Sunday, June 23, 2013

ObamaCare for Mississippians II

But how do we all get health coverage?

Most Americans and Mississippians have health coverage. Most get it through their employers, seniors have Medicare, many of the very poor have Medicaid, and veterans have the VA. Some buy it themselves at outrageous prices.
However, more than a third of Mississippians under 65 are uninsured. Almost half of African Americans are uninsured. Contrary to what you might think, almost three fourths of the uninsured are employed. These numbers are a few years old and are probably worse now.
So what will ObamaCare do for these Mississippians? Unfortunately, Mississippians will not have the same benefits other Americans will have, because our Republican Governor and State Legislature have fought ObamaCare every step of the way. But let's look at how ObamaCare is supposed to work, and then how it will be in Mississippi.
Health care in America is very complicated. ObamaCare was not the easiest or best solution, but it was what could be passed by Congress. It kept the employer based system that we've had for many years and tried to correct its drawbacks. There are several layers to these corrections, and we'll look at them one at a time. 

The Working Poor

There are working people who don't qualify for Medicaid, either because they have no children or they earn too much. But they don't earn enough to afford to buy insurance. Under ObamaCare,  Medicaid would be expanded to cover ALL people with incomes at or below 135% of the poverty level. In Mississippi, this would give health coverage to around 300,000 Mississippians who have none now. The Federal government would pay 100% for the first 3 years, gradually decreasing to 90% by 2020.
The Supreme Court decision last year that upheld ObamaCare did say that states could not be required to expand Medicaid. To no one's surprise, our Republican Governor immediately said Mississippi would not expand Medicaid - before he had even studied it or looked at the numbers. The Republican leadership in the State Legislature was on board.
Only one problem: Democrats demanded that the expansion be brought to a vote before funding the current program. Democrats are NOT saying they won't vote for the current Medicaid program. All they want is for the expansion to be debated and voted on. If it loses, they'll vote for the current program. Republicans refuse to even debate or vote on it. Why? Who knows? Maybe they don't have the votes to kill it. Maybe some Republicans don't want to go on the record as opposed to a bill that will bring $1 billion to Mississippi, create 9,000 jobs, provide 300,000 Mississippians health care, and save many small, rural hospitals*.
As of right now, the entire Medicaid program is set to end on June 30th. Although the Republicans have a majority in the State Legislature, they need Democratic votes to pass funding bills, which require more than a majority. Since the Legislature is not in session, the Governor must call them into special session next week.
If the Republicans get their way, there will be 300,000 working Mississippians who will NOT have health coverage, whereas Americans in states that expand Medicaid will have coverage. Guess Mississippi Republicans just don't care about those families. There will also be several small hospitals that will be forced to close. Guess Republicans don't care about those communities.
We'll know in a week, and I'll post an update here.
*Hospitals will be adversely affected if Medicaid is not expanded because of a federal funding formula that is beyond the scope of this post. Consequently, Mississippi hospitals are very supportive of expansion.
Coming next: ObamaCare for Mississippians III: What about those uninsured middle class families that don't qualify for Medicaid?

Saturday, June 22, 2013

ObamaCare for Mississippians I

What exactly is ObamaCare 
and how will it affect us in Mississippi?

ObamaCare (more formally known as the Affordable Care Act) had one very simple goal: provide affordable health care to all Americans. However, achieving that goal was anything but simple.

ObamaCare became law March 2010. It was upheld (with some exceptions) by the Supreme Court a year ago. A few months later, President Obama was reelected. So ObamaCare is here to stay for the foreseeable future.

ObamaCare is being phased in over several years, with the most significant changes coming next year. However, several provisions have already gone into effect, and Mississippians are already benefiting from them.
  • Mississippians covered by private insurance companies and Medicare* are receiving preventative care at no cost. Even though extra federal funds are available to states that provide no cost preventative care to Medicaid** recipients, Mississippi and most other states have not yet taken advantage of it. (The Supreme Court ruling allows states to opt out of Medicaid** provisions.) Preventative care is defined by the US Preventative Task Force
  • Insurance companies can no longer refuse to cover children because of preexisting conditions. This protection will be extended to adults next year. Lifetime limits are prohibited, and annual limits are being phased out.
  • Insurance companies must spend 80% of premium dollars on health care - or provide rebates to their policy holders. Last year, 12.8 million insured people received $1.2 billion in rebates. This provision has already led to lower premiums.
  • Young adults without insurance through their work can stay on their parents' policies until age 26. 3.1 million more people have insurance because of this provision.
  • Medicare's* prescription drug coverage has a huge gap in coverage called the "doughnut hole". Increased savings are provided until 2020 when the gap will be closed. Seniors have already saved over $6 billion since 2010.

* Medicare is the health program for people 65 and over and is paid for by a payroll tax.
** Medicaid is the health program for people with limited incomes. It is run by the States, who determine who is eligible. The Federal Government provides matching funds depending on the poverty level of the state. Of course, Mississippi gets the highest percent (75+%). The lowest match is 50%, and several states qualify - Virginia is the only southern state.

Coming next: ObamaCare for Mississippians II: But how do we all get health coverage?

Thursday, July 21, 2011

Our Mississippi Primary Could Have Strange Results

Mississippi voters do not register by Party. When they vote in Primaries, they may choose to vote in either Party Primary. Most white candidates for local races run as Democrats - otherwise they will get no black votes. Black Mississippi voters will just not vote for a Republican - nor do I blame them. As Republicans have tried to take over our state, they have rarely had Republican Primaries. They couldn't afford to fight with each other. Consequently, most Mississippi voters chose the Democratic ballot - even if they were Republicans. That's where all the choices were - in many cases there were no Republican ballots.

This year is different. There are some very healthy Republican Primary races - but they're at the State level. The local races are still mostly Democratic Primaries. So what's a Republican to do? Which ballot do they choose? I'm predicting white voters will choose the Republican ballot in record numbers.

So what will that mean for the Democratic Primaries? The voters will be predominantly blacks and liberal whites. Some conservative white Democratic candidates may be able to convince enough of their friends to vote to eke out a win - but if they have a black opponent, they're in trouble.

Record numbers of black and liberal white Democrats will win Primaries - and in many races, that's the election. People (especially whites) will be shocked by the results - but you won't, now that I've warned you. When people express their shock, just ask them what Primary they voted in.

PS: Johnny Dupree wins the Democratic Primary without breaking a sweat. The General Election? That's a different story.

Friday, February 04, 2011

Frances Perkins - a Heroine

Do you know who Frances Perkins is? Don't feel bad if you don't - most people don't. Yet she has probably had more of an effect on the everyday lives of every American than any other woman - and most men.

The only thing I knew about her was that she was the first woman Cabinet Secretary - Department of Labor under FDR. The reason I know that much is because I remember when she died in 1965. I remember thinking how impressive it was that a woman had that position - I knew of no woman Secretaries at that point. Actually, in 1953, twenty years after Perkins was appointed, Oveta Culp Hobby was appointed Secretary of Health, Education, & Welfare by President Eisenhower - but I guess I was too young to remember her. I certainly never learned about either woman in school. It would take another 20 years for the next woman. In 1973, Anne Armstrong was appointed Counselor to the President (considered a Cabinet level position at the time) by Richard Nixon. I was well aware of her and all the subsequent female Cabinet members in every administration. (See Equal Representation in Government for a list.)

Last year, I came across a book about Perkins: The Woman Behind the New Deal: The Life and Legacy of Frances Perkins written by Kirsten Downey, a Pulitzer winning journalist who spent eights years researching this book. Intrigued by how a woman pulled this off, I read it immediately. WOW! This woman was amazing! I could not believe how much she accomplished.

Perkins was trained as a social worker. In her first job out of graduate school, she witnessed the infamous Triangle Shirtwaist Factory fire, and her life was never the same. At that point, she dedicated her life to worker safety issues. She began by working for nonprofit organizations, but in 1918 she was appointed by New York Governor Al Smith as the first female member of the State Industrial Commission, becoming Chair in 1926. When FDR became Governor, he appointed her as the State Industrial Commissioner. She was in the perfect position to see the Depression develop and predicted it ahead of time. She gave great thought to how to help workers. Therefore, she implemented policies never before considered, such as collecting employment data; employment offices to help workers find jobs; unemployment insurance; minimum wage; the 40 hour work week; elimination of child labor; and fire and safety standards, including no smoking, fire drills, sprinklers, fire escapes, building exits, occupancy limitations, washing and restroom facilities, clean water, and most importantly, with serious enforcement including factory investigations and penalties. Can you believe none of this existed before?

By this time, Perkins was considered the nation's top expert in employment. It's no wonder FDR took her with him to Washington when he became President in 1932. The truth was that he really had no agenda - but Perkins did, and she made his acceptance of it her condition for taking the job. He appointed her Secretary of Labor, a position she held for 12 years, longer than any other. I love this quote from the author - for one thing, it sounds so much like today.

"Housing prices had been pumped up by crazy new kinds of loans, and foreclosures of homes and farms were surging as borrowers faltered under the payments. Companies had enjoyed record profits and ploughed the money into machinery designed to boost productivity, cutting their workforces. The unemployment rate skyrocketed. Companies slashed the wages of the remaining workers, and asked them to work longer and longer hours. And then Wall Street imploded as the stock market crashed. This was the scenario Franklin Delano Roosevelt faced as he entered the presidency in 1933. An era of rampant speculation had come to an end. A women stepped in to put things right."
She was phenomenally successful in implementing the agenda she laid out for FDR. She started with a Labor Department that was a total disaster of real corruption and mismanagement and turned it into a model government agency - including a process of streamlining government purchasing that saved enormous amounts and was then used throughout the federal government. She knew that the key to relieving the Depression was to get money into the economy, and she did that through her Department. She took all the policies she had established in New York and made them part of the federal law - thus extending these protections to all Americans. But perhaps her most famous legacy was the passage and implementation of the Social Security Act. Please notice that all of her accomplishments are still in place today. She completed her entire agenda with one exception: national health insurance. If only FDR had lived a little longer, we wouldn't have to be still fighting that battle 70 years later.

What is so amazing about Perkins is not only WHAT she achieved but HOW she achieved them. First of all, she suffered such incredible sex discrimination that we can't even imagine. I shivered as I read about all the horrible things that were said and done to her. The Congress even tried to impeach her! She just ignored them and kept plodding away with her goals. She was the most persistent and patient advocate and never let an obstacle stop her. She had the most astonishing creativity in figuring out how to overcome adversity. Finally, the way she dealt with people showed her intuitive sense of just how to appeal to or overcome those with the power to achieve her goals. You know why we've never heard of her? We thought FDR did all this. She didn't care at all about receiving credit - and no men voluntarily gave it to her - she just wanted to get the job done. And this was a Washington bureaucrat! If only we had her now.

There is no way I can come up with enough superlatives to describe this woman to whom all Americans owed so much - and I've only scratched the surface of what she accomplished and howYou'll just have to read the book!

Sunday, August 01, 2010

Elizabeth Warren - Obama's Test of Masculinity

Elizabeth Warren is really the only candidate to chair the newly created Consumer Financial Protection Agency (CFPA). If Obama does not appoint her, it will prove he has no balls.

Warren is a professor of law at Harvard Law School. Her entire career has been devoted to studying middle class economics, and she is a recognized expert in the field. I first heard of her in 2004 when she testified before Congress about the Bankruptcy Reform legislation - a bill strongly supported by banks and credit card companies to correct bankruptcy abuse that was allegedly widespread. Warren testified about the study she had done on bankruptcies of middle class families, half of which were due to unexpected medical expenses - and 75% of those families had medical insurance. Of course, the Republican Congress ignored her and instead listened to the banks and passed the bill - which has had a devastating effect on middle class families but was very beneficial to banks. Some of the perks it gave banks contributed to the massive bank failure.

Warren was appointed to, and became Chair of, the Congressional Oversight Panel that was created to investigate the US big bank bailout. In that capacity, she represented the interests of the public - and not the banks - and insisted on transparency and accountability. Her position did not give her power to actually do anything, but her reporting what was happening and what should be happening was, needless to say, not very appreciated by Big Banks or by the U S Treasury Department.

Warren is the mother of the CFPA. She has been lobbying incessantly for its inclusion in the financial reform legislation recently signed into law. Every time the Big Banks and Secretary Geithner thought they had it killed, Warren came roaring back. Without her, it would not have survived.

Warren is so obviously the only candidate for CFPA Chair. Aside from having created the Agency, she has the necessary knowledge of the arcane American financial system. She also has the credibility to protect the American people, especially the middle class. Plus, she is blatantly independent and not beholden to anyone - except the public. So who would possibly oppose her? Easy answer - Big Banks - and they have a lot of influence. But also the Secretary of the Treasury, who doesn't want anyone overseeing what he's doing - especially some uppity woman he can't control.

If Obama does not appoint her, he will confirm his lack of balls. All those voters who were so hot for him when he ran for President are going to discover he really is impotent. This will be the kiss of death for the Democrats in the 2010 elections - not to mention the end of any meaningful financial reform.

Wednesday, May 12, 2010

Hysterical Hypocrisy - Republican Style

Today Republican House Whip Eric Cantor introduced a program called YouCut. When I first heard of it, I thought it was very clever. It gives the public a chance to vote on what federal programs they want to see cut from the budget. However, when I went to the website, I discovered it wasn't clever at all - just the same ole crap we always see.

The website lists 5 programs for voters to choose. The choices are all typical programs that Republicans hate. So this is just a typical hypocritcal attempt to get email addresses - sort of like political phishing. It pretends to be seriously interested in your opinion, hoping to fool voters into providing personal information. It's the techy version of the old mailers that asked for your opinions on a survey. When you opened it, it asked typical partisan questions - and then said if you wanted anything to happen, you had to send money - right now.

The only question to be answered now is just how gullible are Republican voters? Will they fall for this scam? Probably.

If there was any integrity in Congress, someone could become an immediate hero to millions of voters by asking real questions. If we are going to really deal with a serious deficit, some very tough choices are going to have to be made. It's obvious no one in Congress has the courage to make these choices - they're too afraid of losing their next election. Wouldn't it be nice if one brave soul would step forward and present the public with the real choices and ask for their response?