Inching toward universal healthcare: New York City to guarantee healthcare to everyone, Washington State plans a public option

A demented old racist has taken our federal government and TV news bureaus hostage, so it’s easy to overlook the progressive policy announcements made over the last few days. But with new Democratic administrations taking office and others looking to make a splash, it’s been a good few days, especially for healthcare policy.

In New York on Tuesday, Mayor Bill de Blasio announced that the city would be moving toward guaranteed healthcare for undocumented immigrants and low-income residents. It’s not any kind of Medicaid expansion — states run that program — or new health plan, but instead, a guarantee of proactive care that won’t cost patients anything if they can’t afford to pay.

From the NY Times:

The city already has a kind of public option for health insurance for low-income New Yorkers, through an insurance plan run by city hospitals known as MetroPlus.

The new proposal would improve that coverage, which already insures some 516,000 people, and aim to reach more of those who are eligible, such as the young and uninsured, and others who qualify but have not applied.

It would also provide additional direct city spending, at least $100 million per year when fully implemented, officials said, for the city’s hospital system to support care for those without insurance. The city estimates the uninsured population to be about 600,000 people, including as many as 300,000 undocumented residents. A major component of that effort would be improving customer service, including the phone line, to help those with questions about their care.

The program will have a membership card that will allow patients to get care from a wide array of doctors. Right now, over half a million people use the city’s emergency rooms for their medical care, which is a very unhealthy and fiscally disastrous status quo. According to NBC New York, this new program will allow people to seek “primary and specialty care, from pediatrics to OBGYN, geriatric, mental health and other services.”

Continue reading “Inching toward universal healthcare: New York City to guarantee healthcare to everyone, Washington State plans a public option”

The Obamacare court decision was a disgrace, but let’s use it to flip the Senate in 2020

First thing’s first: As the title of this story states, the Texas court’s decision to strike down Obamacare was a lawless act of partisan idiocy, and will hopefully be reversed upon appeal. There is no silver lining in taking healthcare away from 20 million people.

That all said, this is the hand we’ve been dealt, and fortunately, we know how to play it now.

As Bloomberg reports today, the case is likely to stretch into 2020, and possibly beyond if it reaches the Supreme Court. That means that it will be the defining issue of the 2020 elections (well, beyond Trump’s brain rot and treason), and it could mean a lot of trouble for the GOP. Healthcare was the top issue in 2018 and voters broke overwhelmingly for Democrats on the subject, helping them take back the House and, notably, expand Medicaid even in three red states.

One of those states was Nebraska, where voters enacted Medicaid expansion via ballot initiative despite years of the GOP-controlled state legislature’s refusal to do so. Once implemented, an additional 90,000 people in Nebraska will have healthcare. That’s not a benefit they’re going to want to give up. And that puts Sen. Ben Sasse, who is up for re-election in 2020, in a perilous situation.

Continue reading “The Obamacare court decision was a disgrace, but let’s use it to flip the Senate in 2020”

The wreckage from a week of Republican power-grabs

The Republican Party has now fully entered the next phase of its all-out war on American democracy — not only are they cheating in an effort to win elections, they’ll now disregard the will of voters when they lose. After giving it a test run in 2016, when the GOP-controlled North Carolina legislature tried to strip Democratic Governor-elect Roy Cooper of many of his powers, Republicans are going all-in on the strategy in key states across the country.

The scheme played out this past week in Michigan, Wisconsin, Ohio, and once again in North Carolina, where Republicans have become the nation’s leaders in abject and blatant cheating. It’s hard to keep up with all the corruption, as so many of the most insidious clauses and maneuvers are nestled into giant bills that were kept secret from the public up until now. To help catch you up, here’s a running list of state GOP’s anti-democratic lame-duck treachery.

Wisconsin:

In a marathon Tuesday night session that stretched into the next morning’s rush hour commute, the GOP-held legislature passed a number of bills that will hamstring Democratic Governor-elect Tony Evers and Attorney General-elect Josh Kaul. The state is already gerrymandered beyond belief, which allowed Republicans to keep their legislative majority despite Democrats earning a majority of statewide votes this November. You’d think that would send a message to GOP legislators, but that assumes that modern Republicans have consciences or even self-awareness.

Awaiting outgoing GOP Gov. Scott Walker’s signature are a number of bills that will significantly weaken the executive branch and hurt voters and working people. They will:

  • Curtail early voting, reducing it from six to two weeks before the election;
  • Double down on new Medicaid work requirements
  • Stripping the Attorney General of the ability to remove the state from lawsuits, including the suit against the Affordable Care Act
  • Takes away Evers power to control or disband a key economic development council
  • Require legislative approval for some decisions made by the Governor

Continue reading “The wreckage from a week of Republican power-grabs”

Julie Oliver, in TX-25, is running one of the most inspiring campaigns of 2018

After years of establishment Democrats running rote, indistinguishable TV ads and peddling cautious, focus-group-tested messaging, a wave of fresh, progressive candidates have decided to communicate like actual humans. Fresh faces such as Randy Bryce and Alexandria Ocasio-Cortez have produced a series of especially moving digital ads that have gone viral, and this week, even amidst the Kavanaugh calamity, a new progressive star was born.

Julie Oliver, who is running to represent Texas’s 25th district in Congress, narrates her own life story in the ad; she grew up in near-poverty and ran away from home as a teenager, squatting in abandoned buildings until she got pregnant at 17. Shunned by her boyfriend’s family, she returned home, where her mother agreed to help her — on the condition that she get back to school.

The rest is the sort of up-from-your-bootstraps American Dream success story that seems to only happen in movies or very hypothetical conservative scenarios: Oliver worked and raised her family while attending college and law school, and now at 45-years-old, she’s an accomplished lawyer and community leader running for Congress. Her experience makes her uniquely empathetic to the needs of working people, a quality in short supply in Washington today.

Continue reading “Julie Oliver, in TX-25, is running one of the most inspiring campaigns of 2018”

Medicare-for-All can happen, but maybe not how you’re expecting

What’s the largest medical bill you’ve ever received? OK, I don’t want to make you sick thinking back on it, so I’ll tell you mine: Back in 2012, I was slapped with a hospital bill for half a million dollars, which is more than most Americans pay for their house. This wasn’t some elective procedure, either — open-heart surgery very rarely is.

It’s important to note that this happened after the passage of the Affordable Care Act. Obamacare was a nice upgrade to a fundamentally flawed system. More people got health insurance, but it’s often still uber-expensive (and getting worse) and still fully unavailable to tens of millions of Americans. Medicaid is being throttled, Republicans are sabotaging protections, and big pharma is colluding with middlemen to rip-off patients and states. Even people with “good” insurance get screwed — personally, I just got a $500 bill for a ten-minute checkup.

Democrats are finally beginning to realize that continually trying to patch up a ship built to sink is futile. And after years of it being considered a far-left radical idea, single-payer healthcare — or Medicare for All — is becoming the mainstream position of national Democratic leaders.

To take a closer look at the momentum behind the single-payer campaign, I spoke with Dr. Carol Paris, the president of Physicians for a National Health Program. For years, PNHP has been at the forefront of advocating for universal healthcare; during the Trump administration, it has worked to both save Obamacare and educate Democrats and lobby nationally for a more complete overhaul of our still-broken healthcare system. She spoke some hard truths about the state of our politics and party, but they’re important ones for us to understand and accept as we push forward for truly comprehensive universal healthcare.

Note: Because it’s a 501(c)(3), PNHP cannot endorse any political candidates. So, I’ve separately made this list of candidates who support Medicare-for-All — CLICK HERE to donate to them!

Medicare for All has more support amongst Democrats than ever. Why do you think that’s happened?

It really began growing as the reality of the failure of the Affordable Care Act to control costs and insure everyone became clearer… I don’t think that moved the legislators, I think it moved their constituents to put pressure on them to endorse single-payer.

The Affordable Care Act did extend care for a lot of people, but costs still go up. Were you expecting that?

I was not optimistic. The best thing about the Affordable Care Act was the Medicaid expansion. We could have done that with so much less effort and expenditure of resources and just forgotten about the rest. The best part of it and what helped the most people was the Medicaid expansion. With the marketplace and the subsidies, there’s so many problems, because the private for-profit insurance industry is baked into it. That’s a big part of it.

The industry says it can do things more efficiently, but that hasn’t been borne out. What kind of tricks is it still able to pull, despite new regulations?

The individual mandate created a whole market for new customers. Then there was the requirement that insurers can no longer deny coverage to people who are either too sick to be profitable or too old and therefore more risky. Eliminating those but adding the mandate put the insurance industry in a precarious situation of having to figure out how to work around the guaranteed issue and community rating while still drawing in the mandated younger members.

So what they do is they make narrow coverage networks. So you can get a plan with a subsidy or plan on the marketplace that will bring down the cost of your premium, but they do it by requiring you to go on a plan that has a very narrow network. There was a study and it found that in New York, none of the marketplace plans included the number one cancer hospital in the city, Memorial Sloan Kettering.

As far as pharmaceuticals, they’ll just put the expensive pharmaceuticals into a higher tier so that they’re just shifting more and more of the cost of care to the consumer.

So how do you envision a full Medicare-for-All system working?

The only way to actually implement it in a way that will be cost-effective over time is specifically to do it as a single-payer strategy. All single-payer means is instead of multiple insurance companies providing insurance as well as Medicare and Medicaid and Tricare and all the others, everyone is in a single risk pool.

It really is only going to be feasible if it’s done on a national level. when you’ve got 325 million people and everyone working is contributing to the tax base that is paying for our healthcare. You’ve got a big enough tax base then to actually cover everyone’s needs for all medically necessary care — including dental, vision, and long-term care.

The problem people get hung up on is, “Oh my God, my taxes are gonna go up?” This is a situation where your taxes go up modestly and your net income goes up as well, and the reason is because when your taxes go up, it’s for covering the things that you’re now not paying for out of your after tax dollars, premiums, copays, deductibles, out of network costs. All of that goes away.

One thing I can never answer is what happens to all the jobs in the insurance industry?

Written into the House’s Medicare-for-All bill, HR 676, is funding to provide unemployment for a year and retraining for anyone who makes $100,000 a year or less in the insurance industry. And remember that we’re going to need some of those people to administer the Medicare for All plan. So the number of [of workers] isn’t going to go to zero.

I was actually just having dinner last night with a surgeon from Nashville who told me a great story. She’s a 67-year-old general surgeon and she was just saying she was so fed up with trying to get the care for her patients that they need. She does a lot of breast surgery and there’s a particular kind of breast cancer called BCRA 1 and 2, where if you have those genetic markers, it is a reasonable option for a woman to have prophylactic bilateral mastectomy, without having breast cancer.

Blue Cross Blue Shield denied the patient’s claim, her preauthorization to get this done. And what the doctor told me was that she finally remembered that a colleague of hers had quit the practice of medicine and was now working at Blue Cross Blue Shield doing preauthorization. So she called him up and he finally agreed that this was reasonable and authorized it. I’m telling you the story to say there are a number of doctors and nurses who are licensed clinicians in this country who have stopped practicing clinical medicine because they burned out and are now working for the insurance industry. These are people that could go right back into the delivery side of healthcare.

So if Democrats take back Congress and then the White House, how do you make the push for this, after the Affordable Care Act was what they mustered last time?

You’re talking to a person who is not easily persuaded that the Democratic Party is our friend. Remember that in 2009 we had a majority in the House and the Senate and we had a Democratic president and we couldn’t even get single-payer included in the discussion of health care reform. I’m actually of the persuasion that we need to have our grassroots organizing working on Republican members of the House and Senate, too. You get them to co-sponsor single-payer legislation. I don’t think that’s impossible. I think if the grassroots makes it toxic for any member of Congress, Democrat or Republican, for them not to get on board, then they’ll get on board because they want to hold onto their seat.

I think it’s great if people want to put their time and energy into Democratic candidates who say that they will support. But corporate Dems are still in control and I am not convinced that just getting more Democrats elected to office is going to turn the tide. I think what’s going to turn the tide is what we saw last week, with a new Reuters poll that showed 84.5% of Democrats and 51.9 percent of Republicans now support Medicare for All, and 70% overall.

That’s how we’re going to get Medicare, in my opinion, by also having moderate Republicans who are absolutely being screwed by the rising cost of healthcare. I think they’re going to get on board with this and say, “I’ve got to do this for myself and my family and stop listening to Fox News and astroturf groups like the Partnership for America’s Healthcare Future.”

So let’s say we do get Medicare-for-All. What happens when a president or Congress who hate it take office, as we’re seeing right now with the GOP sabotaging the Affordable Care Act?

I actually don’t want to pass Medicare-for-All legislation if it’s done the way the Affordable Care Act was passed, through reconciliation and no bipartisan support. If we do it that way, then they’re just turning it into a hot potato, just like the ACA is, and it’s just going to get beaten back and forth between parties and never have the opportunity to become the beloved program that Medicare became. What I really would hope is that we passed this legislation because there is such a groundswell of support among the American people that members of Congress simply get on because they don’t have any alternative.

We’re seeing more buy-in from the business community, especially small businesses that are beginning to realize that the Chamber of Commerce is not their friend and that it’s in their best interest to support Medicare-for-All, that it would be so much better for their bottom line. And look at the teacher strike in West Virginia, there was actually a picture of a teacher holding up a sign that said, “We’ll work for health insurance.” So I think we need to be just continuing to grow the movement among our own citizens who are day in and day out being beaten and beleaguered by the profiteering healthcare system.