Issue 3: Obamacare and the Dakota Access Pipeline
Salutations Runners,
I hope you all had a wonderful Thanksgiving. Last week’s letter can be read here. This week we’re going to talk about the Affordable Care Act (ACA) aka Obamacare and the appalling situation going on in Standing Rock, North Dakota.
Topic 1: The Affordable Care Act and Medicare
I think it’s really important that we all keep reminding ourselves of Donald’s 100 Day Plan. In the first newsletter, I made a plug for NPR’s factchecked version, which I am recommending again today. In the plan, Donald pledged to “5. Repeal and Replace Obamacare Act. Fully repeals Obamacare and replaces it with Health Savings Accounts, the ability to purchase health insurance across state lines, and let states manage Medicaid funds.” NPR’s factcheckers summarized that he will be able to do this pretty easily through a process known as “reconciliation”, which does not allow for a filibuster. Since that time, Donald has waffled a bit on his promise to fully repeal the ACA, saying that he thinks parts of it are good and should stay. He has specifically called out the provisions that allow children in their mid-20s to stay on their parents’ plans and one that forces insurers to cover those with pre-existing conditions as being positive. But:
Given the general principle that Obamacare is up for a major rehaul, what are the alternate plans presented by Republicans to take its place? When will the be implemented? What are their consequences? Well friends, I found all of this out for you so let’s break it down.
Among the most likely plans to replace the ACA is the one put forward by Paul Ryan. This was dubbed “Obamacare-light” by NPR. The biggest single change from the ACA to Ryan’s plan is the removal of the individual mandate, meaning people will no longer be required to have insurance. This is a staple — along with high-risk pools and the removal of prohibitions on buying insurance from different states — of the majority of Republican replacement plans.
Like Obamacare, people with pre-existing conditions could not be denied health care under Ryan’s plan…unless they let their insurance coverage lapse. In that case, they can be denied and may not be eligible again until the age of 65, when Medicare becomes available (if it still exists; more on that later). Ryan’s plan to help with this problem is something called a “high risk pool”, which is a special, government-subsidized coverage for hard to insure people such as those with chronic illnesses. High risk pools have been tried in 35 individual states and have failed in every single one of them for various reasons.
Conservatives have always wanted to push for high-deductible insurance plans so that people buying those plans will spend less from their paychecks up front, but have to pay for more for their own care later on. Ryan’s plan emphasizes health savings accounts or HSAs. HSAs are accounts that you can deduct from a paycheck to save up over the long term for health emergencies tax free. As you might expect, this is possible in reality only for the wealthy. If you have no money or not much money to spare to put into an HSA, it isn’t going to help you.
There is a lot for liberals to criticize in Ryan’s healthcare plan, from the high-risk pools to the emphasis on high-deductible plans. But we could do worse, and most conservative plans have the same features we won’t like but leave even more people uninsured. I encourage you to read the details for yourself.
Donald’s pick for Secretary of Health and Human Services, the agency which oversees the ACA, Medicare, and Medicaid, was announced this week. That pick was Georgia Representative Tom Price, and he could not be a more obvious choice for someone who is dead serious on replacing Obamacare. Price’s plan is one of the other replacement options for the ACA, called the “Empowering Patients First Act”, and it is significantly worse for the very sick than Ryan’s plan. This plan would call for a full repeal of the ACA’s Medicaid expansion, which currently covers millions of low income Americans, with no replacement whatsoever. It also does not completely ban, only restricts, discrimination against people with pre-existing conditions. Additionally, the tax credits proposed under the Empowering Patients proposal would be based on age, rather than on income as under Obamacare. This proposal completely baffles me because it means millionaires will get the same tax credits for health insurance as those on welfare as long as they’re both in the same age group.
At this point, it is not a question of whether or not the Affordable Care Act will be replaced, it’s when and how. In other words, which plan will the GOP pick? The major points of debate, according to Sarah Kliff at Slate (who wrote many of the articles I used for research on this topic), are likely to be:
- Should Republicans save Medicaid expansion in some way? As mentioned earlier, some Republican replacement plans do see a future for Medicaid expansion. And there might be support for this from within the Trump administration: Vice President-elect Mike Pence is among the 10 Republican governors who have expanded Medicaid in their own states. So Price’s plan could face some pushback in this space, particularly from legislators and governors worried about their constituents losing coverage.
- How generous should those high-risk pools be? Price envisions spending much less on the insurance plans for Americans with preexisting conditions than Speaker Ryan does.
- Will Republicans weather the political backlash to raising the costs of employer-sponsored insurance? The proposal to limit the tax exclusion for health insurance would amount to a significant price increase for those with the most generous health insurance plans. Employers will view it as a massive tax increase. Like Obamacare’s Cadillac tax, it would almost certainly face significant political backlash.
The idea of not replacing Obamacare with ANYTHING is somewhat laughable at this point. Republicans can’t afford to anger their constituents that use the ACA, of which there are over 20 million. There are a lot of other proposals floating around besides the two I just mentioned (that article there might be your must-read article from this section, FYI). So if Republicans aren’t able to agree on a replacement plan for some time, what will they do? They might try something called “repeal and delay”:
“Republicans could repeal Obamacare immediately but delay the actual dismantling of it for two or three years. They might get around to drafting a replacement plan during that time — or if they didn’t, they could just delay the effects of repeal indefinitely.”
This would cause periodic panic over the state of insurance markets — much like the state of panic induced by looming budget deadlines in today’s Congress — which would be repeatedly averted by Republicans voting to delay another six months or one year, repeat ad nauseum until they agree on a replacement. This tactic, however, has real world consequences for insurance markets and citizens in the meantime. Obamacare is made up of a network of private insurance companies in a pool of insurers offered to enrollees. Why would these private companies choose to stay in the pool when Obamacare has been repealed? If private insurers pull out of the marketplace, over 10 million people insured under the ACA will be without coverage at least until a replacement is enacted and possibly permanently, depending on what the replacement plan is. The only way to prevent this would be for Congress to subsidize the high risk cost for insurers to stay in the pool, which would be very expensive.
It isn’t just the ACA that is on the chopping block under Donald’s regime. Congressional GOPers have long had their eyes on Medicare and Medicaid. Though Donald himself never initially targeted those programs in his plans, in fact promising to protect Medicare during the campaign, there have been signs that he is being pushed in that direction by Ryan and others. His selection of Tom Price pretty much completely cements the new position that Donald is gunning for Medicare, as Price has already introduced a plan that would phase out Medicare within the first six months of 2017, avoiding a filibuster in the process. Republicans have been trying to turn Medicare into a voucher system for six years now, and this could be their moment. Republicans have also long wanted to pass Medicaid onto the states to handle. Medicare and Medicaid are *foundational* and long standing American health care programs that cover many vulnerable Americans. They are also extremely popular. What does that mean for us?:
“So what can liberals do in response? Using reconciliation means that Republicans can accomplish this entirely on their own. The only question is whether Democrats will make the idea so toxic that they threaten the job security of anyone in Washington who goes along with it … Every senior in every district in America should be aware of the GOP plan to destroy a health-care guarantee that has lasted for generations …
Democrats can take up the fight immediately, in the special elections that will arise as Trump fills out his cabinet. CIA director nominee Mike Pompeo’s seat in Kansas and Price’s in Georgia are pretty red, but seniors typically represent the largest voting bloc in these low-turnout races. In 2011, the last time Ryan made a serious push to privatize Medicare, Kathy Hochul won a right-leaning seat in upstate New York by making the race entirely about social insurance [emphasis mine]. This can be replicated, proving the concept that trying to dismantle programs Americans have paid into their entire working lives is political suicide.”
Watch out for these special elections and support the Democratic candidates. I will be keeping you up to date on them in this letter as well. You heard it here first (or you didn’t, whatever you informed person you): Kansas and Georgia special elections are coming up, with more to follow. Look out for Senators who are going to make this about healthcare (Joe Donnelly, a vulnerable Democrat in Indiana has already started).
And stay knowledgeable. Keep watch on the races in the states with the highest numbers of ACA enrollees (of which Florida is one). If you happen to end up at a town hall meeting for one of your reps, which I suggest you attend if at all possible in the next several years, get up and ask what their position is on the ACA and which plan they support to replace it and how. Tell them how many voting members of their state will lose their health insurance if they vote for that plan.
Furthermore, right now Paul Ryan has been conducting a survey where you do not have to speak to anyone and which takes literally 2 minutes to do, where you can register a favorable opinion of the Affordable Care Act. I haven’t been able to verify that the survey is still going on, because when I call I get a message that all circuits are busy. They could really just be busy, or the survey could be over, but it’s worth a shot anyway. Just follow these instructions:
If you would like to express your support for the Affordable Care Act, call 202–225–0600. There will be a couple moments of silence after it picks up, so just wait through this. When it gives you options, press 2 to weigh in on the ACA. You’ll hear a brief recording about HR-3762, Paul Ryan’s proposal to gut the ACA, and President Obama’s use of his veto power to stop it. Then, you will have a chance to indicate your opinion with the press of a button. Press 1 if you support the ACA/Obamacare.
Topic 2: Standing Rock and the Dakota Access Pipeline
I will allow the New York Times to summarize in brief the backstory of the Dakota Access Pipeline for me, because I am a Slytherin and I am soooo not above that sort of thing:
“The pipeline, all but built, is meant to ship crude oil from North Dakota to Illinois. Built almost entirely on private property, the pipeline crosses ancestral lands of the Standing Rock Sioux, passing less than a mile from the tribal reservation. Tribe members fear contamination of their drinking water and damage to sacred sites. They are trying to persuade the federal government to deny permits allowing the pipeline to cross the Missouri River near their reservation.”
To add more context to that, the original route of the pipeline passed near Bismarck, ND instead of through Tribal land, but the Army Corps of Engineers rejected that route due to, among other things, potential threats to the drinking water of Bismarck residents; so in short we are literally forcing unsafe water onto Native lands when it was already determined to be hazardous for “normal citizens”. No decision has been made as of today on the fate of the pipeline. The Army Corps of Engineers has said more input from the Tribe is needed before it will grant a permit, while the pipeline company has asked a Federal judge for the right to build anyway.
In the meantime, protesters at Standing Rock are being brutalized by a militarized police force: shot with water cannons and rubber bullets, maced, and otherwise harassed. Even worse, the Army Corps of Engineers recently issued a letter ordering the water protectors (as they call themselves) to evacuate their camps by December 5. The last time the protectors were moved it got pretty violent with over 140 arrests.
This is happening under President Obama’s watch. Donald actually has nothing whatsoever to do with the treatment of these peaceful protesters (although it appears he owns stock in the company that is building the pipeline because of COURSE he does, which will likely cause a lot of grief for the water protectors down the road); this is all on the Obama administration. Please call the White House at 202–456–1111 and ask President Obama to step in and tell the National Guard to stand down. He can also pressure the North Dakota Sheriff to pull back on militarized tactics. He has not really taken a firm stance on this, which is disheartening, to say the least, of a President I generally admire greatly.
You can also donate to the Standing Rock Sioux and their efforts. Activists have been saying that money, not goods, is the best option, despite many “gift registries” that are floating around on Amazon and other places. You can donate to the tribe directly at this link or to the legal defense fund for the protesters at this one.
You could even go to Standing Rock and protest yourself. I wasn’t even going to suggest this option, because it’s such a huge thing for someone to do, but what kind of advocate am I if I can’t even LAY OUT the radical options for people? There are a lot of guides out there for non-Native people going to Standing Rock, detailing what they should bring and how to be respectful allies. I have to really caution, however, that this is not only a radical option, but possibly an unhelpful one unless you really know what you’re doing and have a lot of confidence in your ability to be a supportive ally and the ability to carry your own weight. Don’t be these people, aka white people showing up and being cultural tourists.
You can follow activists on the ground through social media, because mainstream media is often delayed in getting news (not to mention thatjournalists are being arrested there for coverage). I’d recommend a follow for Dr. Adrienne Keese on Twitter, originally recommended by my friend Felecia. The Twitter hashtag #noDAPL will get you the latest news. Follow the protester camps and the Tribe on Facebook (I’d recommend the camps first) for updates as well.
As of right now, over 2,000 veterans are planning to deploy to Standing Rock on December 4 to help protect the protesters. You can donate to their GoFundMe page here. If you’re a veteran or know a veteran who would be interesting in helping with future efforts, you can get on their supporting roster for future events.
That’s all I’ve got. I don’t know how much information on any one topic one person is able to absorb, but hopefully you’re able to keep an eye on things like this in the coming weeks. Even as I’ve written this I’ve seen reports of supplies being cut off to the camp, and of local Ace Hardware refusing to sell supplies to water protectors anymore after being pressured by local authorities, and there is further violence all the time.
Good Night and Good Luck
This week most of the news I wanted to discuss falls into the two topics of Standing Rock and Obamacare. So, in short, you guys are so lucky.
-Let’s start with the secret service. The Trumps want to remain in Manhattan part time during at least the first year of Donald’s presidency, and the news has been full of that decision this week, not least of which because several estimates put the daily cost of this for the city of New York at over $1 million. Again: $1 million. Per day. On top of that, it seems like the Secret Service is going **rent rooms from Trump Tower** in order to be near the first family. That blog post I linked to makes this sound like it’s totally normal because the Secret Service always rents accommodations whenever it is traveling to protect the First Family. However, they do not rent accommodations that are owned by the first family. Do I even have the words to explain how messed up it is that the Secret Service, whose members are offering their lives to protect Donald and his family, are paying money to a property that Donald owns and thereby causing Donald to profit directly from said protection?? No. No I do not have the words.
-Jill Stein, as you may have heard, is raising money to request recounts in Wisconsin, Pennsylvania, and Michigan. She has already requested the recount in the first two states. Early this week it was revealed that the Clinton campaign will be participating in these recounts. It’s important to note that no one, the Clinton and Stein campaigns included, believes there is actual evidence of voter fraud or tampering, or that the outcome of the election will be changed by these recounts. The exercise is largely a symbolic one to prove beyond any doubt that there was no election fraud. That doesn’t make it unimportant. In fact that is extremely important. Clinton’s general counselalso emphasizes that Jill Stein asked for this recount and the Clinton campaign merely feels that it has an obligation to participate.
-On Tuesday, Donald took to Twitter again, to say the following:
Whew, oh boy. I keep pointing to absurd thing Donald says on Twitter and some of you might have opinions about that, but I maintain this is some scary shit. Look, in regards to overreacting to Donald’s twitter account, I get no satisfaction witnessing his fits of passion; the way he primps and preens and knows he’s goading us to reaction. But stuff like this is important. Anyway, for those who don’t know, the Supreme Court ruled in 1958 that you can’t revoke citizenship as a punishment, and as recently as 1990 that flag burning is protected by the First Amendment. Donald has made many statements that are at odds with the Constitution and the law.
-Texas passed a horrible anti-choice bill requiring abortion providers to hold funerals for the fetal remains so….yup. Indiana actually has a similar law, signed by Mike Pence of course. Local abortion providers in these and other red states could really use your dollars, perhaps more than the National Planned Parenthood organization. If you can spare some, do it.
-Also from Twitter Donald has finally announced that he plans to do…something? (emphasis on the something, because he was pretty vague) to reduce his conflicts of interest while in office. He is holding a press conference with his children on December 15th to explain. As the Post points out, the fact that his children will be there suggests that he is still planning to hand control of the businesses over to them, which doesn’t resolve the conflict of interest problem, especially if he continues to involve them in governmental operations to the degree he has so far. We shall see.
-This week House Democrats held their election to choose the new House Minority Leader. Nancy Pelosi won the vote handily against her Democratic rival Tim Ryan of Ohio, but it is by far the most she has ever been challenged for the position. Pelosi is no doubt the older face of the Democratic party in the House, but Tim Ryan in my opinion wouldn’t have been too much of a change anyway. I haven’t had as much time as I’d like to mull over how I feel about this, but in any case the vote is over and it’s done. Pelosi now holds the position for another two years.
-I’m going to try to summarize all the bullshit of this Carrier story for you quickly. Essentially, Donald has promised to give tax breaks and other incentives to United Technologies, the parent company of Carrier, in order to get them to keep some of the jobs they were exporting to Mexico in the US: 1,000 of the 2,100 jobs to be exact. Why is this bad? Well, imagine a bunch of other companies who threaten to move jobs overseas for the purpose of tax breaks, and then after they receive them, move MOST of those jobs overseas anyway. How is this a benefit for the US? Search me.
-And finally, I’ll end on a happy note. I’m not sure how many of you knew this, but technically the North Carolina Governor’s race has still been going on all this time, mostly due to heinously anti-gay Republican Pat McCrory, champion of North Carolina’s anti-trans “bathroom law” refusing to concede. This week his opponent Democrat Roy Cooper pulled into the lead by over 10,000 votes, and North Carolina law prohibits a recount if the difference is 10,000 or more. So YAY, we won one!!!
Bonus Topic 3: Update on DC Paid Family Leave
For those of you who have chosen to get involved in the DC Paid Family Leave bill (of which there are several, you guys rock!), a draft of the bill was released this week that was a bit disappointing. On the one hand, we got 11 weeks of paid family leave, but on the other we got zero personal medical leave. As the Paid Family Leave Coalition puts it, this means if your husband gets cancer you can take time off from work to take care of him, but if YOU get cancer you can’t take any time off work for yourself They have sent an email with a list of actions to do in the next week before the bill hearing, which include actions on social media, in-person lobbying efforts, and more. I’ve made it into a google docfor you if you’d like to help us out.
And that’s it for today Runners! We made it through another week. Check out my Pinterest board for a random stew of random articles in no particular order (I am so good at pitches!), and leave anonymous feedback telling me how these letters are getting way too long on my Google feedback form. Tell your friends, family, co-workers, and pets to subscribe to The ForeRunner at http://tinyletter.com/theforerunner or read my back issues, all of which are public, at http://tinyletter.com/theforerunner/archives. Every time you get someone to subscribe, a fairy somewhere does NOT fall down dead. Save the fairies. Subscribe.
In solidarity,
JM
This week’s event link round-up (local to DC unless otherwise noted)*:
December 1: Virtual Campaign Meeting on Paid Family Leave strategy hosted by the Paid Family Leave Coalition. RSVP to hannah@jufj.org with your name, email, and phone number first, click the link to join the meeting at 6pm on December 1
December 4: Taking the Reins: A Discussion on WOC Grassroots Organizinghosted by the Women of Color Network at Scion Restaurant
December 6: Markup of the Universal Paid Leave Act at the DC Council Building. (I will be there, as will several other readers!)
December 7: Data entry for SURJ (Stand Up for Racial Justice) DC
December 8: CNN Panel on the Election hosted by Politics and Prose (facebook link)
*These events are vetted in a sense by me. I will try to tell you if they’re full, and I only post them if I think they’re legitimate or worth going to
