Health Care

Obamacare Reality Check

— submitted by Rich Dunn, RNDC 2nd Vice Chair

If you’re asked about Obamacare, use it as an opportunity to show how much difference progressive change can make. Open enrollment began one year ago, on October 1st, 2013. The websites had a rocky rollout, but 10.3 million Americans who had no health insurance a year ago now have coverage. Competition has increased – there are now 25% more insurance companies offering policies in the health insurance market. United Healthcare, the market leader, will be offering policies on 25 state exchanges in 2015, double the number in 2014. The system was designed to foster competition, and that is exactly what is starting to happen.

According to the Republicans, the ACA was going to be a government takeover of heathcare. But you wouldn’t know that from how private sector insurers have been doing on the stock market. United Healthcare’s stock is up 16%, Humana’s is up 34%, Aetna’s 22%, Cigna’s 13% and Wellpoint’s a whopping 37%. Some government takeover that turned out to be.

On top of that, 8.2 million seniors have saved over $11.5 billion, money that went right back into the economy. Republicans predicted that Obamacare would send costs through the roof, but between 2010 and 2013 health care costs have only risen at an annual rate of 1.1%, which is the slowest rate of increase of any three year period on record and below the overall rate of inflation.

Hospitals are expected to save $5.7 billion dollars this year alone in uncompensated health care costs. Republicans kept saying that all people without insurance had to do was go to the emergency room, but as usual they never mentioned who was supposed to pick up the tab – the hospital, of course. Thanks to Obamacare, that’s now far less of a problem. Most of that $5.7 billion in hospital savings happened in states like Nevada that opted to expand Medicaid. The 23 Republican states that refused Medicaid expansion are seeing a wave of hospital mergers and closures thanks to the rising cost of uncompensated care.

The next open enrollment period begins on November the 15th, and even though there may be more website glitches, it is bound to go a lot smoother this time around. You may have noticed that the Republicans have stopped talking about repealing Obamacare after more than 50 attempts, and that’s because it’s working. It doesn’t solve the long term cost problem – only healthier lifestyles can do that – but at least fewer Americans will be at needless risk because they can’t afford to see a doctor when they get sick.

And don’t forget that insurance companies can no longer drop you from coverage because you get sick. They can no longer refuse to sell you coverage because of a pre-existing condition. Women can now get free breast cancer screening. The “donut hole” for senior meds is being closed. Children can now stay on their parents’ policies to the age of 26. We’ve also seen the end of lifetime limits to insurance reimbursements.

The rate of uninsured Americans has already dropped from 21% to 16%, which is pretty impressive progress considering the level of Republican obstruction at all levels of government. Had that obstruction not occurred, we would now have more like 20 million newly insured Americans instead of just 10.3 million.

Our friend Mark Amodei supported every single attempt to repeal or delay the implementation of the Affordable Care Act, something voters can’t be reminded of too often. Amodei has been part of the problem from day one, and it’s a little late for him to strike a pose as a bipartisan pragmatist who stays above the fray. It’s time for him to go!

4.683 Million Unanswered Questions in Halbig

Appeals will continue, but let’s take the Halbig decision at face value. How much will this decision cost the working poor? The amount varies with income and other variables, but for a 40 year old individual making $30,000 a year, the tax credit was estimated at $1345 (KFF estimate here). Retroactive tax bills under Halbig will be significant and everyone impacted will have trouble paying for health insurance going forward (about 57% of exchange participants were previously uninsured, according to a KFF survey).

How many people will be hurt?

Read more here at “The Incidental Economist” ….

#ItsNotUpToThem Week

— Roberta Lange, Nevada State Democratic Party Chair

A few weeks ago, the United States Supreme Court issued a backwards ruling that allows for-profit corporate CEOs to make medical decisions that should be made between a woman and her doctor.  That’s right – in the year 2014, the Supreme Court thinks female employees’ healthcare decisions should be made in a corporate boardroom, not a doctor’s office.

This week, the United States Senate will vote on legislation to address the Supreme Court’s ruling and ensure women who work at for-profit corporations have access to reproductive healthcare.  While Democrats like Senator Reid, Reps. Dina Titus and Steven Horsford, and Erin Bilbray support ensuring women have access to reproductive healthcare, Republicans like Dean Heller and Joe Heck have consistently voted to restrict women’s access to contraception.

In support of the Senate bill, Nevada Democrats are launching #ItsNotUpToThem week.  All week we will be highlighting how dangerous the Republican agenda is for the health of Nevada women.  Because whether it’s Mark Hutchison leading the charge to go back to a time where private insurance companies could treat being a woman as a pre-existing condition, or Joe Heck voting to weaken the Violence Against Women Act, it’s time we send a message to Nevada Republicans that women’s healthcare decisions aren’t up to them or corporate bosses.

Sign your name here to tell Republicans it’s 2014, not 1914.    


Please note that Roberta mentioned Candidate Erin Bilbray who is running agains Rep. Joe Heck, but failed to mention Candidate Kristen Spees who is running against Rep. Mark Amodei to represent those of us who are unfortunate enough to live in NV-Congressional District 2!

Think Supreme Court’s Burwell v. Hobby Lobby ruling was just about birth control? Think again!

— Anthony Romero, ACLU Action team

HobbyLobby01

Immediately after the Hobby Lobby ruling, Rick Warren and other high-profile religious leaders began lobbying the Obama administration. Their demand? A religious exemption from his executive order which would ban federal contractors from discriminating on the basis of sexual orientation or gender identity. This is not about freedom of religion—it’s about corporations using religion as a license to discriminate with taxpayer dollars.

This executive order is the next battleground between those clamoring for exemptions and those, like us, who believe that religious liberty shouldn’t be an excuse to impose your beliefs on others. While we can’t change the Supreme Court’s ruling, we can call on Obama to resist the pressure from the religious right.

Urge Obama to protect LGBT workers. Let him know we don’t support giving federal contractors the legal right to discriminate.

The Court’s decision created the potential for far-reaching, discriminatory ramifications. In their ruling, they set a dangerous precedent, sanctioning discrimination against women under the guise of religious liberty. Justice Ruth Bader Ginsburg said it best: “the court, I fear, has ventured into a minefield.”

Just yesterday, the ACLU withdrew support for the Employment Non-Discrimination Act because of a loophole that would grant religiously affiliated organizations free rein to engage in workplace discrimination against LGBT people–the very thing ENDA is intended to prevent.

There is a clear line connecting the Court’s ruling about contraception and the hiring and firing of LGBT employees. That line is allowing bosses to use their personal religious beliefs to discriminate against their employees.

If tens of thousands of us speak out against this today, we can help Obama resist the mounting pressure from religious groups seeking the right to discriminate.

Tell Obama not to water down his landmark anti-discrimination executive order by including religious exemption.

Our bosses’ beliefs shouldn’t impact our rights as an employee. Let’s stop this before the floodgates open. Sign our petition today.

Corporate Rights Trump Women’s Health in Hobby Lobby Ruling

‘This ruling goes out of its way to declare that discrimination against women isn’t discrimination.’

- Lauren McCauley, staff writer at Common Dreams

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Defenders of women’s health and reproductive freedom are reacting with anger to the U.S. Supreme Court’s decision on Monday which ruled that an employer with religious objection can opt out of providing contraception coverage to their employees under the Affordable Care Act.

Writing for the majority side of the 5-4 decision in Burwell v. Hobby Lobby, Justice Samuel Alito argued that the “the HHS mandate demands that they engage in conduct that seriously violates [employers'] religious beliefs.”

Rights advocates were quick to condemn the court’s decision.

“Today’s decision from five male justices is a direct attack on women and our fundamental rights. This ruling goes out of its way to declare that discrimination against women isn’t discrimination,” said Ilyse Hogue, president of NARAL Pro-Choice America.

“Allowing bosses this much control over the health-care decisions of their employees is a slippery slope with no end,” Hogue continued. “Every American could potentially be affected by this far-reaching and shocking decision that allows bosses to reach beyond the boardroom and into their employees’ bedrooms. The majority claims that its ruling is limited, but that logic doesn’t hold up. Today it’s birth control; tomorrow it could be any personal medical decision, from starting a family to getting life-saving vaccinations or blood transfusions.”

Ninety-nine percent of sexually active women in the U.S. use birth control for a variety of health reasons, according to research by women’s health organizations.

“The fact of the matter is that birth control is a wildly popular and medically necessary part of women’s health care,” said Nita Chaudhary, co-founder of UltraViolet, a national women’s advocacy organization.Chaudhary adds that despite it’s clear necessity for the reproductive health of the majority of women, one in three women have struggled at some point to afford birth control.

Monday’s ruling focuses specifically on companies that are “closely-held,” which analysts report covers over 90 percent of businesses in the United States.

The dissenting opinion, penned by Justice Ruth Bader Ginsburg and supported by Justice Sonia Sotomayor and mostly joined by Justices Elena Kagan and Stephen Breyer, acknowledges that the decision was of “startling breadth” and said that it allows companies to “opt out of any law (saving only tax laws) they judge incompatible with their sincerely held religious beliefs.”

The opinion was based largely on the Religious Freedom Restoration Act (RFRA), which provides that a law that burdens a person’s religious beliefs must be justified by a compelling government interest.

“There is an overriding interest, I believe, in keeping the courts ‘out of the business of evaluating the relative merits of differing religious claims,'” Ginsburg adds, concluding: “The Court, I fear, has ventured into a minefield.”

Echoing Ginsburg’s concern, Rev. Barry W. Lynn, executive director of Americans United for Separation of Church and State called the ruling “a double-edged disaster,” saying it “conjures up fake religious freedom rights for corporations while being blind to the importance of birth control to America’s working women.”

Similar reactions were expressed on Twitter following the news. Summarizing the crux of the decision, NBC producer Jamil Smith wrote:

The Hobby Lobby decision means that in terms of personhood, corporations > women. And Christianity > everyone else.

— Jamil Smith (@JamilSmith) June 30, 2014

Others, joining Ginsburg’s outrage that now “legions of women who do not hold their employers’ beliefs” would be denied essential health coverage, expressed their opinions under the banner “#jointhedissent.”

#jointhedissent Tweets

The majority opinion leaves open the possibility that the federal government can cover the cost of contraceptives for women whose employers opt out, leaving many to look to the Obama administration for their next move.

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If This is What it Means to be “Conservative” — I’m Proudly a Bleeding Heart Liberal

Clearly, members of the GOP in the House are all about looking for ways to handicap ANY organization tasked with performing regulatory actions that might impede their ideological plans for the future of the United States of Republica.  A case in point is this recent  press release from Representative Amodei’s office.  My comments are in blue italics at various points throughout his release.  Some original text has been highlight in RED for emphasis.

Amodei: Appropriations Financial Services bill reins in IRS, ACA and Dodd Frank

Wednesday June 18, 2014

FOR IMMEDIATE RELEASE                                 Contact:    Brian Baluta, 202-225-6155

WASHINGTON, D.C. – The House Financial Services and General Government Appropriations Subcommittee today passed its fiscal year 2015 bill, which would provide annual funding for the Treasury Department, the Judiciary, the Small Business Administration, the Securities and Exchange Commission and several other agencies.

The bill totals $21.3 billion in funding for these agencies, which is $566 million below the fiscal year 2014 enacted level and $2.3 billion below the president’s request for these programs.The legislation prioritizes programs critical to enforcing laws, maintaining an effective judiciary system and helping small businesses, while targeting lower-priority or poor-performing programs – such as the Internal Revenue Service – for reductions.

Well now, that makes just a ton of sense.  IRS is tasked with collecting revenue necessary for the operation of various government operations … so let’s under fund them so we can then make a scapegoat of them when they can no longer effectively perform their regulatory and tax-collecting functions.

“Every day, I am asked, ‘Why don’t you do something?’ This bill ‘does something’ by removing funding from executive agencies that have become political tools of the administration,” said Amodei.   

Bill highlights:

Internal Revenue Service (IRS)– Included in the bill is $10.95 billion for the IRS – a cut of $341 million below the fiscal year 2014 enacted level and $1.5 billion below the President’s budget request. This will bring the agency’s budget below the sequester level and below the level that was in place in fiscal year 2008. This funding level is sufficient for the IRS to perform its core duties, including taxpayer services and the proper collection of funds, but will require the agency to streamline and make better use of its budget.

Interesting! They continually carp about the IRS not providing for an EMAIL BACKUP strategy as part of their business plan. Server BACKUPs are NOT FREE!  How much more will they stop BACKING UP because they no longer have sufficient funding to do their tax collection duties, let alone ancillary functions like BACKUPS, SYSTEM UPDATES, SOFTWARE IMPROVEMENTS, etc.?

In addition, due to the inappropriate actions by the IRS in targeting groups that hold certain political beliefs, as well as its previous improper use of taxpayer funds, the bill includes the following provisions:

Here we go again, perpetuating the falsehood that ONLY right-wing political groups were scrutinized, when it was actually liberal groups that were denied with some that had already been given tax-exempt status seeing that status revoked (e.g., EmergeAmerica affiliated groups).  NO politically-focused groups should be receiving TAX-EXEMPT 501(c)(4) status, PERIOD!

A prohibition on a proposed regulation related to political activities and the tax-exempt status of 501(c)(4) organizations. The proposed regulation could jeopardize the tax-exempt status of many non-profit organizations and inhibit citizens from exercising their right to freedom of speech, simply because they may be involved in political activity.

Sorry, but I don’t get to deduct my “freedom of speech” contributions to political endeavors.  Thus, NO politically-focused organizations should be able to have a free of tax right to free speech at the American Taxpayer’s expense!

A prohibition on funds for bonuses or awards unless employee conduct and tax compliance are given consideration.

A prohibition on funds for the IRS to target groups for regulatory scrutiny based on their ideological beliefs.

Congress passed a law that clearly states that to be considered 501(c)(4) organization, your activities must be EXCLUSIVELY-FOCUSED on “Social Welfare” activities.  Politically-focused activities are NOT social-welfare activities and thus, it IS the IRS’s responsibility to scrutinize and deny tax-exempt status to ANY organization (conservative, liberal or otherwise) not meeting that exclusivity provision.

A prohibition on funds for the IRS to target individuals for exercising their First Amendment rights.

More BS related to the previous proviso — the IRS is NOT prohibiting ANYONE from exercising their free speech.  The IRS is merely and rightfully determining whether a group is a group exclusively devoted to providing SOCIAL-WELFARE opportunities/activities and thus, whether that group is entitled to TAX-EXEMPT status!

A prohibition on funding for the production of inappropriate videos and conferences.

Really?  Oh, please, pray tell, what “inappropriate videos” might it be that the IRS is producing?

A prohibition on funding for the White House to order the IRS to determine the tax-exempt status of an organization.

Again, if you want to allow any organization wanting to conduct EXCLUSIVELY politically focused activities to never have to pay taxes, well then, you need to REPEAL the law that PROHIBITS them from being tax exempt!  You cannot have a LAW on the books that says one thing and then prohibit the IRS, which is responsible for administering that section of the law, from enforcing it!

A requirement for extensive reporting on IRS spending.

Affordable Care Act (ACA) –The bill also includes provisions to stop the IRS from further implementing ObamaCare, including a prohibition on any transfers of funding from the Department of Health and Human Services to the IRS for ObamaCare uses, and a prohibition on funding for the IRS to implement an individual insurance mandate on the American people.

Well, let’s see.  We elected President Obama and a Democratic Congress to get health care reform. Then, the Republican propaganda machine bought a Republican House.  Despite their efforts to gerry-rig the system, we still re-elected President Obama. Health care reform is one of the hardest things we’ve ever worked on. But no matter, they just keep trying to either LIE ABOUT REPEAL or DEFUND access to healthcare for the American People despite its need or popularity.

Securities and Exchange Commission (SEC)– Included in the bill is $1.4 billion for the Securities and Exchange Commission (SEC), which is $50 million above the fiscal year 2014 enacted level and $300 million below the President’s budget request. The increase in funds is targeted specifically toward critical information technology initiatives. The legislation also includes a prohibition on the SEC spending any money out of its “reserve fund” – essentially a slush fund for the SEC to use without any congressional oversight.

In addition, the legislation contains requirements for the Administration to report to Congress on the cost and regulatory burdens of the Dodd-Frank Act, and a prohibition on funding to require political donation information in SEC filings.

My my, lookie here — looks like an increase in funding.  But wait, isn’t this the organization that’s supposed to regulate Wall Street?  It’s a shame that the increase in funding is just for a bit of information technology so they can determine how their GOP-Donor base is affected by any sort of regulation.  It’s also despicable that they’ve included a proviso that PROHIBITS any reporting of information as to Corporate political donations.  If you and I donate, our freedom of speech is broadcast for all to see … but the Republican Donor-base has a special privileged secreted freedom of speech.  Apparently the Republicans believe their Donors are free to speak with their Dollars, but the general American public is underserving of being able to speak with their dollars in response.

Consumer Financial Protection Bureau (CFPB)– The bill includes a provision to change the funding source for the CFPB from the Federal Reserve to the congressional appropriations process, starting in fiscal year 2016. Currently, funding for this agency is provided by mandatory spending and is not subject to annual congressional review. This change will allow for increased accountability and transparency of the agency’s activities and use of tax dollars. The legislation also requires extensive reporting on CFPB activities.

The Republicans have done EVERYTHING conceivably possible to handicap, repeal, defund and decapitate the Consumer Financial Protection Bureau (CFPB).  This is yet their latest attempt to defund and cripple any and all Consumer financial protection at the behest of their Donor-base.

An Anti-Shackling Wake-Up Call

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Anti-shackling protestors in NY in 2009

— By Heather Schultz

Female incarceration rates are growing twice as fast as male incarceration rates and the prison system remains decades behind on women’s reproductive rights. The majority of states do not protect incarcerated women against shackling procedures, where they are forced to give birth while physically restrained. This unnecessary practice is both inhumane and humiliating as it involves the placement of shackles and handcuffs around a woman’s ankles and/or wrists, as well as chains around their stomach throughout labor and delivery. Those in favor of shackling also argue that it is necessary to prevent incarcerated women from harming themselves and others, but in fact, the majority of incarcerated women are nonviolent offenders.

This month, Massachusetts and Minnesota enacted laws that prohibit the shackling of incarcerated women during labor, childbirth, and recovery. They join 19 other states that have adopted anti-shackling legislation. As the prison system gradually learns to apply a gender-sensitive lens, the unconstitutional and barbaric practice of shackling must be abolished entirely at the local, state, and federal levels.

Read more here.

Letting Employers Off the Hook

— by Rich Dunn, NVRDC 2nd Vice Chairman

H.R. 2575, the “Save American Workers Act” (which is a bill, not an act), would change the definition of “full time” under the ACA from 30 to 40 hours, allowing employers to evade the health care mandate entirely simply by lowering hours worked to 39½. Needless to say, this bill has zero chance of ever becoming law while Barack Obama is president.

H. R. 2575:  To amend the Internal Revenue Code of 1986 to repeal the 30-hour threshold for classification as a full-time employee for purposes of the employer mandate in the Patient Protection and Affordable Care Act and replace it with 40 hours.
1. Short title
This Act may be cited as the Save American Workers Act of 2014.
2. Repeal of 30-hour threshold for classification as full-time employee for purposes of the employer mandate in the Patient Protection and Affordable Care Act and replacement with 40 hours
(a) Full-Time equivalents
Paragraph (2) of section 4980H(c) of the Internal Revenue Code of 1986 is amended—
(1) by repealing subparagraph (E), and
(2) by inserting after subparagraph (D), the following new subparagraph:
(E) Full-time equivalents treated as full-time employees
Solely for purposes of determining whether an employer is an applicable large employer under this paragraph, an employer shall, in addition to the number of full-time employees for any month otherwise determined, include for such month a number of full-time employees determined by dividing the aggregate number of hours of service of employees who are not full-time employees for the month by 174.
(b) Full-Time employees
Paragraph (4) of section 4980H(c) of the Internal Revenue Code of 1986 is amended—
(1) by repealing subparagraph (A), and
(2) by inserting before subparagraph (B), the following new subparagraph:
(A) In general
The term full-time employee means, with respect to any month, an employee who is employed on average at least 40 hours of service per week.
(c) Effective date
The amendments made by this section shall apply to months beginning after December 31, 2013.
Passed the House of Representatives April 3, 2014.

It’s not clear that this bill would necessarily make a lot of difference in the real world, since 98% of large employers already provided health coverage to their full time employees before the ACA imposed the mandate, but it has become so expensive that if one company did it, others might follow to stay competitive.

But even without this change, some companies might decide to just pay the penalty and dump their employees on the exchange, where the subsidies would (like food stamps) amount to just another layer of corporate welfare. The penalty (around $2,000 per employee) is far lower than the cost of health care (around $10,000 per employee).

To keep their employees whole, companies dropping health coverage could increase wages by the amount of their subsidized exchange premiums. Or even a little more. In that scenario, both the employer and the employee would come out ahead, but exchange premiums would inevitably rise to pay for the subsidies. This is an inherent flaw in the ACA. Employer penalties are way too low.

On April 3rd, H.R. 2575 (raising the “full time” threshold to 40 hours) passed House 248 to 179, with these 17 “Republicrats” voting Aye:

Aye   D   Barber, Ron AZ 2nd
Aye   D   Sinema, Kyrsten AZ 9th
Aye   D   Bera, Ami CA 7th
Aye   D   Costa, Jim CA 16th
Aye   D   Murphy, Patrick FL 18th
Aye   D   Bishop, Sanford GA 2nd
Aye   D   Barrow, John GA 12th
Aye   D   Lipinski, Daniel IL 3rd
Aye   D   Schneider, Bradley IL 10th
Aye   D   Delaney, John MD 6th
Aye   D   Peterson, Collin MN 7th
Aye   D   McIntyre, Mike NC 7th
Aye   D   Schrader, Kurt OR 5th
Aye   D   Gallego, Pete TX 23rd
Aye   D   Cuellar, Henry TX 28th
Aye   D   Matheson, Jim UT 4th
Aye   D   Rahall, Nick WV 3rd

Rep. Amodei and the GOP’s House of Cuts

HHS announces important Medicare information for people in same-sex marriages

Dept. of Health & Human Services

04/03/2014

Today, the Department of Health and Human Services (HHS) announced that the Social Security Administration (SSA) is now able to process requests for Medicare Part A and Part B Special Enrollment Periods, and reductions in Part B and premium Part A late enrollment penalties for certain eligible people in same-sex marriages. This is another step HHS is taking in response to the June 26, 2013 Supreme Court ruling in U.S. v. Windsor, which held section 3 of the Defense of Marriage Act (DOMA) unconstitutional. Because of this ruling, Medicare is no longer prevented by DOMA from recognizing same-sex marriages for determining entitlement to, or eligibility, for Medicare.

Read more about today’s announcement here …