployed because of the coronavirus. Charles Schumer and the Democrats rightly objected to the Republican Senate’s bill and fought to focus on people instead of big business. The Democrats got much of what the wanted in the bill.

The New York Times reports:

The resulting measure is an attempt to sustain the workers and businesses that are losing income as vast sections of the American economy are shutting down under quarantine orders and to help the economy rebound quickly once the pandemic abates.

It includes direct support for companies large and small that have lost all or most of their customers in recent weeks, and direct payments to low- and middle-income families. The package also includes measures meant to encourage companies to keep employees on their payrolls even if their businesses have shuttered temporarily — and it increases aid to workers who are laid off anyway or have had their hours and wages cut back.

The measure will be the third legislative action taken by Congress this month to address the pandemic. Mr. Trump previously signed both a $8.3 billion in emergency aid and a sweeping package providing paid leave, free testing and additional aid for families affected by the pandemic into law.

In the final measure, lawmakers agreed to a significant expansion of unemployment benefits that would extend unemployment insurance by 13 weeks and include a four-month enhancement of benefits, officials familiar with the unfinished agreement said. Democrats said that it would allow workers to maintain their full salaries if forced out of work as a result of the pandemic.

In the interim, lawmakers also agreed to provide $1,200 in direct payments that would apply equally to workers with incomes up to $75,000 per year before phasing out and ending altogether for those earning more than $99,000. Families would receive an additional $500 per child.

We haven’t seen a senate compromise of this magnitude in a very long time. Probably not since Mitch McConnell said in October 2010, “The single most important thing we want to achieve is for President Obama to be a one-term president”.

Bravo Democrats. It’s your time to lead. Keep doing it and do it well, then maybe President Trump will be a one-term president.

Coronavirus Stimulus Bill Sabotaged by Republicans

Coronavirus Stimulus Bill Sabotaged by Republicans

Senate Republicans don’t care about people. They only care about big business, corporate donors, and their extremely wealthy friends. We knew that when a Republican controlled senate passed President Trump’s Tax Cuts and Jobs Act in December 2017. It gave huge tax cuts to corporations and provided a big tax loophole for pass-through income. The bill was advertised as a move that would lower taxes for workers and help businesses expand by providing them with more cash. Most workers saw very small decreases in their taxes and some actually saw their taxes go up a little, but businesses were left with a lot more cash in pocket and they used it to buy back their own stock to line the pockets of their already obscenely rich corporate executives. They did not increase investment any more than they would have otherwise and they did not provide any substantial increases in wages or benefits for workers. Some cities and states saw increases in wages because they mandated higher minimum wages themselves. Republicans in congress refused to increase the minimum wage like they always do.

Trump’s tax-cut was an expensive failure.

So they were fine with their 1.5 Trillion Dollar tax cut for the rich, but they aren’t so fine with a new and much needed coronavirus stimulus bill that will cost somewhere between one to two trillion dollars if most of that money is funneled to the people who really need it – the unemployed workers.

The Democrats focused their efforts on people first, not profits first. They would direct the money to the millions of people in the service industry (restaurants, bars, hotels, ride-share drivers, salon workers, dental hygienists, etc.) who are all out of work. This is a huge sector of our economy. Workers need cash to buy food, pay rent and mortgages, and obtain healthcare – all urgent stuff. The stimulus bill should provide that urgent aid first. A one-time check in the $500 to $1,200 won’t provide the long-term aid they are going to need.

The spending should cover the cost of extending the unemployment insurance for at least a year or two. It should probably force large employers to provide sick pay for as long as is necessary for their workers to recover from COVID-19. The bill should prevent people from losing their jobs because of government-mandated work stoppages. It should make sure that everyone afflicted with the disease gets the healthcare they need regardless of whether or not they have insurance. To put it simply, the stimulus bill can’t be about “creating jobs” right now. It should be all about alleviating hardship and suffering caused by the outbreak, because it can’t help put people back to work until the pandemic is gone, and it looks like that isn’t going to happen for months.

The Republicans’ bill includes $5B for a corporate slush fund. It’s weak on worker retention and has loopholes. It’s treasury lending section is vague. It doesn’t provide provisions to protect people from evictions and foreclosures. It provides zero money for state and local governments. Is that because the states hardest hit are blue states? No additional spending on SNAP when the program will obviously be under extreme pressure. No direct payments for people who did not file tax returns in 2018 or 2019. It offers no help for the uninsured and no help for people with student loans.

What this all adds up to is, as James Martin wrote in The New York Times today, a Moral Evil. That’s suffering caused by the actions of individuals or, in this case, the inaction of individuals. And even worse; the deliberate redirection of resources that should be used to alleviate suffering of the most vulnerable people to the least vulnerable, most wealthy people in our country. That’s right. Who do you think will be the recipients of a slush fund?

Maybe enough Republicans in the Senate will read The Bible tonight and decide to do what Jesus would do (from the James Martin column):

Needless to say, when caring for someone with coronavirus, one should take the necessary precautions in order not to pass on the infection. But for Jesus, the sick or dying person was not the “other,” not one to be blamed, but our brother and sister. When Jesus saw a person in need, the Gospels tell us that his heart was “moved with pity.” He is a model for how we are to care during this crisis: with hearts moved by pity.

I’m not betting on it.

Democrats’ Aim Should Be Universal Coverage – Improving the ACA is the Right Vehicle

Democrats’ Aim Should Be Universal Coverage – Improving the ACA is the Right Vehicle

I get why the liberal wing of the Democratic Party is obsessed with enacting Medicare-for-All as the vehicle to universal coverage. I do. There’s no question that if we got it right, it would be both far more equitable and cost-effective than the present chaotic patchwork of a “system” that we’re currently lumbered with. I was raised in England and I know what a blessing the National Health Service has been, warts and all, in providing first class health care to everyone and without driving any of anybody into bankruptcy.

I also understand only too well the frustration of forever being told that it simply can’t be done, that the odds are stacked against it. How do we know unless we try, right?

Nevertheless, reality must intrude. First, as we have already seen with the few states that have tried to add a public option to their ACA markets that the health care industry will wage total war on any suggestion of even a modest expansion of of a public health care option. And when I say the health industry, we’re talking the insurance companies, the hospital industry, the pharmaceutical industry and much of the medical profession, particularly specialists, surgeons and the hospitals each of whom gain the most from the present lack of price controls on any but Medicare patients, and who will fight tooth and nail to keep it that way. Added to the health industry’s implacable opposition will be the Republican Party and the entire right-wing universe complete with relentless fear mongering and lies. And they will have a powerful issue that lends itself to demagoguery. Socialized medicine! Egads!! The fact that they’ve called the ACA, modest insurance reform at best, the same thing will of course be lost in the din.

Second, a total reform of the entire US health care system, one that dwarfs the enactment of the ACA, will require the support of most Americans, 180 million of whom currently have employer-provided health insurance which most of them believe is just fine, thank you very much. And Democrats would be asking them to give that up and see their taxes increase to boot – a hard sell even though insurance premiums will go away. All of this on the promise that expanding Medicare to include everybody, entirely rationale but something we’ve never tried before, would be better. And then there’s the seniors who are currently well satisfied with their Medicare and will be scared into believing (by you know who – see above) that somehow they will lose much of what they have if their health care is folded into a national scheme for the whole population.

In short it will not merely be an uphill struggle to enact Medicare-for-all but the policy equivalent of free climbing Half Dome in Yosemite National Park and to believe otherwise is delusional.

But there are other ways to universal coverage. In fact there are many models among developed countries that have achieved and did so with a system that incorporates private insurance albeit heavily regulated. Switzerland is one, for example. Check this link to the non-partisan Commonwealth Fund for a thumbnail sketch of the Swiss system and that of other developed nations from whose systems we can draw lessons .

Which brings us to the Affordable Care Act. Like all compromises on huge and complex pieces of legislation, the ACA is manifestly imperfect and in need of substntial improvement, for example by vastly reducing out-of-pocket expenses and greatly expanding the income cut off to receive premium subsidies. Yet the law has significantly increased the number of people with health insurance whilst proving unexpectedly resilient in surviving GOP efforts to repeal it and the Trump administration’s attempts to weaken it. If Democrats win the White House and Congress in 2020, they have an opportunity to undo all the damage of the Trump era and to make the ACA a far bigger success in providing affordable health coverage to a vulnerable population.

As well, Democrats have other costly priorities to address such as climate change and relieving our kids of the huge debt burden of college loans, to name but two. A full throated battle for a single payer health system will suck all the political oxygen out of the air and leave us with little energy to seriously tackle those issues. And that would be a tragedy.

The Republican Party is now the Official Party of Hate, Oppression, and Fear

The Republican Party is now the Official Party of Hate, Oppression, and Fear

racism-hate-fear-tony-puryear-smAll the racists, xenophobes, misogynists, and nationalists across our country heard Donald Trump’s dog whistle “Make America Great Again” and united to vote for Donald Trump to make the Republican party the official party of hate, oppression, and fear. They heard Donald Trump say things about groups they hate, people they want to oppress, and heard him stoke the fires of fear. All these things he said  appealed to them (“He says the things I’m thinking”), so they voted for Trump.

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Who Supported Donald Trump for President

Who Supported Donald Trump for President

Now that a few days have passed since the election, we have some demographic statistics that show who supported Donald Trump for president. We know his entire campaign was centered on racism, and disgruntled white Americans overwhelmingly voted for him. And one of those disgruntled white people was David Duke, the former Imperial Wizard for the Ku Klux Klan. He tweeted, “Our people have played a HUGE role in electing Trump!” and “Anyone telling you this was a vote for ‘unity’ is a liar and they know it!” And it wasn’t just the KKK – Trump had the support of pretty much all of the hate groups in America. Haters attract haters.

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A Question for all the Donald Trump Supporters

A Question for all the Donald Trump Supporters

A Question for all the Donald Trump supporters who continue to baffle me with their unwavering support for a politician who is clearly at odds with their own personal values and moral codes.

So what if one day between now and November 8th Donald Trump actually acted out all of his narcissistic, bullying, racist, xenophobic, misogynistic, war-crimes rhetoric and did this:

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Donald Trump Doesn’t Pay Income Tax, and He’s Proud of it

Donald Trump Doesn’t Pay Income Tax, and He’s Proud of it

trump-clinton-debate-1

During Monday night’s debate, Donald Trump pretty much admitted, without directly saying so, that he doesn’t pay income tax, and he’s very proud of it. Here’s an excerpt from the debate transcript:

CLINTON: Third, we don’t know all of his business dealings, but we have been told through investigative reporting that he owes about $650 million to Wall Street and foreign banks. Or maybe he doesn’t want the American people, all of you watching tonight, to know that he’s paid nothing in federal taxes, because the only years that anybody’s ever seen were a couple of years when he had to turn them over to state authorities when he was trying to get a casino license, and they showed he didn’t pay any federal income tax.

TRUMP: That makes me smart.

That kind of response by people accused of shirking their responsibilities to pay income taxes isn’t new to me. I have heard people say that avoiding paying taxes is like a sport to them. They think of it as a challenge, and they put their all into the game.

Hillary Clinton doesn’t think that’s a good game. She kept talking over his interruption and said:

CLINTON: So if he’s paid zero, that means zero for troops, zero for vets, zero for schools or health. And I think probably he’s not all that enthusiastic about having the rest of our country see what the real reasons are, because it must be something really important, even terrible, that he’s trying to hide.

Charles Krauthammer, longtime conservative Republican pundit for The Washington Post and Fox News, is on the record for not supporting Trump for president. Trump’s self-satisfied statement about avoiding income taxes provided him with more evidence for why Donald Trump is not presidential material. Via Media Matters:

[Donald Trump] couldn’t resist the temptation to be the smart ass and to show that he’s clever. Look, the pride he has is his success. That’s how he defines himself, and he wasn’t ashamed to admit that he could have done this. He was actually conceding that he may not have paid any income tax. Now, in a boardroom with a bunch of other CEOs and you’re boasting about your success, you say that. You don’t say it in a presidential campaign. Whereas Hillary said today, if it’s smart not to pay any taxes and you’re a billionaire, well what about the rest of us? And I think this thing could have legs, first concession that he may not have paid taxes.

Or to put it another way, in the words of The Rude Pundit:

And she wiped the floor with him on his tax returns. I cannot remember a more bizarre moment in a debate than Trump saying, proudly, about not paying any federal income taxes, “That makes me smart.” No, motherfucker, that makes you a pathetic worm who gets all the benefits of the government without contributing when you brag about how much money you have.

Right. He wants to “Make America Great Again” but he doesn’t think he should pay taxes, and his tax plan is to cut taxes for all his billionaire friends that aren’t smart enough to figure out how they can pay nothing.

However, I did find a post on Crooked Timber by Corey Robin who thinks that Trump’s boastful comment about avoiding taxes may have been to his advantage:

On the other hand, there’s a not so small current in American politics that would hear that, that Trump didn’t pay his taxes, and think, with him, that he was indeed smart for having outsmarted the system. And would want to align themselves with him as a result. In the hope that they too could learn these tricks some day or that they too could one day be rich enough not to pay their taxes.

This is a nation of con men (and women), as everyone from Melville to Mamet has understood. A nation that dreams of, and longs for, the quick buck. The more crooked the path, the more glorious the payoff.

I can only hope that for all of our sakes that Charles Krauthammer is right (I can’t believe I just typed that) about how Trump not paying taxes will turn away voters, because most people, including most of Trump’s supporters, don’t like freeloaders (especially the non-white, non-Christian ones).

This is How Republicans Solve the Global Warming Problem

This is How Republicans Solve the Global Warming Problem

Jeb Lund writing for The Guardian:

You might have missed it, but Florida has solved climate change. Our state, with 1,300 miles of coastline and a mean elevation of 100 feet, did not, however, limit greenhouse emissions. Instead, the state’s Department of Environmental Protection (DEP), under Republican governor Rick Scott, forbade employees from using terms like “climate change,” “global warming” or “sea-level rise”. They’re all gone now. You’re welcome, by the way.

It’s pointless to call linguistic distortions of reality like this Orwellian: people tune you out when you use that word and, besides, Big Brother at least had wit. These are just the foot-stamping insistent lies of intellectual toddlers on the grift. It is “nuh-uh” as public policy. This is an elected official saying, “I put a bag over your head, so that means now I’m invisible” and then going out looting. Expect to see it soon wherever you live.

The Florida Center for Investigative Reporting broke the news on Sunday, stating that the prohibition on the terms “climate change,” “global warming” and “sea-level rise” went into effect after Scott’s inauguration. Former DEP counsel Christopher Byrd and five other former employees stated that the policy was unwritten and “distributed verbally”. Even when working on projects with people outside their department, employees had to scrub reports of any mention of the terms and, when necessary, replace them with euphemisms. For instance, “Sea-level rise was to be referred to as ‘nuisance flooding’” – like your high-rise atop the San Andreas fault features an “increased likelihood of intermittent wobbliness”.

(read the whole thing)

And here’s the perfect comic to go along with it.

GW gag order