Tag Archives: Affordable Care Act

When You’re Starving, Half a Loaf Could Still be a Great Deal

bread line affordable care act nixon family assistance plan stimulus bill Biden

February 28, 2021

Pearl River     The Biden stimulus bill won’t deliver on a minimum wage increase, nor will it correct all of the defects in the Affordable Care Act or bring world peace in our time, but it has many benefits, and I can hardly wait. At the same time, in these areas and many others, there is more work that needs to be done, and while we all put our shoulders to the wheel for a full loaf, it’s worth thinking about how to get as much as we can while the opportunity still exists in this interregnum before the next election.

I’m confused by some Congressional spokespeople who argue that they made a promise of $15 per hour and are duty bound to deliver it. Sounds good to me, but reality does intrude. It’s not an individual commitment, but a collective responsibility, and that means winning more elections at all levels from local to state legislatures to Congress itself. Reportedly, there is discussion in Washington of a Plan B on $15 per hour that would require Fortune 500 companies to pay that sum as a minimum rate. That’s interesting, although I have no idea whether it’s legal, and would bet there will be lawsuits that linger through much of Biden’s term. It’s still worth remembering that many states and companies, including huge number of employers of essential workers numbering millions, are stuck at $7.25. President Biden has indicated he could live with $12 per hour by 2025. Some Republicans have come close to that figure. In Louisiana, Mississippi, Texas, and the like, $12 per hour sure sounds good. There needs to be a Plan C that starts to put together the coalition to finally raise the federal minimum wage to that level. Remember, it’s a minimum, and nothing will stop cities and states, where it is possible, to scaffold up from these levels, in fact it would be easier to do so.

On the Affordable Care Act, the stimulus reportedly would make it possible to add 1.2 million people in coverage by increasing subsidies and even allowing more middle-income families to buy into the marketplace. Sounds like a good start. The filibuster rule will prevent wholesale improvements, but what is the chance for a Plan B there that puts a cap of some kind, darned near any kind, on deductibles that would make the cheap plans companies with more than 500 workers are able to pay worth a worker’s purchase? Pretend compliance by these companies is a farce. We’ve seen deductibles in the $5, $6, and $7000 level. The Massachusetts model under then Governor Romney had a cap. Where’s the deal that can be made there?

I can still remember, painfully, the Obama majorities and our failure to get anything through on immigration on “the nothing but the full loaf” strategy. Heck, I can remember our failure to make a deal on Nixon’s Family Assistance Plan, which has meant millions sentenced to abject poverty while we insisted on “Adequate Income Now” at $5400 for a family of four.

Speaker Pelosi famously dissed former Freedom Caucus representative Mark Meadows when he was serving as Trump’s chief of staff about his years of obstruction resulting in his not knowing “how to make a deal.” While fighting to move the country forward, I hope that we are working to help a bunch of people in the House and Senate behind the scenes to make the deals that might not raise all boats in one great flood, but could pull a huge number of us over the water line to economic safety.

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Expanded Medicaid

The Pandemic Case for the Affordable Care Act

New Orleans       There’s no rhyme or reason to it, but bizarrely the Trump administration recently marched into court to once again challenge the legal standing of the Affordable Care Act.  Perhaps someone in the campaign wasn’t sure that former Vice President Joe Biden had enough issues already to make his case, so they wanted to remind him that his work with the Affordable Care Act was still a straight arrow to the heart and health of America ready in his quiver to bleed out the president.

The numbers are no friend to the administration.  In fact, the latest reports seem to indicate that they may be trying to sweep the pandemic surges under the rug by having hospitals drop reporting to the Center for Disease Control and instead cycle them over to a private contractor.  The one set of numbers they can’t really hide are those that indicate the numbers of people who are losing healthcare in the middle of the pandemic.  Job and employer-based insurance doesn’t travel well to the unemployment line.  5.4 million Americans lost health insurance in four months because of job losses, shattering a record according to Families USA.  Kaiser estimates the number is 27 million, counting family members as well.  That’s a lot of Americans who are now facing huge risks with no safety net.

As the virus surges in the South and the West, it is hard not to note that it is in these two regions where redder states have not expanded Medicaid under the Affordable Care Act for largely ideological reasons, leaving jobless victims without health care in double jeopardy. And, why?  The most common rationale was fear over future costs as the government’s initially generous shouldering of the cost ebbs.  Turns out that doesn’t hold any water.  Two Harvard economists have calculated that the money spent on Medicaid expansion more than paid for itself, even after accounting for the fact that benefits that come in the future are worth less today, making the Affordable Care Act a great deal.

The public knows it, especially now.  Ask Oklahoma, a state so red that it’s margin of victory for Trump was close to astronomical in 2016.  They may be conservative there, but they’re not crazy.  They weren’t willing to risk their lives for Trump’s Tulsa rally for one thing, but more importantly, they voted soundly to direct the state recently to add Oklahoma to the expanded Medicaid states under the Affordable Care Act.

Republicans opposing the Affordable Care Act now in the time of pandemic is not a viable healthcare strategy.  It’s a retirement plan, sealed and specially delivered by the American people.

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