CHIP Funding Fail

The party claiming to represent “family values” also known as the Republican Party is once again showing its hypocrisy. Nearly two months ago the funding for the decades old Children’s Health Insurance Program (CHIP) expired and the funding bill Republicans in the House passed would simply take the $8 billion a year from Medicaid and more from other public health programs to pay for it. Senate Republicans knew that wasn’t going to fly and have even filed bill that continues funding without sticking it to the poor and other vulnerable Americans but there have been no hearings on the bill, nor have they scheduled a vote on it.

There’s no telling when Republican leaders will get around to pursuing a funding solution for CHIP but it looks like they’re going to hold the lives and health of 9 million poor children and pregnant women, more than 400,000 of them Texans, as hostage to get concessions like budget cuts from Democrats. In the interim, 11 states expect to run out of funds by the end of December and are preparing to send letters telling the parents of these children that if they get sick don’t expect them to receive medical care. How’s that for a Christmas present? Ebenezer Scrooge would be so proud.

The CHIP program only covers persons under age 19 and pregnant women who are either citizens or legal U.S. residents. If the family has only one child the total annual income must be less than $24,473 so we’re talking about folks on very low incomes.

CHIP covers primary health care, prescriptions, mental health, vision, physical and occupational therapies and dental care for children under 19. Additionally women receive CHIP coverage for prenatal and postpartum services.

Some states have enough funding to last a few more months but some don’t. Several states have already made emergency requests for funds to hold it over until February by which time they hope Congress gets around to deciding if the program will be retained.

The Senate and House are now very busy working toward providing massive tax cuts to billionaires while claiming they’re going to put more money in the pocket of working and middle class Americans. Of course, tax breaks for billionaires didn’t do anything to help working families under Reagan nor under George W. Bush. Republican leaders must think Americans are like Charlie Brown to their Lucy promising to hold the ball for him to kick this time.

One of the provisions getting a lot of attention will allow deductions for private jets. This is the same bill also takes away the deduction for school supplies that teachers purchase for their classrooms so it’s clear who Republicans really care about and it isn’t you and me.

CHIP has had bi-partisan support since its inception, yet this time around Republican leaders are so focused on the tax cuts they promised to their wealthy benefactors they just can’t find the energy to do the right thing. I guess we shouldn’t really be surprised at the heartless greed exhibited by congressional Republicans, after all they’re still trying to gut the Affordable Care Act, Medicare and Medicaid. Apparently they’re idea of right to life doesn’t include actual living people.

Published in the Seguin Gazette, November 25, 2017

Trump Incompetence Might Strengthen the ACA

For all that Republicans complain about the Affordable Care Act it has been tremendously successful in increasing the percentage of Americans covered by health insurance of one sort or another. In those states, unlike Texas, that took the Medicaid expansion funds offered very few are left without access to quality healthcare. Every year more people have learned about the availability of insurance coverage at affordable rates and signup rates continue to climb.

This year we have a Republican president who is determined to undermine the law of the land and has taken measures intended to reduce the number of Americans with health insurance. Trump has reduced the time period of open enrollment in half, to just 6 weeks, ending December 15. Possibly worse, he’s cut funding for advertising of open enrollment by 90% leaving groups that assist people in selecting and signing up for affordable, subsidized plans scrambling for ways to overcome the barriers.

A couple of weeks ago, in an attempt to overcome the lack of promotion, a small group of Democrats knocked on nearly 400 doors in Seguin handing out flyers and explaining that help is available through CentroMed and other providers both in and near Seguin. We want everyone to know that they can call one central phone number, 210-977-7997, or visit the coalition website www.enrollsa.com to make an appointment.

One of the great things about the Enroll SA coalition is even if the applicant isn’t eligible for subsidized health insurance through the Affordable Care Act the enrollment staff will check eligibility for other forms of assistance including Medicaid, CHIP (Children’s Health Insurance Program) or low cost care at community clinics.

While some of Trumps efforts to undermine the Affordable Care Act may very well have the intended effect his incompetence and that of his staff may also work against him. His executive order ending payments to insurance companies called cost-sharing reduction (CSR) subsidies. They are paid directly to insurers, and they provide financial assistance for individuals who make between 100 and 250 percent of the poverty line. Cut those subsidies off, and insurers will try to make up the difference by raising premiums. In a report on the likely effects of cutting off the subsidies earlier this year, the Congressional Budget Office estimated that premiums would be about 20 percent higher for typical plans purchased under the law.

But the joke is on Trump, as the premium hikes won't directly affect most low-income people, because Obamacare's subsidies increase with premiums, insulating those individuals from higher costs. Instead, this move is likely to raise premiums for people who earn too much to qualify for subsidies under Obamacare, the people who have already been hit hardest by the law's price hikes.

There are some reports of insurers offering plans with premiums in the range of $0-10 for those who are eligible for subsidies so if a member of your family or your friend isn’t currently insured be sure to let them know that now might be the best time of all to apply for coverage. Give them the phone number 210-977-7997, or help them visit the coalition website www.enrollsa.com to make an appointment. The great folks at CentroMed on County Line Road in New Braunfels as well as some organizations right here in Seguin can help anyone find out how to get covered.

Published in the Seguin Gazette - November 17, 2017

Tax Breaks for Billionaires Bad for You and Me

If Republicans have their way on the tax plan they’ve proposed you and I will end up subsidizing tax breaks for billionaires. The bill eliminates deductions that you and I use when we suffer major losses like fires and floods or medical costs due to life threatening illness in order to drop the corporate tax rate from 35% to 20%.

Teachers in Texas are already underpaid, schools are underfunded and this terrible tax plan takes away the deduction teachers can now take for supplies they purchase for their classrooms out of their own money.

Texans hospitalized for life threatening illnesses like cancer, heart attacks or severe infections will be further harmed by losing the deduction for major medical expenses.

The Republican tax plan hurts struggling students and recent college graduates by eliminating the student loan interest deduction. Current rules allow borrowers paying off education loans can deduct up to $2,500 of interest paid on student loans.

The Republican proposal hurts families with four or more children doing away with the dependent exemption, which provides $4,050 for each qualifying dependent and replacing it with a child tax credit to $1,600. They are also calling for a new $300 credit for each parent and non-child dependent, but this tax break will expire by the end of 2022.

What’s worse is that even with all that and more passing the bill would cause the federal deficit to increase by $1.5 trillion because they can’t eliminate enough deductions to pay for the huge tax breaks being offered to big business. Unlike the extra $300 child tax credit the corporate tax break doesn’t expire.

Big business is raking in record profits, they don’t need a tax break. Republicans claim that if businesses get a tax break they’ll raise wages and salaries but it didn’t work for Ronald Reagan in the 1980’s, or under Bush in the early 2000’s, and it didn’t work in Kansas this decade where Gov. Sam Brownback’s tax cuts did so much harm to the economy the Republican state legislature had to override him in order to restore services.

This tax plan does nothing to raise wages and will in fact harm the economy by taking money out of the hands of people who will spend it and putting in the hands of those who already have so much they’ll save it. The only way to expand the economy and raise wages is to increase demand and this tax plan does exactly the opposite.

Every day somewhere in the United States a bridge collapses forcing people to use a longer route. Every day many new potholes open up damaging tires and suspensions. Every day all over America millions of drivers sit in stop and go traffic costing them time and money. All these problems also cost business in lost efficiency and therefore profits. Instead of giving big business and billionaires more tax breaks we ought to be spending money on repairing our roads, replacing aging bridges, building new schools and replacing other city infrastructure like water and sewer lines many of which are so old they leak or are unsafe.

If we spend our money on replacing infrastructure both citizens and businesses benefit. Putting people to work will raise demand for workers and give those workers money to spend in store creating demand for yet more workers. That increase in demand for workers is what will cause wages and salaries to rise and improve the lives of all of us not just the billionaires.

Published in the Seguin Gazette - November 10, 2017

Opioid Crisis Versus Other Vices

The media and our politicians have recently made a lot of noise about the horrors of prescription opioid addiction. They quote alarming sounding statistics like 34,000 people in the U.S. died from prescription drug overdoses in 2016. What they fail to do is put the issue in perspective by comparing death rates caused by various other vices in which Americans partake.

Consider this; last year 480,000 Americans died due to smoking tobacco. That’s more than 12 times the number who died taking prescription drugs yet we no longer hear much about government efforts to convince people to stop smoking. The really alarming statistic though is that 41,000 people died from second hand smoke, those folks didn’t have the nasty habit but lived or worked with someone who did and lost their lives because of it. On average smokers die 10 years earlier than non-smokers. About 15% of Americans still smoke but the rate has been falling gradually for the last 50 years.

Smoking tobacco isn’t the only socially acceptable vice that kills more than prescription drugs, obesity or being significantly overweight also kills far more than drug use at a rate of 300,000 Americans per year. While tobacco use has been falling, obesity has been rising for the last 30 years and today nearly 38% of Americans are obese.

Then of course there is the real drug of choice, alcohol, which kills 88,000 Americans every year. Last year more than 10,000 of those deaths were in automobile accidents of which 8,400 were not the drunk driver. Alcohol related deaths are also on the rise with nearly one in seven Americans or 32 million people struggling with a serious alcohol problem last year. That’s more than the population of Texas.

After all those preventable but socially acceptable causes of death we get to opioids. In 2016 more than 20,000 Americans died of overdoes involving prescription opioids. That’s less than one fourth of those from alcohol related causes. It’s half as many as those killed by second hand smoke.

For more than 40 years the country has fought a war on drugs as President Nixon famously labeled it and we still have drug abuse and deaths due to overdoses. We have an entire federal agency and every local police department in the country focusing resources on drug users and their suppliers.

Based on recent history I foresee further tightening of regulations and enforcement making it even harder for people with serious chronic pain like arthritis and fibromyalgia to get the small doses of morphine that make their lives tolerable.

Why do our leaders ignore the positive results of the efforts to get people to stop smoking that have succeeded without recourse to armed officers arresting people on the street? Why do our leaders appear to ignore the far greater scourge of alcohol abuse which has no criminal penalties unless the user is caught driving while intoxicated? Why aren’t we as a nation focusing on the far greater number of deaths and long term health problems caused by obesity? Why is drug use treated more vigorously than other more dangerous vices?

 Published in the Seguin Gazette November 3, 2017