Senate to Choose Between Health Catastrophe or Something Worse

Mitch McConnell and his Republican allies have one more trick up their sleeves to try to get some health care bill through the Senate. This week they will seek a vote to proceed to debate on the bill passed in the House on the understanding that there will be a process, colloquially known as voterama, in which a series of votes on one or more substitutes to the bill, or amendments, will be introduced. That is, Senators are being asked to proceed to debate without any clear idea what final bill they will eventually vote on. I will say more about the process in a moment. But first I want to urge you to join the Insure PA / Protect Our Care phone bank to ask people in those states with Senators who are unsure about their position to call those Senators and ask them to vote no. (You can… Continue reading

It Couldn’t Be Fixed: Policy and Politics in the Republican Health Care Bill

Now that the Senate Republican effort to repeal and replace the Affordable Care Act has failed, let’s take a step back and understand why no bill based on the Republican approach to health care could have been fixed enough to reduce the pain to levels acceptable to a majority of Republicans in Congress, let alone to the American people. The basic design of the bill was deeply flawed from the perspective of anyone who thinks that America has a responsibility to guarantee quality, affordable health care to all. The design only made sense if one, instead, seeks a politically palatable way to reject that responsibility and reduce federal health care spending in order to cut taxes on large corporations and the rich. What started as a bill to repeal the Affordable Care Act (ACA) became a bill to partly repeal the health insurance regulations and subsidies for insurance purchased in… Continue reading

Are the Republicans Ready to Gut Higher Education to Avoid a Severance Tax on Natural Gas Drilling?

As we enter the third week of an impasse over funding the 2017-2018 Pennsylvania state budget, an astonishing possibility has come into view: the House Republicans, led by Speaker Mike and Turzai and Majority Leader Dave Reed, appear to be prepared to block funding for the four state-related universities – Penn State, University of Pittsburgh, Temple University and Lincoln University – rather than agree to the Governor’s demand that they raise $600 to $800 million in new recurring revenues. Governor Wolf and the Republican-led legislature have apparently agreed to a number of one-time revenue measures to close the budget deficit – proposals like borrowing from other funds or selling licenses for new gaming sites – that only bring in revenues in one year. But the Republicans, particularly in the House, appear unwilling to agree to Governor Wolf’s insistence that the fiscal health of the commonwealth requires new recurring tax revenues… Continue reading

PA House GOP Stealth Attack on Medicaid

**UPDATE 7/11/17 – 4:45 PM** The House passed the bill through to the Senate 102-91. The Senate must again vote on the bill as amended PA House Republican leaders are trying to force Pennsylvania to seek federal waivers for our Medicaid program that would establish requirements that Medicaid recipients either be working or searching for a job and that that ask them to pay premiums or higher co-pays for their insurance. These ideas were part of Governor Corbett’s plan to expand Medicaid, which Governor Wolf rightly rejected. Now, the House will vote on these terrible provisions as part of the budget code (instructions for implementing the budget) for 2017-18 after it was added as an amendment in the House Rules Committee. What’s the objection to work requirements or premiums for Medicaid? First, support for a work or job search requirement is based on a misconception that there are a large… Continue reading

S&P to PA: Snap Out of It

Remember when, in the movie Moonstruck, the character played by Nicholas Cage tells the character played by Cher that he loves her. And she slaps him in the face and says, “Snap out of it?” Well that’s what the financial firm Standard and Poor’s just told the state of Pennsylvaniayesterday. They, once again, threatened to downgrade our bonds – forcing up the interest rates we pay – if we don’t get our fiscal house in order. They are telling our General Assembly to: Snap out of our reliance on one-year revenues, like licenses for gaming or liquor sales to “balance” our budget. Snap out of our willingness to move money from one fund to another to “balance” our budget. Snap out of our penchant for over-estimating revenues to “balance” our budget. Snap out of our tendency to shift spending from one year to another to “balance” our budget. And most… Continue reading

Senate Bill Raises Marketplace and Employer-based Premiums for Most Pennsylvanians

We have been focused recently on the impact of the Senate health care bill on Medicaid, mainly because the dangers of both the House and Senate bills to Medicaid have not been well known, and because the Senate bill is far worse than the House bill. So, in this and next post I want to remind you that if you purchase health insurance on the exchanges / marketplaces or receive it from your employer, the Senate bill is bad for you as well. The following table looks at the impact of the Senate bill on the average premiums Pennsylvanians at different ages and income levels will pay for silver plans on the marketplace. For all but 35 year olds at 300% of the poverty, premiums will be higher than under the ACA. For Pennsylvanians who have lower incomes or are older, the premium increases are substantial. For forty-five year olds… Continue reading

How Dumb Does Senator Toomey Think We Are?

Marc Stier | 07/02/2017 Blog I’m not just a practitioner of political rhetoric, but also a connoisseur of it. I can appreciate a good argument and a well-turned phrase put forward by our ideological opponents. And, rather than get disturbed by what the other side says, I take their best work as a challenge. But what truly does get me angry is when our opponents not only lie, but do so with arguments that are insulting to the intelligence of the people we are trying to influence – the citizens of Pennsylvania and America. So it’s no wonder that I find what Senator Toomey says about the impact of the Senate health care bill on Medicaid so utterly offensive. When I hear him speak on the plan he played a major role in devising, I can’t help but wonder, ‘how dumb does Toomey think we are?’  I can quickly answer: Not… Continue reading

The Republicans of My Youth Didn’t Borrow to Balance Budgets

First of two pieces of why I miss the Republicans of my youth.  There are times when I miss the old-fashioned Republicans of my youth, in the small-town America in which I grew up, about 40 miles over the Pennsylvania border in rural New York. Those mostly Protestant Republicans were the bankers, the insurance agents, the ministers, as well as many of the doctors and lawyers. They were a little stiff and formal in their suits and ties, horn-rimmed glasses, grey suits and deep voices—and the hats they all wore in the early 60s. They were men (no women were among them) who carried themselves with an easy dignity and a concern for propriety. Some of them were no doubt louts or adulterers behind closed doors. Some drank too much in private—or sometimes even in public in the evening. Some may have cheated in business or on their taxes. But… Continue reading

First Look at the 2017-18 State Budget

While we will need some time to analyze the details of the budget that the House and Senate will pass today, our preliminary view is that it is, as we had expected from the beginning of the year, an austere budget that does not really address the deep public investment deficit of the state, but it certainly could have been far worse. Given that the General Assembly seems utterly unwilling to raise revenues to meet public needs, negotiations by the leaders of the legislature and Governor Wolf have led to a budget that still takes some small steps forward. We caution, however, that we have only half of a budget so far. No plan has been passed to secure the revenues necessary to balance the budget. And, as we will point out later today in more detail, we are deeply troubled by reports that the deficit for the year that… Continue reading

State As Well As Federal Republicans Go After Medicaid

At both the state and federal level, Republican Party leaders seem to be on the warpath against Medicaid. Thankfully, rank and file Republicans in both legislatures and the public seem to be pushing back against them, as long, bi-partisan support for Medicaid continues. At the federal level, both the Senate and House Republican health care bills call for drastic cuts to not just the Medicaid Expansion but traditional Medicaid. The cuts they propose will lead to tens of thousands of seniors, children, disabled people and working adults losing health care. Thankfully some Republicans are pushing back against the proposal. Four Pennsylvania Republican members of the U.S. House delegation voted against the House bill. And while Senator Toomey is pushing to make the Senate bill worse, so far he hasn’t convinced all his Republicans colleagues to join him. In Pennsylvania, Republican leaders want to seek federal waivers for our Medicaid program… Continue reading