It’s Not Just a Number

Originally published at ThirdandState. The Congressional Budget Office (CBO) analysis of the Republican health care plan, the ACHA, released today shows the danger of Congressional action in advance of a serious analysis of the impact of legislation. Though it was touted as a new and improved version of the bill that failed in March, the CBO analysis shows the bill that passed the House is no better, and in some ways, far worse. The CBO estimates that, at the end of ten years, 23 million fewer Americans will have health insurance because of the legislation, which is one million less than the estimate of their earlier bill. Most of the lost health insurance created by the AHCA is the result of the slow repeal of the Medicaid expansion and the replacement of the federal entitlement to traditional Medicaid by a per-capita cap on federal funding of the program. These devastating … Continue reading

Health Care Again

Originally published at Third and State April 21, 2017.  News reports indicate that, as many of us had feared, the Republicans in Congress and President Trump have not given up on their effort on health care, not only to repeal and replace the ACA but to institute a per capita cap on Medicaid spending. The new plan, as we will explain in a moment, is even worse than the last one. But before we get to the details, we need to stop and ask, “why are we here again?” Knowing the answer to that question is critical to understanding what the Republicans propose. Why Health Care: Avoiding the Loser Label There are basically two reasons the Republicans are seeking a mulligan on health care. The first is that Trump and the Republicans promised to repeal the ACA and don’t want to look like losers to their hard-core, right-wing voters and … Continue reading

New Data, Good News: Health Care

Most news is bad news. And political campaigns are more likely to flag what is wrong with our country than what is right with it. So, it’s not surprising that in the heat of a presidential election, we are more focused on what is wrong with our country than what is right with it. But as the federal government updates its statistics on income, poverty, and health care this week, we can take a moment to appreciate the good news—government at the federal and state level has been increasingly successful at encouraging prosperity. We start today with health care. The Affordable Care Act remains controversial and even those of us who support it recognize that further reforms are needed to guarantee that quality health care remains affordable to everyone. There can be little doubt that the ACA is working in Pennsylvania and beyond. Between those who bought health insurance on … Continue reading

Take the Money for Medicaid

Originally published in the Philadelphia Inquirer, February 11, 2013 By Valerie Arkoosh and Marc Stier Imagine a new federal program guaranteed to provide Pennsylvania with $43.3 billion between 2013 and 2022 for repairs to roads and bridges. Imagine that the program is paid for entirely by the federal government for the first three years. After that, Pennsylvania will have to put in $4 billion. Imagine that despite the expenditure, Pennsylvania saves a greater amount because the new federal funding would replace almost $4 billion in state funding. And imagine that the new funding would create tens of thousands of jobs in the state and generate millions of dollars in state and local tax revenue. Can anyone imagine Gov. Corbett turning down this deal? Of course not. Yet in his budget address Tuesday, Corbett did just that, failing to embrace $43.3 billion from the federal government over 10 years to expand … Continue reading

Single Payer Advocates Can’t Make Up Their Minds About the Problem With the ACA

Ever since the Affordable Care Act was passed, the left wing critics of it—especially the single payer advocates—have said, wrongly, that it was passed at the behest of the insurance companies and that subsidies in the exchanges are a handout to them. This was never true for few reasons, not least because the insurance companies spend at least a hundred and forty million or so opposing the ACA. Now, to my great surprise, one of the leaders of the single payer movement in PA, Chuck Pennacchio, has posted an article on Facebook in which he seems to entirely reverse direction without noticing it. Continue reading

David Brooks Gets It Wrong About Education and Health Care

David Books outdid himself today in writing post about education and health care that is completely misleading about improvements in both in the last fifty years and about the limits of productivity increases in both areas. It takes more than a FB status update to explain why. Read this blog post for details. The short story though, is that if you really think there haven’t been any improvements in either education or medical care in this country since 1960, you don’t deserve to have your opinions appear on the op-ed page of The New York Times. And if you think that huge productivity increases in labor intensive fields are possible, then maybe you should explain why NY Times columnists do only two columns a week instead of the three they did in the 1960s. Continue reading

What the Court Did, Why, and What it Means for Politics and Health Care Policy

We got very good news from the Supreme Court today. There are no constitutional barriers to the ACA going fully into effect. The exchanges, subsidies for insurance and the expansion of Medicaid will provide affordable insurance for over thirty million people who don’t have it now. Over a hundred million people will be protected from losing their insurance or paying more if they have pre-existing conditions or are older or women. And the provisions already in place—that make preventive care free, that reduce pharmaceutical costs for seniors, that enable people 26 and younger to stay on the insurance of the parents—will remain in place. This is all great news. And it would not have happened without all the hard work you did in support of what became the ACA. That work didn’t stop after the legislation was passed. As I explain more below, the decision today was in no small … Continue reading

Two Thoughts in Advance of the Supreme Court Decision

Can we progressives not attack each other after the decision? I’m going to be writing more about the ACA and the Court after we hear the decision. But here is one plea in advance of the decision: can we progressives not get in a circle and start shooting at one another? That means, can the single payer folks not lead off with “if Obama only had pushed single payer through Congress we wouldn’t have to worry about the Court today?” Everyone who pays any attention to Congress knows that single payer had no chance in 2009-2010 and it does the progressive cause no good to make up stories about what is politically possible and what is not. More importantly we need to unite against the enemy, which is not the supporters of Obamacare but the corporate conservatives who, if they get their way today, are going to go after Medicare … Continue reading

Send Tim Holden Packing on Tuesday

Voters in the 17th Congressional District in Pennsylvania have an opportunity to do something really important, not just for themselves, but for the entire country: defeat Congressman Tim Holden. who represents the Republican wing of the Democratic party.   It is obviously important to the 17th District to have a member of Congress who actually support their interests, not those of the corporate rich. And it’s important to the Democratic Party and the country as a whole to rid ourselves of members of Congress who fail to do the minimal in standing up for the ideals of our party. Defeating such members will send a critical message throughout the Democratic Caucus: Democratic members of Congress are accountable to us. And, as I explain below, defeating Tim Holden will remove from office a whining, gutless, dishonest example of the American politician at his worst. Continue reading