Medicaid

Obamacare Marches On, Step by Step

THE AFFORDABLE CARE ACT, which has now been the law of the land for five years, is beginning to reshape the national landscape in significant ways.

According to a New York Times analysis of the ACA’s first enrollment period, about 10 million additional people gained insurance in 2014. Many of them fall into demographic groups that have historically struggled to access coverage, such as low-income Americans, people of color, and women. Ultimately, President Obama’s health law is slowly making the country more equal.

There are a few ways the ACA is accomplishing that goal. It has built-in consumer protections to ensure that insurance companies treat people more fairly. It’s created state-level marketplaces to give people new options for purchasing private plans. And it’s expanded the pool of people who are eligible for public coverage through the Medicaid program.

Health policy experts agree that adding more low-income people to the Medicaid rolls represents one of the biggest successes of the ACA so far. According to the Urban Institute, a nonprofit research group, the states that agreed to expand their Medicaid programs—27 so far, plus the District of Columbia—have seen about a 40 percent drop in their uninsured rates.

“This has been a lifesaver for me. I hadn’t seen a doctor for 11 years,” Marc Sigoloff, a freelance writer in Illinois, told me. Sigloff signed up for Medicaid and subsequently discovered he had a brain tumor.

Carol Fisher Hardaway is now covered through Maryland’s Medicaid program. She told me she has a newfound peace of mind since she doesn’t need to worry about affording the treatment for her multiple sclerosis. Her reduced stress, in fact, is quantifiable. When we talked in October, she had just found out her blood pressure was at a healthy level for the first time in nearly 15 years.

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Tough To Connect Dots On Ligamfelter's Medicaid Position

As Jim Wallis, a New York Times bestselling author, public theologian, speaker, and acclaimed commentator on ethics and public life, has frequently noted: “Budgets are moral documents.” The moral aspects of Virginia’s budget have been addressed by the various faith communities in the Commonwealth and have been persuasively articulated by the Catholic bishops of Virginia in their statement (April 11, 2014) on expanding Medicaid: “Our advocacy is informed by...teaching that, first, everyone has the right to life, and second, healthcare is a right – not a privilege – that flows from the right to life itself… Virginia should start accepting federal money that can provide nearly 400,000 of its poorest residents the health insurance they currently lack and desperately need.”

Better Together

LIKE THE 2013 Moral Monday protests—which over the course of last spring and summer saw more than 900 people arrested for peaceful civil disobedience, February’s Moral March was notable for the diversity of races, ages, causes, and faiths represented. This is the fruit of long-term coalition-building among progressive groups and individual activists sparked by Rev. William Barber in late 2006 that resulted in the formation of the Historic Thousands on Jones St. People’s Assembly Coalition. This coalition, under the banner of the “Forward Together Moral Movement,” worked out of these established relationships, including significant church involvement, to organize the 13 Raleigh Moral Mondays and more than 25 local Moral Mondays statewide last year. The model seems to be spreading, with groups in Tennessee, Georgia, and South Carolina staging similar protests.

This movement has its work cut out for it—the voter suppression package that the North Carolina legislature passed last year is considered to be one of the harshest in the country. (The U.S. Justice Department has sued the state over the new law.) Lawmakers also cut the earned-income tax credit for 900,000 North Carolinians, cut tax rates for top earners while raising taxes on the bottom 95 percent, rejected Medicaid expansion, cut pre-K for 30,000 kids, have undermined environmental protection enforcement, and made it harder to challenge death sentences even if racial bias in a trial could be proved.

But the Moral movement is gearing up for 2014 and beyond—hoping to place young organizers in counties across North Carolina to engage in voter mobilization and education as part of “Freedom Summer 2014,” challenging the voting restrictions in court, and planning more opportunities for peaceful resistance. —The Editors

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Want to Win the War on Poverty? For the Sake of the Most Vulnerable, Let's Work Together

Created by Brandon Hook/Sojourners. Photos: Nolte Lourens/Shutterstock and bikeriderlondon/Shutterstock

The only way to win the “war on poverty” is for liberals and conservatives to make peace — for the sake of the poor. That would be the best way to mark the 50th anniversary of the war on poverty, declared by President Lyndon Johnson in his January 1964 State of the Union address. Making peace means replacing ideologies with solutions that actually solve the problems of poverty. With both Republicans and Democrats speaking out on poverty this week, and the recession slowly receding this should be an opportunity to find the focus, commitment, and strategies that could effectively reduce and ultimately eliminate the shameful facts of poverty in the world’s richest nation.

For any proposal, the basic question must be whether it helps more people and families rise out of poverty and realize their dreams. This means setting aside political self-interest and thinking beyond our too often inflexible ideologies.

Resigning From the AARP

AARP card, via Durham Moose / Flickr

AARP card, via Durham Moose / Flickr

I’m a senior. And I’m mad. In fact, I am resigning from the AARP.

The America Association of Retired People has about 38 million members and is one of the biggest, most influential lobbies in Washington. It has done many good things for older Americans, but in some important ways it is just plain wrong — selfish and guilty of intergenerational injustice.

As Fareed Zakaria pointed out is a 2011 column in Time, the federal government spends about $4 on every senior over 65 and only $1 on every child under 18. “That is a statement about our priorities,” Zakaria rightly says, “favoring consumption over investment, the present over the future, ourselves over our children.” Partly as a result the poverty rate for children (22 percent) is much higher than that for seniors (9.7 percent). 

The Consequences of Opting Out of Medicaid

Writing for The Nation, Bryce Covert examines how state-level opt outs of Medicaid expansions will affect women:

"The Medicaid expansion is a crucial component of the law’s overall goal of extending coverage to over 30 million uninsured Americans by 2019, covering almost half of the total number of people the bill promised to insure. Originally, the law included a provision that the federal government could take away all of a state’s Medicaid funding if it refused to go along with the expansion, which all but ensured participation. But the Court ruled that such a maneuver was unconstitutional. Just a few days after the decision was announced, seven Republican governors said they would flat-out reject the money to expand Medicaid rolls, with at least eight more looking to follow suit. More have said no since then.

This could create a no-man’s land for those who earn less than 100 percent of the federal poverty line, making them ineligible for tax subsidies to help them buy insurance, but don’t qualify for their state’s (unexpanded) Medicaid program. These Americans are surely struggling to get by, but not quite enough to get health coverage promised to those above and below them."

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When Grandma Can’t Eat

Image: OneSmallSquare / Shutterstock.com

Image: OneSmallSquare / Shutterstock.com

As Congress continues to wage a war of political ideology over budget cuts and entitlement programs, they need to remember that these abstract policy debates have real consequences for millions of Americans. 

Deciding between funding programs that feed the hungriest Americans versus giving tax breaks for the wealthiest Americans is not really a choice, at least not when it comes to the demands of the Gospel.

The Morning News: Monday, Dec. 19, 2011

North Korean Leader’s Nukes, Threats Stoked World Fears; Extension of Tax Cut Stalls in House as GOP Objects; Christian Group Recalls Pink Bible; For Times Such As These: The Radical Christian Witness of the New Monastics; ‘People’s year’ gives hope that the tide is turning; Speaker targets immigration law; Vaclav Havel, Czech’s Velvet Revolution Leader, Dead at 75; Paul Leads Iowa, Gingrich drops to 3; Mitt Romney’s Dream World: Cutting Billions Out of Medicaid Will Not 'Hurt the Poor'.

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