Congressman Evans: Senate Healthcare Bill Is a Disgrace

Congressman Dwight Evans. Photo: Wikipedia.

Congressman Dwight Evans. Photo: Wikipedia.

Democratic Congressman Dwight Evans (PA-02) released the following statement after Senate Republican Leadership unveiled a draft of their healthcare bill:

Republicans in the House and Senate say Obamacare is collapsing in our communities nationwide; yet today as a response to fix this ‘so called’ crisis, Senate Republican Leadership has released their draft of a bill that does nothing but reduce access to adequate healthcare. As it stands now, the Senate healthcare bill makes extreme cuts to the federal Medicaid program and doubles down on the President’s vow to repeal the Affordable Care Act (Obama Care).
[Read more…]

GOP State Rep.’s Jaw Dropping Response To Mom of Sick Child

Insulin Needles

Insulin Needles for Diabetics.

— by Charles Gaba

There is a diabetes support Facebook community called Living in the World of Test Strips in which the following was posted by the mother of a child with diabetes. I’ve retyped it here (with permission) for better readability:

This morning I emailed the Mississippi House of Representatives because T1 (Type 1 diabetes) kids with Medicaid in Mississippi aren’t getting the necessary diabetes supplies and meds they need to stay healthy. Republican Mississippi State Representative Jeffery Guice took the time to respond. I feel it only appropriate to share. If you feel inclined, you can contact Rep. Guice at Jguice@house.ms.gov.

From: Nicki Nichols

I am the mother of a child with Type 1 diabetes and an advocate who works with the Diabetes Foundation of Mississippi. We have recently begun having a lot of problems with Medicaid/CHIP coverage of the essential diabetes supplies needed, not only to keep our kids healthy, but to literally keep them alive. Many parents, myself included, have found that while supplies are deemed necessary and technically covered by insurance, we cannot get Medicaid and/or CHIP to pay for them, and suppliers aren’t able to help us.

They are normal kids who lead full lives, as long as they have the proper diabetes care!

I have spent countless hours, day after day, calling Medicaid/UHC Community Plan, researching medical suppliers, reading Medicaid Policy guidelines and UHC Community Plan coverage guidelines, even researching Medicaid fee schedules, in an attempt to get my daughter’s supplies covered and shipped. I am not the only parent who has been through this! No parent should have to fight for so long for their child’s essential medical supplies and medical needs when it’s explicitly stated as a covered benefit. Yet, I have gotten nowhere.

Is there someone in the legislature that can and will help these children stay healthy? They must have these medications and supplies which administer the medications in order to remain healthy and, quite honestly, alive!

From: [Mississippi GOP State Representative] Jeffery S. Guice

I am sorry for your problem. Have you thought about buying the supplies with money that you earn?

Thank you, Jeffrey Guice

From: Nicole Nichols

Thank you kindly for your response.

I have thought quite often about buying these supplies with money that myself and my husband earn. Unfortunately, if we were to pay out of pocket for these supplies, with money that we earn, that sum would leave my family of four homeless.

You see, type 1 diabetes is an expensive disease.

  • Insulin: $400 per vial of Humalog (2 vials a month for my daughter, 3 for my husband with T1)
  • Insulin #2: $150 per vial of Lantus (for emergency pump failure)
  • Test strips: $300 per month (per person)
  • Insulin pump supplies: $375 per month (per person)
  • Dexcom CGM sensors: $300 per month (per person)
  • Glucagon: $450 per syringe
  • Ketone strips: $80 for a box of 10
  • $150 per month in various smaller prescriptions such as adhesives, alcohol swabs, glucose gels, etc.

Do you earn enough money to pay for these items every month?

While you may, my husband and I, unfortunately, do not. We are working individuals, with college degrees, a small home, older but reliable vehicles, and without Medicaid to cover the LIFE SUSTAINING medications and supplies that my child needs, we would be homeless.

Insulin alone amounts to more than my house payment every month. Insulin literally keeps this little girl alive.

So, thank you for your incredibly rude response, sir. I can see exactly how far out of touch you really are with the residents of Mississippi.

And might I add, belittling the mother of a child with a chronic health condition, who is appealing for your assistance on behalf of the CHILDREN OF MISSISSIPPI is reprehensible. You are a pitiful excuse for a human being, Representative Jeffery Guice.

Sincerely, Nicole Nichols, MS Resident

Note: I’m not sure how often Lantus or Glucagon is needed, but by my count the above adds up to at least $5,200 per month, or a minimum of over $62,000 per year.

(Update: According to Ms. Nichols in this local story about the situation in the Clarion-Ledger, the cost for her daughter’s treatment/medication is around $2,000; the balance appears to be for her husband, who also has diabetes. This actually makes the family more sympathetic, because she’s only asking for state assistance for her daughter’s portion of the bill.)

This is an awful story, and this state representative is truly a jackass, but this is also hardly surprising. The Republican mindset in general (there are exceptions) is that if you’re not physically disabled, you shouldn’t be receiving financial assistance, period. The fact that it might cost thousands of dollars you don’t have to keep your kid alive is beside the point.

This is among the main reasons given by many conservatives about why 19 states still refuse to expand Medicaid under the ACA, even though doing so is a huge financial boost for their state and 90% or more of the costs are covered by the Feds.

Now, in this case it’s the CHILD who is on the program, not the parent, but since the parent is responsible for/speaking on behalf of the child, it amounts to the same thing. This jackass rep either doesn’t grasp how expensive the medication in question is (which shows stunning ignorance) or knows but doesn’t give a crap.

On a larger scale, however, this really does illustrate the philosophical differences between the parties (and/or between conservatives/progressives, depending on your point of view) when it comes to the social safety net in general. The Republican attitude, as I noted above, is that anyone who isn’t physically disabled should “get off their lazy asses and work for a living” (sometimes coached in different language, sometimes not). The default mindset here is that if you aren’t able to “pull your own weight” (i.e., afford to pay over $60K/year just to keep your kid alive in addition to the rest of you not starving to death yourselves), you must be either “lazy” or a “moocher.” This is the same attitude which brings us idiocy like “drug testing welfare recipients” programs, which time and time again end up with the state wasting millions of dollars in taxpayer money only to turn up just a handful of (or in many cases, none at all) drug users in the process… which is not only a huge waste of time and effort, but is also ironic since the ostensible reason for the testing requirement is supposedly to save taxpayer money.

The Democratic mindset — in general — is that society at large should help out anyone who falls below a certain income threshold, period. What that threshold should be may change from time to time, or it may vary depending on the type of assistance (Medicaid, SNAP, tax credits, etc), but the larger point is that if you can’t afford certain essential services — food, shelter, healthcare — society should help provide them. In return, if and when you rise above that threshold, it’s your responsibility to chip in to help others caught in the same dire straits. The more successful you are at climbing that ladder, the bigger portion of your success you’re expected to give back to society to help others. And if you’re lucky enough to never have been in that situation in the first place, then count your blessings and chip in… because you never know whether you will be some day later in life.

Perhaps nothing better illustrates this disconnect in the right-wing brain than successful Emmy-award winning actor Craig T. Nelson, appearing on the Glenn Beck show some years back:

This really should speak for itself, but I’ll spell it out anyway: Here’s an extremely successful actor, best-known for his roles in “Coach” and as “Mr. Incredible,” openly admitting that at one time he was on both food stamps and welfare, but that “no one helped him out”.

Again, to state the obvious: What the hell do you think food stamps and welfare are, you nitwit?

If no one had helped him out, he presumably would’ve starved to death or turned to a life of crime, which in turn very likely would have resulted in him being shot, stabbed to death or imprisoned. In any event, the odds of him ever becoming a successful actor would have been greatly diminished, and he wouldn’t be whining about the evils of public assistance as a guest on a nationally broadcast TV show 30-odd years later.

That’s right: Without public assistance, we very likely never would have had The Incredibles. We should probably double the food stamp budget for that reason alone.

In any event, I wish Ms. Nichols all the best in her quest to straighten out her daughter’s Medicaid coverage situation.

Update: The message appears to have gotten through to Rep. Guice (at least to the point that he’s issued an apology, anyway):

Guice, who told The Clarion-Ledger Tuesday morning “I don’t do interviews” and declined to comment, issued an apology Tuesday night.

I realize my remarks to Mrs. Nichols were completely insensitive and out of line,” Guice said in an emailed statement. ” I am sorry and deeply regret my reply. I know nothing about her and her family and replied in knee-jerk fashion. I’d like to think the people of Mississippi and my constituents know that I’m willing to help where I am able.”

OK, great. Now let’s see if he and his colleagues actually do anything to resolve the issue itself.

Democrats Seek to Take Back PA 6 With Mike Parrish

Mike ParrishWe spend a lot of time thinking about the presidential race, but we should remember that the House and its 435 seats are also on this November’s ballot. Here in Pennsylvania’s 6th Congressional District, the Democratics have an opportunity to capture the seat because their running a strong candidate with a great biography against first term Republican Ryan Costello who’s been committed to voting the GOP line since he got to DC. I had the opportunity to spend a few hours with Mike Parrish, Democrat for Congress and you can read all about his background and his stand on the issues.  [Read more…]

Supreme Court Takes On Affordable Care Act Again

the PillSince its founding in 2003, Jewish Social Policy Action Network (JSPAN) has been in the forefront of the Jewish community in supporting the right to reproductive freedom and protecting religious liberty. Sometimes we take the lead by filing amicus briefs in the Supreme Court, as we did in the Hobby Lobby case, arguing that private corporations should not be able to claim a religious right to deny their employees access to reproductive healthcare services. At other times we work in coalition with Jewish and non-Jewish groups.

Recently JSPAN joined with the ADL in asking the Supreme Court to uphold the provision in the Affordable Care Act’s contraception mandate that requires a religious institution opposed to contraception to sign a waiver stating such, after which employees can receive it through third parties.

In Zubik v Burwell, petitioners claim that merely signing a waiver violates the signers’ religious tenets, and is thus unconstitutional according to the Religious Freedom Restoration Act. JSPAN heartily agrees with the ADL that signing the waiver does not pass RFRA’s “substantial burden” test. Moreover, finding for the petitioners would prevent employees who favor the use of contraceptives from exercising their own freedom of religion. An ADL press release said, “Allowing one’s religious beliefs to be an effective veto of virtually any federal law or rule would undermine our country as a nation of laws.”

Joining JSPAN in recognizing this as an issue of great interest to Jews were Bend the Arc (of which JSPAN is an affiliate), Keshet, National Council of Jewish Women, and Women’s League for Conservative Judaism.

Rabbi George Stern, Executive Director
Rabbi Seymour Rosenbloom, President

JSPAN Supports Providing Contraceptives to Workers


A package of birth control pills.

Earlier this year, the Jewish Social Policy Action Network (JSPAN) filed an amicus curiae brief, urging the U.S. Supreme Court to uphold the Affordable Care Act’s mandate that private, for-profit corporations provide employees with coverage that includes all FDA-approved contraceptive methods.

The key issue in Sebelius v. Hobby Lobby, now before the Court, is whether for-profit corporations have a right to deny contraceptive coverage to women workers based on religious objections of the corporation’s owners. JSPAN argues that it would not be proper to treat the religious views of the corporation’s shareholders as an exercise of religion by the corporation.

More after the jump.
In the fall of 2013, JSPAN filed an amicus brief in Town of Greece v. Galloway, which is also now pending before the U.S. Supreme Court. JSPAN therein urges the Court to reverse its prior opinion and ban government sanctioned legislative prayer.

Additionally, earlier this year JSPAN has joined with the Anti-Defamation League and other groups in briefs to federal courts of appeals in challenges to state same sex marriage bans in Utah, Virginia, and most recently, Oklahoma.  

Medicaid Expansion: Red States Choose Politics Over Saving Lives


The Affordable Care Act mandated that people earnings over 133% of the poverty level ($23,550 for a family of four) must sign up for health insurance and provided financial subsidies in order to make that insurance more affordable. To require families earning below that level to purchase insurance would probably have required the cost of insurance to be completely subsidized. In order to provide free health insurance to those too poor to afford private insurance, the Affordable Care Act proposed increasing Medicaid’s income cut to from the Federal poverty line to 138% thereof.

However, in June 2012, the Supreme Court ruled that the Federal Government could not require states to expand Medicaid eligibility. The Affordable Care Act requires the Federal Government to cover all of the cost of Medicaid expansion through 2017. Starting then the Federal Government covers 95% of the cost and the states cover 5% until 2020, when the states are asked to cover 10% of the cost. In the meantime, there is no cost to the states, yet many states with Republican governors and/or legislatures have refused to expand medicaid.

This leaves eight million Americans in Health insurance limbo. They are “too poor” to qualify for health insurance market place subsidies, and they are “too rich” to qualify for Medicaid. This leaves them without any affordable options for health insurance.

Even worse, a new study found that in states with no expanded medicaid, those who earn 138% of the poverty line or less suffer more often with high blood pressure, heart problems, cancer, stroke and emphysema.

Since this costs the states nothing to provide this coverage over the next 3 years, the only possible reason to refuse this grant is political. The Red States are worried that people will appreciate the benefits of this coverage, reward the Democrats that provided it, and demand that the coverage be continued past 2017 when the states will be asked to make a small contribution to the cost.

This is a very cynical view of politics. Politicians should be looking out for the interest of the country, not of themselves nor their party. Instead these “leaders” who rejected medicaid expansion are putting the lives of their citizens at risk to score political points.

A group of researchers from the Harvard Medical School published a peer-reviewed study in Health Affairs concluding:

Nationwide, 47,950,687 people were uninsured in 2012; the number of uninsured is expected to decrease by about 16 million after implementation of the ACA, leaving 32,202,633 uninsured. Nearly 8 million of these remaining uninsured would have gotten coverage had their state opted in. States opting in to Medicaid expansion will experience a decrease of 48.9 percent in their uninsured population versus an 18.1 percent decrease in opt-out states…
We estimate the number of deaths attributable to the lack of Medicaid expansion in opt-out states at between 7,115 and 17,104. Medicaid expansion in opt-out states would have resulted in 712,037 fewer persons screening positive for depression and 240,700 fewer individuals suffering catastrophic medical expenditures. Medicaid expansion in these states would have resulted in 422,553 more diabetics receiving medication for their illness, 195,492 more mammograms among women age 50-64 years and 443,677 more pap smears among women age 21-64. Expansion would have resulted in an additional 658,888 women in need of mammograms gaining insurance, as well as 3.1 million women who should receive regular pap smears.

Do not despair though, not all Republicans value obstructionism over life. Ohio Governor John Kasich (R) explained why he expanded Medicaid to include 300,000 Ohioans:

When you die and get to the meeting with St. Peter, he’s probably not going to ask you much about what you did about keeping government small, but he’s going to ask you what you did for the poor. You’d better have a good answer.

Cartoon courtesy of Mike Stanfill.

Flurry of Last Minute Signups Sends Obamacare Over the Top


Health insurance waiting room, Philadelphia, PA.


Health insurance waiting room, Jacksonville, FL.

Yesterday, March 31, was the last day of open enrollment for the Affordable Care Act (a.k.a. “Obamacare”). Those who have begun the signup process have two weeks to complete the process. Everyone else must now wait until November 15 to sign up unless they are eligible for Medicaid or CHIP, or experience a “qualifying life event.”

  • Typical qualifying life events include: moving out of state, certain changes in income, getting married or divorced, or having a baby.
  • Also, those who were unable to apply due to factors beyond their control (e.g. “Natural disasters. Domestic abuse. Website malfunctions. Errors by insurance companies. Mistakes by application counselors.” etc.) can call 1-800-318-2596 and explain their situation in order to get a 60-day extension.

Many people procrastinated and had to rush in order to avoid a financial penalty and be covered before January 2015.

In states across the nation — red and blue — people lined up to apply for health insurance in person, call centers were swamped, and the healthcare.gov website buckled under the unprecedented load. The photos shown here give a flavor of what this looked like.

More after the jump.


Health insurance waiting room, Houston, TX.


Line for health insurance, Las Vegas, NV.


Line for health insurance, El Paso, TX.


Line for health insurance, Columbia, SC.


Line for health insurance, Chicago, IL.

According to the Associated Press, the flood of applicants allowed Obamacare to exceed its enrollment expectations:

President Barack Obama’s health care overhaul was on track to sign up more than 7 million Americans for health insurance on deadline day Monday, government officials told The Associated Press….

Seven million was the original target set by the Congressional Budget Office for enrollment in taxpayer-subsidized private health insurance through new online markets created under Obama’s signature legislation.

That was scaled back to 6 million after the disastrous launch of HealthCare.gov last fall….

“This is like trying to find a parking spot at Wal-Mart on Dec. 23,” said Jason Stevenson, working with a Utah nonprofit group helping people enroll.

At times, more than 125,000 people were simultaneously using HealthCare.gov, straining it beyond its capacity….

Officials said the site had not crashed but was experiencing very heavy volume. The website, which was receiving 1.5 million visitors a day last week, had recorded about 2 million through 3 p.m. EDT. Call centers have more than 840,000 calls.

The RAND Corporation estimates that:

  • One-third of those enrolled in private health insurance at HealthCare.gov were uninsured. That works out to about 2.4 million people.
  • Furthermore, “4.5 million previously uninsured people have signed up for Medicaid since the law launched in October”. This is in part due to the Federally funded Medicaid expansion which most states have taken advantage of (though not Pennsylvania, for example) and in part this is due to increased awareness of Medicaid eligibility criteria.
  • “3 million young adults age 26 and younger have gotten covered through their parents’ insurance plan, as the law allows.”

In all, this means that 9.9 million previously uninsured Americans now have health insurance because of the Affordable Care Act. While much work remains to be done before all Americans have  health insurance, Obama’s signature piece of legislation seems back on track.

Getting A Better Return On Our Healthcare Investments

The graph on the right shows how the United States stands out in the world of health care; we spend far more on healthcare than any other country but our life expectancy is lower than most advanced nations.

However, now that healthcare.gov is back online, many Americans have turned back their personal cost-curve on health care. Even Speaker of the House John Boehner (R-OH) was embarrassed by his success in signing up for Obamacare during a big show he orchestrated in order to demonstrate the failure of the website. (According to NBC, a DC Health Care exchange representative actually tried to contact Boehner by phone during the enrollment process but was put on hold for 35 minutes.)

Here is a sample success story from the Los Angeles Times:

Judith Silverstein, 49, a Californian who was diagnosed with multiple sclerosis in 2007. Her family helps her pay the $750 monthly cost of her existing plan–which she only had because of federal law requiring that insurers who provide employer-based insurance continue to offer coverage if the employer goes out of business, as hers did. Next year she’ll get a subsidy that will get her a good “silver” level plan for $50.

Three local stories follow the jump.

  • In Lackawanna County, after years of denials because of his pre-existing condition, a self-employed contractor now has better health care coverage for less money thanks to Obamacare.
  • According to the Pittsburgh Post-Gazette, a man from Pittsburgh’s South Side man has benefited twice from Obamacare — first with high-risk coverage, then with lower-cost coverage through the exchange.
  • In Philadelphia, Obamacare has cut a diabetic small businesswoman’s monthly premiums by $500 – and that’s before she factors in the tax credits.