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Health

Who Is Still Uninsured In Massachusetts?

A new report from the Robert Wood Johnson Foundation of the uninsured in Massachusetts holds important lessons for federal regulators and lawmakers as they plot ways to implement the individual health insurance mandate in 2014. Massachusetts, which implemented an individual requirement to purchase health care coverage in 2006, now has the lowest uninsurance rate in the country — 4.1% in 2008 — but has yet to achieve true universal coverage. The RWJ report examines who makes up that 4% and why:

Consistent with earlier work on the characteristics of uninsured adults in Massachusetts and in the nation as a whole, we find that the adults who remained uninsured under health reform in Massachusetts in 2008 were more likely than those with insurance coverage to be:

- Male, young, and single

- Racial/ethnic minorities and non-citizens

- Unable to speak English well or very well

- Living in a household in which there was no adult able to speak English well or very well

Compared with insured respondents, uninsured adults also reported substantially lower educational attainment and less employment and had lower family income and greater financial stress.

In other words, despite the state’s far-reaching enrollment campaign, “broad-based policy initiatives and outreach under federal reform may be less effective at stimulating take-up among certain demographic groups than among the population as a whole,” the study finds. “These hard-to-reach groups will require targeted policy and outreach efforts that address their particular barriers to health insurance take-up.”

Other than the ‘Enroll America’ campaign between the health insurance industry and consumer group Families USA, health care reform regulators and lawmakers have said little publicly about the importance of enrolling everyone in health insurance once the individual mandate becomes operational in 2014. These results and Massachusetts’ experience suggest that the government should pay particular attention to lower-income communities, many of whom will become Medicaid eligible.

Politics

Chamber Blames Women For Pay Gap: They Should Choose The Right ‘Place To Work’ And ‘Partner At Home’

us_chamber_of_commerce Today is the anniversary of the passage of the 19th amendment to the U.S. Constitution, which granted the right to vote to women. The U.S. Chamber of Commerce has decided to use this day of equal rights for women to argue that women are now to blame for unequal pay in the workplace. On the organization’s official blog, ChamberPost, Senior Director of Communications Brad Peck today makes the argument that the pay gap between men and women in the American workforce — women currently earn roughly 77 cents to every dollar a man earns — is “the result of individual choice rather than discrimination.” He argues that, instead of bold legislative action being taken to help correct this pay gap, women should pick the “obvious, immediate, power-of-the-individual solution: choosing the right place to work and choosing the right partner at home“:

Most of the current “pay gap” is the result of individual choice rather than discrimination. [...]

It is true that culturally speaking women are more likely to have to make the tough choices about work-life balance. But as we all seek to fit our values into a dynamic 24/7 economy, let’s not overlook the obvious, immediate, power-of-the-individual solution: choosing the right place to work and choosing the right partner at home.

Peck’s argument that women could close the pay gap by simply choosing jobs in better paying fields and marrying wealthier men is based on a faulty premise — that the pay gap in the United States between genders exists because women choose to work for less and men choose to work for more.

While it’s true that women sometimes migrate into fields that have lower pay, what Peck ignores is that even within the same occupation, women are paid less. For example, data collected by the Census Bureau in 2007 shows that “female secretaries…earn just 83.4% as much as male ones” and female truck drivers “earn just 76.5% of the weekly pay of their male counterparts.” A report put out this year by the University of Minnesota finds that women in that state are “are paid $11,000 dollars less each year than men with the same jobs.” A 2007 American Association of University Women report compared men and women with similar “hours, occupation, parenthood, and other factors normally associated with pay” and found that “college-educated women still earn less than their male peers earn“; the report concludes that workplace discrimination is the culprit in the wage gap.

It is important to note that this pay inequity is so pervasive that it even affects people who undergo a sex change. In 2008, researchers Kristen Schilt and Matthew Wiswall examined the wages over their lifetimes of people before and after a sex change operation. Even “when controlling for factors like education, men who transitioned to women earned, on average, 32% less after the surgery. Women who became men, on the other hand, earned 1.5% more.”

Unfortunately, the Chamber of Commerce has a long history of overlooking women’s struggles in America and of actively opposing movements for gender equality. While opposing the Pregnancy Discrimination Act in 1978, the Chamber argued that pregnancy was a “voluntary” act and thus should not have discrimination protections in the workplace. In 1987 it ominously warned that the Family and Medical Leave Act would set a “dangerous precedent” of employer-sponsored benefits. And last year, the organization lobbied against legislation that would allow rape victims to bring lawsuits against their employers.

Update

FDL’s Michael Whitney has more on the Chamber’s long history of choosing to stand against women.

Economy

Fox News Pushes Tax Cuts For The Rich, Tax Increases For The Poor

Last month, Wall Street Journal editorial board member Stephen Moore explicitly called for raising taxes on the poorest Americans in order to finance tax cuts for the rich. And he is not the only member of Rupert Murdoch’s media empire that thinks taxes need to be cut for the rich but increased for the poor.

As I noted yesterday, the U.S. Chamber of Commerce’s chief economist, Martin Regalia, said that allowing the Bush tax cuts for the richest two percent of Americans to expire would be “a bullet in the head for an awful lot of people.” Fox News’ Bill Hemmer decided to run a segment on the comments, where Fox Business’ Eric Bolling agreed that having the rich pay the same rates that they paid under President Clinton would somehow doom the economy. But he then went on to complain that “unfortunately” 47 percent of households “don’t pay a dime in federal income tax”:

HEMMER: A bullet in the head? Is that what tax increases do?

BOLLING: Sure. If we do have an economic recovery from this massive recession we’ve been in, it will be the bullet in the head to the economic recovery because this will be the biggest, by far, tax increase that America’s ever seen, coming at absolutely the worst time. As it is Bill, they’re going to say, ‘well it’s only for the rich.” This will trickle down to every human being who pays taxes. Unfortunately, there’s only about, I don’t know, 53 percent of American households who pay federal income tax, the other 47 percent don’t pay a dime in federal income tax.

Watch it:

If Bolling thinks its unfortunate that so many people have no federal income tax liability, is he calling for raising their taxes? Moments after saying that its “absolutely the worst time” to raise taxes on the rich? And agreeing that tax increases amount to “a bullet in the head?”

The reason that so many people have no federal income tax liability is that “their incomes were too low, or they qualified for enough credits, deductions and exemptions to eliminate their liability.” 6 out of 10 non-payers have incomes of less than $20,000, and more than two-thirds of those who pay no federal income tax do pay federal payroll taxes. And, of course, they pay state and local taxes, including more regressive local sales taxes.

Plus, the fact that so many have no federal tax liability is a reflection of how much income is concentrated in the hands of the rich. The richest one percent of Americans currently make nearly 25 percent of the country’s income.

Extending the tax cuts for the rich — which costs $830 billion over ten years and $36 billion next year alone — is the least efficient way to boost the economy via tax policy. And as the record of the Bush administration shows, tax cuts for the wealthiest Americans do not trickle down to everyone else. So let’s call this segment what it was: shilling for the rich while pushing higher taxes for the poor.

Politics

GOP IA state candidate deletes offensive Facebook posts, but unsure if AIDS is punishment for gays.

Yesterday, the Iowa Independent broke the story that Jeremy Walters — a Republican candidate for the Iowa State house — posted Facebook messages in which he quoted biblical verses saying that gay people should be “put to death” and suggested that AIDS is a punishment for the sin of homosexuality:

JeremyWaltersFaceBook

Walters’ statements were immediately condemned by One Iowa, the state’s largest lesbian, gay, bisexual, transgender (LGBT) advocacy organization, and the Iowa Republican party, leading the candidate to remove the posts. But in a subsequent interview with the Wonk Room, Walters explained that his outburst was motivated by the recent Prop 8 decision and that he was still uncertain if God was trying to kill gay people. Read the interview here.

Health

Health Insurers Lobbying To Make Profits Seem Smaller Than They Are

Yesterday, the National Association of Insurance Commissioners (NAIC) adopted relatively robust draft definitions for calculating the medical loss ratios (MLR), prohibiting “insurance companies from considering costs related to fraud prevention and detection, utilization review, and individual wellness promotion (among others) when calculating their medical loss ratios (MLRs).” The insurance industry, which has been lobbying the NAIC to include a broad range of activities as medical expenses, criticized the document and warned of “unintended consequences” if certain practices could not be classified as “quality improvement.” Under the new health care law, insurers are required to spend 80% to 85% of premiums on health care and issue rebates to consumers if they fail to meet this threshold. But consumer advocates who attended the NAIC conference tell me that the real battle will now focus on whether issuers will be able to deduct all federal taxes before calculating the MLR, an issue the NAIC punted during its conference.

Insurers have seized on a single mention of “federal taxes” in Section 2718 of the health law — the section that deals with MLR — to argue that they should be allowed to exclude all federal taxes from their revenue (the denominator in the MLR ratio), a move that would save issuers millions of dollars and allow them to meet the MLR requirements without necessarily spending more on care.

Democrats are now disputing their claim. In a letter to HHS Secretary Sebelius, the six Democratic committee heads with jurisdiction over health care argued that they did not intend for issuers to exclude all federal taxes — only those that pertain to health care:

As the NAIC works to craft proposed definitions, we are writing to clarify legislative inent as it pertains o the exclusion of Federal taxes from revenue calculations. Section 2718 sets forth the computation of MLR for the purposes of computing annual premium rebate. Section 2718(b)(1)(A) defines the denominator of the MLR for this purpose as “the total amount of premium revenue (excluding Federal and State taxes and licensing or regulatory fees…).”

“Federal taxes and fees” in this context is meant to refer only to Federal taxes and fees that relate specifically to revenue derived from the provision of health insurance coverage that were included in the PPACA. Thus, the Federal taxes and fees that fall into this category are: (1) the annual free imposed by section 9010 based on each health insurer’s market share based on net premiums written; (2) the annual fee imposed by section 6301 on each health insurance policy (based on the average number of people covered under the policy), and (3) the tax imposed by section 9001 on high-cost employer-sponsored health coverage. Federal income taxes or payroll taxes were not intended to be excluded from the denominator.

Similarly, NAIC consumer representative and Washington & Lee Law Professor Timothy Jost argues in this brief that issuers’ insistance on a very literal translation of the statute is transparently self serving and hypocritical. Throughout the definition making process, Jost argues, the NAIC “have consistently eschewed a literal approach to interpreting the statute, trying practically to effectuate the intent of Congress while accommodating the practical realities of insurance regulation.” “Time and again insurers have supported definitions that deviate from the literal language of the statute when following the literal language of the statute would be to their disadvantage.”

Ultimately, allowing insurers to deduct all federal taxes would frustrate the intent of the law — it would make the companies’ income appear to be lower than it actually is and deprive consumers of possible rebates. For now, the industry is determined to get its way and has, according to some sources, even threatened to go to court over the matter.

Politics

‘Tea Party Exchange’ organizer ‘hoodwinked’ local Ohio businesses into forking over cash for failed scheme.

There is already a disturbing trend of profiteering among the Tea Party movement, from Glenn Beck’s Goldline scheme to conferences that cost $550 per ticket. Another such scheme unraveled in Ohio today, involving a discount program for Tea Party members at businesses near Dayton. Local businessman Donald Hutchison, who will speak at the Tea Party gathering in Washington, DC on Sept. 11, started the “Tea Party Exchange” last year, in which about 30 local businesses agreed to give discounts to local Tea Party members. The businesses, which believed they would see increased patronage, paid $150 to participate in the program. Yesterday, however, Hutchison abruptly shut down the program, and there is “no word” on whether the participating businesses will get their money back. Bill DeFries, owner of the local Beef O’Brady’s Family Sports Club and participant in the Tea Party exchange, is not pleased:

I feel like I was hoodwinked,” said DeFries. “I think he was trying to make money.”

“I think he should refund everybody their money, including me,” said DeFries, who didn’t get a single TPX customer since he joined June 1.

The participating businesses varied widely, from restaurants to roofing companies. Many were in or near the congressional district of House Minority Leader John Boehner (R). (HT: TP reader EW)

Yglesias

Endgame

Got real estate, I’m buying it all up in outer space:

— Howard Dean lines up with the bad guys.

— Ted Olson lines up with the good guys.

College versus a stereo.

— What’s a good value in college education?

“The Best Class Money Can Buy”.

— Reading things like this I wonder if there’s a case for a Romani State.

Porajmos, the Romani Holocaust.

— Alaska politicians are the most hypocritical kind of politicians.

Fresh from the Scott Pilgrim soundtrack it’s my favorite Canadian band, Metric, playing as The Clash At Demonhead: “Black Sheep”.

Climate Progress

Don Blankenship: The Science Of Climate Change Is ‘Humorous,’ Mountaintop Removal ‘Small Afterdamage’

Coal baron Don Blankenship, the CEO of Massey Energy, perhaps perturbed by the recent opprobrium received by BP CEO Tony Hayward, wants to remind us that he is still the most evil man in America. The explosion of the Blankenship’s Upper Big Branch mine after deliberate safety violations killed 29 miners in the worst coal disaster in 40 years, but the news was overshadowed by BP’s Deepwater Horizon explosion weeks later. Massey Energy is the leading practitioner of mountaintop removal mining, which has led to ecological catastrophe in four Appalachian states, but BP’s blowout hit four states and the Gulf of Mexico.

In an interview with the New York Times, Blankenship argued that climate scientists are clinically insane, blowing up mountains doesn’t harm the environment, renewable energy and over-regulation caused the Bush recession, and critics of his social Darwinism are really just socialists. Up is down in Blankenship’s world: destroying mountains for their coal helps the environment while environmentalists harm the environment.

Blankenship’s words of wisdom on mountaintop removal:

“When the job is finished and reclaimed and revegetated, I think it would be hard to argue any meaningful or extensive damage to the environment.”

“Surface mining provides the funding to make improvements in people’s lives. And that is more important than the small afterdamage of the environment, if you can say that is even damage.”

Blankenship’s words of wisdom on global warming:

Anyone who says they can tell you the temperature of the earth in a hundred years, you should put a straitjacket on them. They don’t have any idea. It’s almost humorous that a country that can’t predict its budget deficit in a year could predict the temperature in a hundred years. The problem with the world’s climate is that it’s impacted by a lot of things. We all know that.

Watch it:

Blankenship’s philosophy of life — the power of denial:

It’s good to be villainized by people who don’t understand and that are wrong. United Mine Workers was a long time the most violent union in America, they committed violence against us, and we beat them, we wouldn’t expect them to like us. Some people believe in CO2 so strongly it trumps every other thought that they’ve got, so we wouldn’t expect them to favor coal mining. Some people believe that the country should be socialized so they are opposed to free enterprise. I mean, you have to have your own beliefs, your own core beliefs, your own strengths and do what you think is right. You can’t do what others believe is right, you have to do what you believe is right.

Watch it:

“There has to be pragmatism in what we do,” Blankenship argues, where “pragmatism” means denying the reality of anything that prevents him from destroying the planet and others’ lives for cash.

Politics

Dean suggests ‘compromise’ on Park 51: No point doing ‘something good’ if met with ‘enormous resistance.’

Today, former Vermont Gov. Howard Dean (D) appeared on radio network WABC-77 and fielded questions from a host about a variety of political issues. At one point, the host asked Dean what his position was “on the controversy surrounding the mosque at Ground Zero,” referring to the Park 51 Islamic community center and mosque. Dean responded by saying he favored some sort of “compromise” of the issue that involved using the proposed site for “people of all faiths.” He called the presence of the mosque an “affront to people who lost their lives, including Muslims.” He then went on to say that while the congregation building the mosque probably has good intentions, “there’s no point trying to do something good if it’s met with enormous resistance from a lot of folks“:

HOST: Governor, what is your position on the controversy surrounding the mosque at Ground Zero?

DEAN: I gotta believe there has to be a compromise here. This isn’t about the right for Muslims to have a worship center, or Jews or Christians or anybody else to have a place to worship, any place at Ground Zero. This is something we oughta be able to work out with people of good faith. And we have to understand that it is a real affront to people who lost their lives, including Muslims. That site doesn’t belong to any particular religion, it belongs to all people of all faiths. So I think a good reasonable compromise could be worked out without violating the principle people oughta be able to worship as they see fit.

HOST: You’re calling for a compromise, are you calling for the mosque to be moved?

DEAN: Well I think another site would be a better idear. Again, I would look to do that in collaboration with the people trying to build the mosque. I think the people who are trying to build the mosque are trying to do something good. But there’s no point in trying to do something good if it’s met with enormous resistance from a lot of folks. This is a very delicate, difficult religious and cultural issue. I think it’s great to have mosques in American cities. There’s a growing number of American Muslims. I think most of those Muslims are moderate. I hope they’ll have an impact on the world, because Islam is really back in the 12th century in some of these countries like in Iran and Afghanistan, where they’re stoning Muslims to death. And that can be fixed. And the way it can be fixed is not by pushing Muslims away, it’s by embracing them and having them become just like any other American, Americans who happen to be Muslim. So the way you do that is to integrate people into the fabric of the United States, which is what I think this congregation wants to do. But I do think we should work out a compromise so that everyone is accommodated by this.

Of course, if progressive movements throughout history had followed Dean’s advice, there’d be very little progress. During the health care debate, Howard Dean boldly said, “I’m going to fight for a public option until we get one. It really is that simple. … We will not stop because Democrats in Washington say it’s done. We will not wait 20 years — 10 years — we will not wait a single year — because we will not stop until every American has the option to voluntarily buy into a program like Medicare.” It appears that running into the “enormous resistance” of the U.S. Senate and political opposition from the insurance, drug, and medical-industrial industries did not stop Dean from fighting for a public option. One has to wonder why he feels like it would be enough to sacrifice the rights of American Muslims to peacefully worship where they please.

Update

Selected passages from Howard Dean’s 2003 Winning Back America:

“Harry Truman was an authentic American hero. . . . Truman acted with clarity and firmness, and he was willing to make unpopular decisions if he knew they’d be good for the long-term future of the country.” pp. 84-85

“Civil rights remains the unfinished business of America.” p. 141

“We cannot allow politicians to try to divide us and turns us against them on the basis of their being immigrants or on the basis of race.” p. 142

“By being afraid to stand up to the Republicans and their radical agenda, the Democrats have actually empowered the radical right.” p. 177

“We have to be positive and lay out an agenda that challenges the mean-spiritedness and cruelty of the Republican right, which commands the three branches of government in America today. We’ve got to stand up for our human values, for our dignity, for our community, and for our respect for one another once again. Our vision of America is one based on hope and based on the responsibility we have for one another.” pp. 177-178

Yglesias

The Coup of 2011

PH2010042102741 1

It occurred to me today that there’s at least some chance that in January of 2011 the US Senate will have 49 Democrats, Joe Lieberman, Charlie Crist, and 49 Republicans. Which is to say that Lieberman & Crist could form a two-man caucus, hold the balance of power, and drive organization of the Senate. Crist could leapfrog seniority and chair a committee. And if it looked like that might happen, mightn’t it make sense for Northeastern moderate Republicans (Snowe, Collins, Brown, Castle) and Southern moderate Democrats (Landrieu, Pryor, Hagan) to join their rebellion against the two party system? After all, Duverger’s Law predicts that we should only have two parties in any given place but it might make sense for those to be different parties in the different regions.

I recall back when Jim Jeffords switched parties in 2001 thinking that it would have been canny for Collins, Snowe, Specter, and Lieberman to all band together with him to form some centrist bloc that could control the agenda. There turn out to be lots of reasons why that sort of thing doesn’t happen. But one thing I’ve learned over the past nine years is that the American political system is very norm-driven in addition to rule-driven, and sufficiently entrepreneurial politicians can change things up quite a lot.

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