With the absolute, final-final deadline for 2014 sign-ups now completely passed, and despite numerous speed bumps, implementation of the Affordable Care Act is well under way. From my view as a bedside nurse and advocate for patients and health care workers for more than 30 years, I see a chance to close some dangerous gaps in our country’s health care systems.
In the U.S. we like to think of ourselves as the best at everything. And it’s true that we have the finest health care—for those who can afford it. Unfortunately, for the average American our care is also the most expensive, with some of the poorest outcomes, in the industrialized world. Many Americans, pre-ACA, had no access to anything but emergency care, due to cost and/or pre-existing conditions. These are the biggest gaps ACA seeks to close.
My mother had her hip replaced in 2009. I’m thankful I was there,
This week we continue our series about the shaping of California’s laws and policies by Corporate Democrats. In his second article, Pulitzer Prize-winning investigative reporter Gary Cohn examines how a bill does not become a law when powerful business interests lobby against it.
Jim Araby was dead asleep when his cell phone rang at 6 a.m. last June. Until then the labor activist had been enjoying an idyllic family vacation in Guerneville, on Sonoma County’s Russian River. But the number appearing on his phone told him the call was from Sacramento, suggesting bad news. The voice he now heard confirmed it.
“Can you get here?” a union colleague asked. “We need you.”
Araby, a regional director of the United Food and Commercial Workers, listened in dismay as he learned that Assembly Bill 880, which more than half a dozen community groups and unions had supported,
Having failed to defeat the Affordable Care Act in Congress, to beat it back in the last election, to repeal it despite more than 80 votes in the House, to stop it in the federal courts, to get enough votes in the Supreme Court to overrule it and to gut it with outright extortion (closing the government and threatening to default on the nation’s debts unless it was repealed), Republicans are now down to their last ploy.
They are hell-bent on destroying the Affordable Care Act in Americans’ minds.
A document circulating among House Republicans (reported by the New York Times) instructs them to repeat the following themes and stories continuously: “Because of Obamacare, I Lost My Insurance.” “Obamacare Increases Health Care Costs.” “The Exchanges May Not Be Secure, Putting Personal Information at Risk.”
Every Republican in Washington has been programmed to use the word “disaster” whenever mentioning the Act,
In addition to serving as Senior Fellow for Health Care for the Roosevelt Institute | Campus Network, I am the Executive Director for my campus’ Roosevelt chapter. A few weeks ago at our general body meeting, I asked the crowd whether they had been talking with their friends about the Affordable Care Act and what these conversations sounded like. Did they know the basics: that in January, most Americans will be expected to either carry at least minimal insurance or pay an opt-out penalty? Do they know that they will be able to stay on their parents’ insurance until they are 26, if they so choose? Have they compared the prices of different options available for young adults versus the penalty?
The question meant to take up the first 10 minutes of our meeting turned into a full 40-minute discussion. As we scarfed down our pizza in true hungry college-student fashion,
There are good reasons why President Obama’s leading message on health care during the 2008 campaign, often repeated since, was “if you like your health insurance, you can keep it.” That message was created to overcome the fear-mongering that had blocked legislative efforts to make health care a government-guaranteed right in the United States for a century.
Our health is of central importance to our lives, deeply personal to our well-being and those of our loved ones. That concern has translated politically; for decades, people have told pollsters that health care is a top concern. It is why every 15 to 20 years – from 1912 to 2008 – the nation has returned to a discussion about whether and how the government should guarantee health coverage, the debate rising phoenix-like from one spectacular defeat after another. A big reason for those defeats has been that opponents have exploited those deep feelings to scare the public about proposed reforms.
But they’re winning the big one: How the nation understands our biggest domestic problem.
They say the biggest problem is the size of government and the budget deficit.
In fact our biggest problem is the decline of the middle class and increasing ranks of the poor, while almost all the economic gains go to the top.
The Labor Department reported Tuesday that only 148,000 jobs were created in September — way down from the average of 207,000 new jobs a month in the first quarter of the year.
Many Americans have stopped looking for work. The official unemployment rate of 7.2 percent reflects only those who are still looking. If the same percentage of Americans were in the workforce today as when Barack Obama took office,
In times of national crises, thoughtful journalists often hit the history books to find precedents and analogies.
Here’s a tip from a retired newspaper scribe turned history teacher: Look no farther than late 1860 and early 1861 to find historical parallels to our current crisis.
One hundred and fifty three autumns ago, our nation elected our first Republican president, Abraham Lincoln. Last fall, we re-elected our first African American president, Democrat Barack Obama.
The white, mostly Democratic, slave state South had an almost pathological hatred for Lincoln and his anti-slavery party.
Before the voters went to the polls on November 6, 1860, Southern politicians and newspaper editors warned that the slave states would secede if Lincoln won. (Eleven of 15 did; Kentucky, my home state, and Lincoln’s, did not.)
Today, many, if not most, House Republicans, and more than a few GOP senators, hate Obama to the point that they are willing to push the country into default and risk wrecking the economy over the Affordable Care Act,
On ABC’s This Week, Newt Gingrich and I debated whether House Republicans should be able to repeal a law — in this case, the Affordable Care Act — by de-funding it. Here’s the essence:
GINGRICH: Under our constitutional system, going all the way back to Magna Carta in 1215, the people’s house is allowed to say to the king we ain’t giving you money.
REICH: Sorry, under our constitutional system you’re not allowed to risk the entire system of government to get your way.
Had we had more time I would have explained to the former Speaker something he surely already knows: The Affordable Care Act was duly enacted by a majority of both houses of Congress, signed into law by the President, and even upheld by the Supreme Court.
The Constitution of the United States does not allow a majority of the House of Representatives to repeal the law of the land by de-funding it (and threatening to close the entire government,
It’s been 100 years since ideological conservatives joined with doctors and insurance companies to kill the first movement in the United States for what was then called “compulsory health care.” Now, on the eve of their epic loss, those who deeply hate the idea that we have a collective responsibility to care for each other are desperately trying to stop history’s clock.
Beneath the tested rhetoric from opponents like the Heritage Foundation and Texas Senator Ted Cruz about a government takeover or Obamacare killing jobs and the economy, we can find expressions of the driving force behind the right’s obsession. One telling quote is from Missouri State Senator Rob Schaaf, who declared, “We can’t afford everything we do now, let alone provide free medical care to able-bodied adults.” Another is the proud statement from Steve Lonegan, the Republican candidate for U.S. Senate in New Jersey, who told me in a debate on Obamacare at the FDR Library,
Maria Guevara had been trying to get pregnant for three years when she saw a doctor at Los Angeles County General hospital in 2008. She was understandably thrilled, then, to learn she was indeed three months pregnant at the time of her visit. As Guevara later recalled, when the doctor asked her in English if she wanted to keep the baby, “without hesitation I replied ‘yes’ to his question. Before leaving the hospital, the doctor prescribed me medication that I thought was prenatal care. That lack of communication between the doctor and me has changed my life forever.”
Guevara took the prescribed medication, and experienced violent pain and bleeding. She returned to the hospital, where another doctor told her the bleeding was the result of a miscarriage.
“My baby was dead. The medication the initial doctor prescribed to me was not prenatal care but medication to induce an abortion,” she told a press conference in April at the University of California Davis Medical Center in Sacramento.
In the Appalachian foothills of Georgia, about an hour north of Atlanta, the riverfront city of Rome serves as a regional hub for health care. Near Rome’s tree-lined historic downtown, there are two well-equipped acute care hospitals with a total of more than 530 beds. Two years ago, the Medical College of Georgia opened a satellite campus in the city.
But in Rome, 27 percent of adults under 65 are uninsured, a rate that holds true across the state. Last year, the city’s two hospitals report spending more than $80 million delivering uncompensated care, often in the emergency room, where costs run high. Taxpayers and those with health insurance will end up paying for that care through government subsidies and higher premiums, industry experts say.
Rome’s dilemma is exactly the situation that the Patient Protection and Affordable Care Act, also known as “Obamacare,” was designed to fix — but that fix isn’t coming to Georgia.
The Affordable Care Act, or Obamacare as it’s referred to, is going to dramatically change the way we live our lives and balance our budgets. The largest group of beneficiaries is working people who are currently not covered by their employer yet don’t earn enough to buy health insurance on their own, including a large number of food service and retail workers. These workers currently are forced to pay out of pocket, forgo medical treatment or rely on public health clinics.
You’d imagine these workers would be jumping for joy at the thought of a new federal law requiring their employers to help them meet a critical human need. Unfortunately, there is little recourse for these workers for the next two years. While most of the healthcare dialogue has revolved around the individual requirement, the recent announcement that the employer mandate will be pushed back until 2015 has quietly fallen off the radar.
In my post last week, after the announcement that the employer mandate would not be enforced for a year, I wrote that it was vital that the Obama administration show as much concern for the workers who might be denied health insurance as it did for employers. Specifically, I asked the administration to make clear that a worker would be able to get subsidized health coverage through the new exchanges based on filling out an application, without having to get proof from an employer. On Friday [July 5, the Department of Health and Human Services] issued that ruling.
The decision not to enforce the employer mandate for a year is certain to cost some people health coverage as some employers decide to postpone complying with the law. Their workers, possibly also confused by the delay, may not apply for subsidized coverage. But if they do apply, the new ruling will be a big help to them.
The surprise announcement from the Obama administration that it will delay for one year penalizing employers that do not offer health coverage to their workers is the latest capitulation by the White House to big businesses that want to shirk their responsibility to help pay for health insurance. But the decision leaves huge unanswered questions about whether health coverage for uninsured workers will also be denied.
Yesterday, the Treasury issued a notice delaying for one year, until 2015, the requirement that employers of more than 50 full-time employees (three percent of all employers) report on whether they offer health coverage to their employees. The Affordable Care Act requires that these employers pay penalties when they do not offer qualified coverage or when their workers access coverage through the new health care exchanges. The Treasury’s notice does not change the legal requirement that employers provide coverage,
One of the biggest issues that the Affordable Care Act (ACA) is meant to tackle is the lack of health coverage among low-wage workers. While there is good news for many low-wage workers in the new law, many others will still find themselves locked out of access to affordable coverage. Solving their concerns will be one more part of the huge challenge of confronting the power of mammoth low-wage employers in the new economy.
There has been a lot of coverage about the potential for fast food chains and other employers to cut the hours of some of their employees to under 30 a week in order to avoid having to offer them health coverage. To the extent that employers do cut back hours, it will accelerate a long trend toward part-time low wage work; part-timers increased from 17 percent to 22 percent of the workforce just from 2007 to 2011.
The headlines – “Many States Say ‘No’ to Health Insurance Exchanges,” to take one example – make it seem like bad news. But it’s not. It is good news that half the states are refusing to have anything to do with the new health insurance marketplaces being set up under the Affordable Care Act.
One of the biggest differences between the good version of ObamaCare passed by the House and the mediocre Senate version that became law was the question of whether the federal government or states would run the new health insurance marketplaces (called “exchanges” in the law). But resistance by Republican governors is leading to implementation of the law in a way that is much closer to the vision in the House bill.
The new health marketplaces are the centerpiece of ObamaCare, the mechanisms through which people who don’t get health coverage at work but make too much for Medicaid will be able to purchase subsidized health coverage,
I want to vote for a comprehensive bipartisan plan to address the fiscal cliff. I’m willing to take a tough vote. I’m willing to make sacrifices. I’m willing to feel the heat. But I’m not willing to solve the fiscal cliff by throwing seniors over the cliff. I draw the line at cutting benefits in Medicare and Social Security.
This week, House Republicans unveiled their fiscal cliff counterproposal. While they continue to call for an extension of the Bush tax cuts for millionaires and billionaires, they propose offsetting this cost by gutting Medicare benefits, including raising the age of Medicare eligibility to 67. I won’t go there. As California’s Insurance Commissioner for eight years, I know this would be horrible policy, throwing millions of seniors into the rapacious hands of an insurance industry interested only in profits for its shareholders.
Medicare is a promise we made to seniors more than four decades ago.
“The way the health care delivery system developed in this country has been a global scandal,” said Michael Hiltzik, author and Los Angeles Times columnist, as he concluded the community program he moderated Wednesday [August 22] on the effects of the Affordable Care Act.
Speaking at the National Council of Jewish Women Los Angeles, expert panelists acknowledged the obvious limitations of the act, which was found constitutional (for the most part) by the Supreme Court at the end of June. They also cited new benefits flowing from the legislation. But what became very clear was that there are steps we in California can take to make reform more meaningful even without action on the federal level.
If you want to skip the context and the bad news and go straight to what we can do now, please jump down the page to Recommendations for Action.
(Beginning tomorrow, August 1, health insurance companies will be required to cover women’s preventive care without extra charges. As other provisions of the Affordable Care Act (ACA) continue to unfold over the next few years, more women will gain further access to affordable preventive health care. Countdown to Coverage has been marking the days leading up to August 1 with posts about how ACA – often called “Obamacare” by its opponents — will benefit women, while pointedly rebranding the act “MamaCare.”
We love MamaCare! Thanks to the health care law, on August 1 all new health insurance plans will have to provide pregnant women with coverage for gestational diabetes screening without charging us expensive co-pays and deductibles.
Richard Kirsch has dedicated his life to fighting for universal affordable healthcare. A senior fellow at the Roosevelt Institute and author of numerous studies on healthcare reform, Kirsch wrote New York’s Managed Care Consumer Bill of Rights. Perhaps most notable, however, is the role he played in transforming the recent political discourse with his revolutionary proposal: the public option.
In his new book, Fighting for Our Health: The Epic Battle to Make Health Care a Right in the United States, Kirsch describes the uphill struggle to bring health care to everyone. The book doubles as a memoir and ode to the power of progressive grassroots organizations. He chronicles the history of health care reform as well as his own experience designing and pushing forward the public option — a middle road between private insurance and single-payer coverage.
At a book party and fundraiser at the California Endowment,