insurance mandates

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The GOP thinks their health care bill is so great, they’re shielding themselves from it

  • Republicans appear close to reintroducing an Affordable Care Act replacement bill — legislation they apparently think is so good that they are protecting themselves from being impacted by it.
  • The new GOP-crafted bill would allow states to waive popular protections currently guaranteed in the ACA. 
  • Those protections include mandating that insurance plans cover so-called “Essential Health Benefits,” such as prescription drugs and hospitalization, as well as preventing insurance companies from charging Americans with pre-existing conditions more for coverage.
  • If passed, that means insurance companies could charge Americans with pre-existing conditions more for insurance plans that might not even cover the services they need.
  • However, the GOP’s new bill would not allow insurance companies to waive those protections for members of Congress and their staff
  • Members of Congress and their staff are currently required to purchase their health care coverage through the ACA exchanges under section 1312(d)(3)(D) of the ACA. Read more (4/26/17 8 AM)
vox.com
Senate GOP expected to add new penalties for the uninsured into their health bill
A six-month waiting period for Americans who fail to maintain continuous coverage could come as early as Monday.
By Sarah Kliff

Sarah Kliff and Dylan Scott at Vox:

Senate Republicans are expected to revise their health bill early next week, adding in a provision that could lock Americans out of the individual market for six months if they fail to maintain continuous insurance coverage.

Health insurance industry sources familiar with the plan say the change could be announced as early as Monday.

The six-month waiting period would fill a big policy gap in the current Better Care Act, which requires health plans to accept all patients — but doesn’t require all Americans to purchase coverage, as the Affordable Care Act does. Experts expect that this would cause a death spiral, where only the sickest patients purchase coverage and premiums skyrocket.

But the six-month waiting period could also complicate the Senate Republicans’ repeal efforts, because it may run afoul of the chamber’s complex reconciliation rules. Republicans are using what’s called “budget reconciliation” to pass their health care bill with a bare majority of 50 votes and avoid a Democratic filibuster. But the rules governing reconciliation restrict what policies the GOP can include in their bill — the waiting period is one of the provisions thought to be in doubt.

Why Senate Republicans want an individual market waiting period

All health insurance markets need healthy enrollees and sick enrollees to keep premiums affordable. The healthy people end up subsidizing the high medical bills of the sick people — and also purchase protection against financial ruin should they become one of the sick people themselves.

The Affordable Care Act required all insurance companies to accept all Americans regardless of pre-existing conditions. It also required all Americans to purchase coverage or pay a penalty, a way to push healthy people into the marketplace.

The individual mandate is the least popular provision of the Affordable Care Act and Republicans have promised for years to repeal it. But policy experts agree that they need some other policy to replace it — or else risk sending the individual insurance market into collapse.

[…]

It’s not yet clear if the Senate’s proposal, a waiting period instead of a premium surcharge, would be permissible. Republicans and Democrats will be negotiating with the Senate parliamentarian, who oversees the chamber’s rules, next week to decide what can be included in the bill and what cannot.

But if the waiting period is deemed to comply with the Byrd Rule, it is expected to be added to the Senate bill.

youtube

The Obamacare provision that saved thousands from bankruptcy

Timmy Morrison was delivered by emergency C-section, weighing in at 3 pounds, 9 ounces. Doctors put him under anesthesia within a week and into surgery within a month. Some of the contents of his stomach sometimes made their way to his lungs. Workers in the intensive care unit frequently needed to resuscitate him.

He arrived seven weeks premature — but, in a way, just at the right time.

Six months before Timmy was born, President Barack Obama signed a sweeping health care law that would come to bear his name. Six days before Timmy’s birth, the Obama administration began to phase in a provision that banned insurance companies from limiting how much they would pay for any individual’s medical bills over his or her lifetime. At the time the Affordable Care Act passed, 91 million Americans had employer-sponsored plans that imposed those so-called lifetime limits.

That group included Timmy’s parents, whose plan previously included a $1 million lifetime limit. This Obamacare provision took effect September 23, 2010. Timmy was born September 29. On December 17, he surpassed $1 million worth of bills in the neonatal intensive care unit. He didn’t leave the NICU until he was 6 months old.

If Timmy had been born a week earlier, his medical benefits could have run out while he was still in the NICU. But that didn’t happen. His insurer covered everything. The NICU bills his parents save total just over $2 million (they come out to $2,070,146.94, to be exact).

“He would have lost his insurance at a million dollars,” his mom, Michelle Morrison, estimates, “which would have been about [halfway through] the NICU stay.”

Timmy still has significant and expensive medical needs. His rare genetic disease, called Opitz G/BBB Syndrome, causes abnormalities along the body’s midline. He is now 6 years old and has been under anesthesia 45 times. It happens so much, he and his mom have a routine: They sing the alphabet until he falls asleep.

Timmy breathes through a tracheostomy tube. A nurse accompanies him to school. But he’s still, in most ways, just a normal kindergartner. He climbs off his school bus wearing a backpack covered in cartoon dogs. He rides around his suburban Maryland neighborhood on a bright orange scooter with his little sister, Ivy, until they’re out of breath. He is obsessed with his collection of toy cars, which he zooms around the coffee table after school. He cannot decide whether he likes robots or pirates best.

Timmy’s parents switched insurance plans (and jobs) when Timmy was 8 months old and out of the NICU. On that new plan, he has run up $985,147.19 in medical bills. He will likely hit $1 million in the next few months.

Right now that doesn’t really matter. But if Republicans roll back this provision of the law — as some replacement plans do and some lobbyists are urging — it could drop a threat of bankruptcy onto Timmy’s family.

Timmy could find himself above the cap the moment the new law passed. Or he might have his old costs grandfathered in and the counting start anew. It would all “depend on the language of the statute that Congress passes,” says Nicholas Bagley, a health law expert at the University of Michigan. “I don’t think there’s any guarantee for the family of the 6-year-old boy. There’s just a lot of uncertainty.”

The Affordable Care Act is brimming with provisions like these: small parts of the law that are hugely consequential for the people who rely on them. These provisions complicate the matter of repeal and replace, because they all have constituencies that will show up for a lobbying battle in Washington — and their stories could tug at the heartstrings of voters who otherwise support the repeal effort.

The lifetime limits ban is a few paragraphs of a 1,300-page law. It isn’t crucial to making the coverage expansion work in the way that, for example, the individual mandate or insurance subsidies are. But the ban is absolutely crucial to making the Morrisons’ lives work.

“We don’t really know what to do right now,” Michelle Morrison says. “Should we start pressuring his doctors to do a surgery now so he can get it in time? That doesn’t feel right. Insurance is supposed to cover things that you can’t anticipate — and for us, this is one of them.”

buzzfeed.com
Trump Gives Republicans An Ultimatum On Health Care Bill: Vote Or We're Done
After Republicans delayed a vote on their health care bill, lacking enough votes to pass it Thursday, an agency head told members Thursday night that if they don’t pass it by Friday, the White House is done.
By Paul McLeod, Alexis Levinson

House Republicans clearly do not have the votes to pass their health care bill and on Thursday night, President Trump’s administration told them in no uncertain terms: Pass it tomorrow or we’re done.

After a day full of meetings and last-minute arm-wringing went nowhere, Trump dispatched two deputies to Capitol Hill for an evening meeting of the House Republican conference. Trump adviser Kellyanne Conway, White House senior adviser Steve Bannon and former Rep. Mick Mulvaney, now Director of the Officer of Management and Budget, in the meeting, in which Mulvaney told Republicans that the White House is done negotiation and will move on from the health care issue unless the House passes the bill on Friday, according to a GOP aide.

The threat comes after House Republican leadership desperately scrambled Thursday to save the American Health Care Act. Despite talk of progress, Speaker Paul Ryan and his team clearly still did not have the necessary votes to bring the sweeping bill to replace Obamacare to the floor on Thursday, as originally planned. That vote has been pushed off to Friday for now.

Ryan briefly spoke to reporters after the meeting. “For seven and a half years we’ve been promising the American people that we would repeal and replace this broken law because it is collapsing and failing families. Tomorrow we’re proceeding,” Ryan said, taking no questions and walking away.

When asked whether Republicans now have the votes to pass the bill, Rep. Steve Stivers who chairs the National Republican Congressional Committee told reporters they will see where they are on Friday.

“I think we’ll find out tomorrow,” Stivers said. “I think it’s gonna be a surprise.”

Both the hard-right House Freedom Caucus and some moderate Republicans remain opposed to the bill, despite an overwhelming push from Republican leadership and the White House.

“We’re committed to stay here until we get it done. So whether the vote is tonight, tomorrow or five days from here, the president will get a victory because I believe we all want to negotiate in good faith and deliver on the promise,” Freedom Caucus chairman Mark Meadows said in the middle of a marathon of meetings.

Meadows said he was still a no on the AHCA, as are many of his Freedom Caucus members, but he is “desperately trying to get to yes.”

The problem remains the same for leadership — any push to win over the Freedom Caucus further alienates moderates and vice versa. After nearing a deal on Wednesday night that the Freedom Caucus seemed optimistic about, moderate members said they could not support the changes.

Even after the meeting with members and White House officials on Thursday night, some Republicans remained unmoved. New York Rep. Dan Donovan, the lone Republican congressman in New York City, exited the meeting saying he was still a no.

“I’m not a fan of the Affordable Care Act. It’s hurt people in my district. This is not giving them the relief that they need,” he said.

Meanwhile, Republicans who are on-board with the plan are growing increasingly frustrated with their colleagues who won’t sign on. “You get one chance at something like this. So we need to get it done,” Oklahoma Rep. Tom Cole said. “You’re either part of a team or you’re not.”

Republican leadership made a last-minute pitch to the Freedom Caucus before Thursday’s now-delayed vote that seems to have fallen short. Meadows spoke of promises being too vague and not going far enough to bring down insurance premiums.

The deal revolves around the Freedom Caucus’ desire to do away with the essential health benefits (or things insurance plans must cover) introduced under Obamacare. Ways and Means Committee Chairman Kevin Brady said the compromise involves giving states the power to do away with these benefits, rather than doing it at the federal level.

House Veterans Affairs Committee Chair Phil Roe said this policy would only impact the individual markets, which makes up about 6% of the total health insurance market.

Essential health benefits mandate that all health insurance plans must cover certain things such as hospitalization, maternity costs, ambulances, pediatric care, addiction treatment, emergency services, and prescription drugs.

The Freedom Caucus argues these and other Obamacare rules drive up premium costs. Brady said the group is pushing for even more freedom to remove these rules than what is in the offer currently on the table.

Earlier on Thursday, House Majority Leader Kevin McCarthy would not commit to holding the vote on Friday when asked on CNN. McCarthy said only that the House will begin debating the bill formally on Friday and that he hoped it would pass that day.

But after the meeting with the White House, a GOP aide said that Republicans will vote Friday.

“We’re going to get this done. … I know we’ll get this done,” McCarthy said on CNN. “Look, when we bring it to the floor we’re going to have the votes.”

It takes 22 Republicans to vote no to kill the bill. About two dozen have declared to be either a hard no or leaning no, not including softer members of the Freedom Caucus who could flip if their group ultimately endorses the plan.

White House Press Secretary Sean Spicer told reporters Thursday that the administration is confident the bill will pass, after saying in a press conference earlier this week that “there is no plan B.”

“It’s going to pass, so that’s it,” Spicer said Thursday.

BREAKING: Neil Gorsuch is Donald Trump’s Supreme Court nominee

  • Neil Gorsuch, a 49-year-old judge from the United States Court of Appeals for the 10th Circuit, is President Donald Trump’s pick to replace late Supreme Court Justice Antonin Scalia.
  • Trump announced Gorsuch’s selection in a highly publicized Tuesday evening address. 
  • The pick will likely delight conservatives and dismay progressives; Gorsuch, like, Scalia is a judicial originalist and strict textualist, meaning he believes constitutional law should be interpreted only in the context in which it was written and justices should not consider legislative intent when making decisions.
  • Gorsuch could potentially serve the court for decades, shaping the course of the nation’s judicial system long after Trump leaves office.
  • According to Vox, he’s “reliably, though idiosyncratically, conservative” on a number of issues, including opposition to assisted suicide and euthanasia, that the Affordable Care Act’s birth control mandate is unconstitutional and he has taken a “limited view of a defendant’s right to competent representation.”
  • Gorsuch is quite amenable to the religious freedom arguments social conservatives have deployed to justify discrimination against LGBTQ people in recent years.
  •  He was one of the justices who ruled against former President Barack Obama’s administration in their case against Hobby Lobby, which argued it was free under the federal Religious Freedom Restoration Act not to offer employees insurance covering contraceptives as mandated in the Affordable Care Act. Read more

The point of Harwell’s report was that the investigation found that the workers at the facility were often earning less than China’s minimum wage in some parts of the country, which is a more important metric. Additionally, the average manufacturing employee in China earned twice what employees at G-III were making. What’s more, those employees were forced to work more in overtime than is allowed under Chinese law, working up to 82 hours of overtime a month when the law caps the allowable total at 36 hours. Less than one-third of them were offered mandated medical insurance coverage and pensions, and the company didn’t contribute to an affordable housing fund as mandated.

Slate’s story largely covered those points, too. But the focus on the $1-an-hour actually obscures the deeper issue at play here: A company that, even by the different standards guiding Chinese businesses, wasn’t hitting the mark.

Congress Passes Socialized Medicine and Mandates Health Insurance -In 1798

Congress Passes Socialized Medicine and Mandates Health Insurance -In 1798

“In July of 1798, Congress passed – and President John Adams signed - ‘An Act for the Relief of Sick and Disabled Seamen.’ The law authorized the creation of a government operated marine hospital service and mandated that privately employed sailors be required to purchase health care insurance.”

“Keep in mind that the 5th Congress did not really need to struggle over the intentions of the drafters of the Constitutions in creating this Act as many of its members were the drafters of the Constitution.”

https://www.forbes.com/sites/rickungar/2011/01/17/congress-passes-socialized-medicine-and-mandates-health-insurance-in-1798/#655a63c553ff

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It’s hard to be funny this week.

I had a number of good intentions for the last five days: make headway on my NaNoWriMo project (I did not), finish beta reading for a friend (I did not), and draw some funny stuff for y’all (spoiler alert: I did not.)

Instead, I cried (a lot), panicked over my mother’s cancer treatment coverage (a lot), and called people misogynist racists lacking even a shred of human compassion (spoiler alert: I especially did this a lot.)

I was not very funny. Even now, the jokes I’ve made are the kind of “laugh in disbelief because hey, your friends all died in a plane crash, but look the life raft deployed just fine on the tarmac” sort of funny. I’ve already alienated one friend whose mother may have voted for Trump, and one family member who certainly voted for Trump, and perhaps if I make it to five people within the month that’ll fill up my punchcard and I’ll get a free latte.

Caption: a letter that will guarantee a lot of awkwardness in my future.

I’ve had people try to tell me it won’t be as bad, that he’s already changed his mind about preexisting conditions and gay marriage and aren’t we overreacting, give him a chance, let’s see how he actually governs. 

To which I say: if a man has spent the last year waving a knife in your face and telling the rest of the country he’ll stab you if they vote for him, and your country[’s very flawed electoral college system] says “go ahead, stab them, we actually vote for stabbing”, why on earth would you believe that man when he leans back and says “actually I’m good, no stabbing, even though I promised people with my nuts in a vice that I would stab you. Don’t sweat it.” (Admittedly this metaphor is a little on-the-nose.)

Many creative folks are pretty shaken right now. Good luck affording individual health care without the exchanges, right? Good luck convincing your employer to insure you without the mandate. Good luck hoping your state gives a shit about gay marriage, reproductive rights, but hey come move to the big city on the coast where this stuff is safe, and your vote will now count for 1/6th of a voter in Wyoming.

I chipped away at that shellacking of existential horror today a little. I cut off family, I went to my first protest, I did something to feel like I fought back in a way that wasn’t just passive-aggressive posts on Facebook. (Really more aggressive than passive. Think “YOU CHOSE THIS, YOU WROUGHT THIS ATROCITY ON ME AND MY COUNTRY, AND BY GOD I WILL BE SHRIEKING THIS IN YOUR EAR LIKE THE FURIES ON ORESTES FOR EVERY WAKING MOMENT OF THE NEXT FOUR YEARS.”

Caption: Furies screaming at Orestes and pointing to his mother, whom he stabbed. They are probably saying, “UNFRIEND ME, MOTHERFUCKER, I DARE YOU.”)

Anyway.

I did stuff today. Not fun stuff like drawing or writing, but stuff that felt like I am beginning to draw my line in the sand. A line that says the Electoral College is bullshit. A line that says Trump’s abhorrent stances were never state secrets, and for some they were incentives, for others an acceptable loss. A line that says my people are my people, and they are of many nations, faiths, races, genders, orientations, bodies, and they are my fucking people and if you want them you go through me.

A line that says I’m sorry I didn’t draw this sooner.

I don’t think it’s coincidence that when I came back home from a day of drawing my line, I felt like writing again.

Caption: the sign I made. It says “Tomorrow There’ll Be More of Us”, which is of course a Hamilton quote, and consequently my sign was absconded with by a Hamilton fan while I was on a bathroom break. Moral of the story: never leave your sign unattended. 

But I do hope it’s right. It feels like all around the country these lines are being drawn. People are saying, collectively, this is bullshit in so many ways, on so many levels, it is a tiramisu of bullshit and we are going to be on the right side of history. 

I hope there will be more of us.

I plan on making it a self-fulfilling prophecy.

vox.com
Insurers don’t have to cover birth control under GOP’s revised health bill
The updated Senate health bill kills Obamacare's birth control mandate.
By Tara Golshan

The Affordable Care Act ensures that all FDA-approved birth control methods are covered without a copay if you have health insurance, with few exceptions.

But the revised Senate health care bill would scrap the birth control mandate — allowing insurance companies to sell plans that don’t include any of the currently mandated women’s preventive health services, from birth control to HPV testing.

This change is part of a broader rollback of preventive benefits: If the Senate bill becomes law, health insurers will be able to offer plans that don’t cover a range of these services, from cancer screenings to childhood immunizations. Under the Affordable Care Act, all insurers are required to cover them.

Insurers would have to sell at least one comprehensive plan that complies with all the Obamacare-era regulations. But as long as they did that, they could also sell skimpier, cheaper plans, including ones that exclude women’s preventive care.

The Senate Republican health care bill is daring these moderates to vote for Medicaid cuts
McConnell’s offer is this: nothing. In one critical sense, the new Senate health care bill is the same as the old Senate health care bill: It still includes deep cuts to Medicaid. The revised legislation drafted by Senate Majority Leader Mitch McConnell (R-KY) will make some changes to the original bill, such as adding money to combat the opioid crisis and potentially relaxing Obamacare’s insurance mandates, among other things. Read more

So even though my insurance company covers trans related surgeries, the employer my dad gets the insurance through is self funded so they don’t have to follow New York State law that mandates all insurance providers cover trans related health care. They are a catholic health center so they exclude all the trans coverage that the insurance company they are under usually covers. Three weeks before surgery and my coverage is pulled.

3 ways repealing Obamacare affects millennial health care

What will replace Obamacare?

  • The Urban Institute released a study showing that if parts of the ACA are pulled apart — as was proposed in the vetoed January 2016 bill — without a replacement, nearly 30 million Americans will become uninsured, including 4.4 million children.
  • Republicans are now floating replacement plans, including House Speaker Paul Ryan’s “A Better Way” plan and a proposal devised by Trump’s pick for secretary of Department of Health and Human Services, Georgia Republican Senator Tom Price.
  • Price’s approach is to replace insurance exchanges and individual mandates with tax credits based on age to help people buy insurance themselves. 
  • The government could give grants to states to establish pools for those with high health care costs who cannot find insurance on their own.

Women’s birth control may no longer be covered.

  • Mandating that insurance companies pay for female contraceptives was a hornets’ nest of contention during the design of the ACA.
  •  The issue brought the eventual law before the Supreme Court, which, hampered by a vacant seat, sent the case back to a lower court.
  • Under the ACA, 18 types of federally approved birth control must be covered by health insurance plans offered in the exchange — with no copay and no out-of-pocket expenses.
  • While insurers, under the ACA, are required to cover a type of each of the 18 kinds of contraception for free, they are still allowed to charge women for name brand or more expensive versions.
  • Removing the provision could result in a shift back to private providers for contraceptive care.

Women’s costs may be higher.

  • Women may pay more for the same health insurance if the ACA is repealed. 
  • The ACA issued a final ruling in May highlighting its regulations that prohibit the discrimination of coverage based on race, color, national origin, sex, age or disability.
  • These protections have been in place for many years, but for women the ACA has made a big difference. 
  • Prior to the ACA, women were routinely charged up to 50% more for the same health coverage — and for some women it was as high as 81%. Even after the ACA was enacted, a gender gap sill persisted.
  • But with the final ruling this year, the practice of “gender rating,” or charging women more because they are considered to be a higher risk (i.e., they visit the doctor more, live longer and have babies), is illegal.
  • Still, some health care industry analysts believe that insurance companies should be able to use gender rating as a tool in charging patients more.
  • This suggests that without a mandate to keep insurance companies from charging women more, they may revert to a policy similar to car insurance, in which teenagers can be charged more because of their higher risk.
  • This would leave women without the protection of gender parity.

The return of rescission.

  • One of the things the ACA brought you was the peace of mind that should you — healthy, active and young, the kind of person health insurance companies love — get sick, the company cannot cancel your policy.
  • The practice is called rescission. The ACA outlaws it. With the Republicans’ interest in fewer federal regulations and lower costs, there are no assurances that replacement legislation would have such patient protections in place. Read more
6 million US households face Obamacare tax for not having health insurance

Can’t afford health insurance?  Well, it’s time to pay up.  Obamacare is going to get you whether you participate or not. 

from Wall Street Journal:

The U.S. government estimates as many as six million households may have to pay a penalty for not having had health-insurance coverage last year as required under the Affordable Care Act, officials said Wednesday.

About 150 million taxpayers are expected to file returns during the coming tax season, said Mark Mazur, assistant secretary for tax policy at the Treasury Department. The tax-filing process this year is expected to be trickier because Americans will, in some cases, have to pay a penalty or get smaller refunds because credits they received to offset insurance premiums were too large.

Up to 20% of tax filers—or about 30 million—who weren’t insured for most or any of last year likely will request and receive an exemption from the penalty, officials said. Many exemptions can be applied for during the tax-filing process.

Government agencies are encouraging Americans to file their taxes electronically and are providing filers information via email, phone and text messages. They also are offering support tools on the Internal Revenue Service and other federal websites.

The health law requires almost all Americans to have coverage or pay a penalty, with some exemptions. About 2% to 4% of tax filers are expected to have to pay the fine for not having carried insurance in 2014, which is $95 per adult, or 1% of family income, whichever is greater.

read the rest

That penalty/tax is only $95 now, but that number will grow every year. That’s the way the law is written.  Every year health insurance costs will rise, and every year the Federal Government will punish Americans even more for not being able to afford it.  

This is what happens when the government is allowed to force private citizens to buy something.  

Buycotting. The second great neoliberal innovation in murketing is the creation of the phenomenon of “buycotting,” or as it is sometimes called, “ethical consumerism” (Yates, “Critical Consumption”). Instead of seeming to bypass the market altogether, as in the first case, here everyday participants are enticed to believe that it is possible to mitigate some of the worst aspects of market organization by paying an “ethical premium” for particular commodities and helping to make the world become a better place. Previous generations had sought to punish firms that were perceived to violate ethical norms by boycotting them, viz., organizing the wholesale withdrawal of purchasing power from the products of the targeted firm. In the current neoliberal era, people have been weaned off the notion that concerted political abdication from market behavior can ever succeed in its objectives, and instead have been seduced into believing that the market itself can offer sufficient choice in expression of political programs along the entire spectrum. Worried about global warming? Imaginative entrepreneurs have endeavored to purvey “carbon offsets” to consumers. Want to help African AIDS patients? Get yourself an AMEX Red Card. Want to support small independent producers in underdeveloped countries? Other entrepreneurs have conveniently developed “fair trade” brands for coffee, textiles, glass, and other imports.
The intellectual defenses surrounding the phenomenon of buycotting are especially instructive concerning the ways that the NTC has managed to neutralize its political opponents through the techniques of murketing. It is one of the neoliberal commandments that innovations in markets can always rectify any perceived problems thrown up by markets in the first place. Thus, whenever opponents on the nominal left have sought to ameliorate some perceived political problem through direct regulation or taxation, the Russian doll of the thought collective quickly roused itself, mobilized to invent and promote some new market device to supposedly achieve the “same” result. But what has been often overlooked is that, once the stipulated market solution becomes established as a live policy option, the very same Russian doll then also rapidly produces a harsh critique of that specific market device, usually along the lines that it insufficiently respects full market efficiency. This seemingly irrational trashing of a neoliberal policy device that had earlier been emitted from the bowels of the NTC is not evidence of an unfortunate propensity for self-subversion or unfocused rage against government, but instead an amazingly effective tactic for shifting the universe of political possibility further to the right. For buycotting always constitutes a tactical half-measure within the neoliberal project: one observes this in the initial promulgation and subsequent scuppering of carbon cap-and-trade schemes (described in chapter 6), including consumer purchase of “carbon offsets”; one observes it again in the imposition of “health insurance mandates” as a preemptive substitute for the single-payer system found in Europe, and then followed rapidly with the subsequent sabotage and rebellion against them in the United States, once they became the “centrist” approach to health care reform. The same dynamic has now has been kicking in with some forms of ethical consumerism. Buycotting exists to lull the uncommitted into belief that they can reconcile their skepticism of market results with redoubled participation in market purchases; only then to reprimand them for failing the efficiency test in the sphere of their ethical purchases.
—  Philip Mirowski, Never Let a Serious Crisis Go to Waste
Obamacare, Just Another Bail Out

Try to think of Obamacare as yet another bail out of a troubled industry.  Many folks, financially able, had elected to forego the purchase of health insurance.  This was due to the fact that in their minds as consumers, the value of the product didn’t match the price. Purchase of health insurance didn’t seem like a “win-win” deal.  Part of the reason for the high price is that insurance companies had successfully lobbied to the gunvernment to mandate the coverage of certain services in insurance policies, services for which many people had no use.  In other words, folks were forced to buy insurance policies that covered risks that were very unlikely to be encountered.  

One could not buy a policy without coverage for mental illness, drug abuse, maternity care, etc.  The consumer was no longer in control of determining the risk/benefit in the insurance product.  One had to buy this coverage whether they wanted to or not.  This, of course, drove the price of the health insurance policies through the roof, along with the profits of the insurance companies.  Rather than adjust to this distorted market, more insurance mandates were issued.  Fewer and fewer people found these policies to represent a value and therefore risked the position of the uninsured.

Enter the gunvernment into the market arena.  Out come the guns.  "Let’s just force everyone to buy these awful insurance policies.  Furthermore, let’s disallow policies like high deductible policies, that encourage consumerism in health care.  This “first dollar” coverage will maintain premiums or even drive them to the stratosphere!“  

Insurance executives have told me over the years that the current situation was unsustainable.  What they really meant was that more and more people were abandoning their product, making a go of it on their own, rather than buying in.  In most cases, this is a good bet, particularly for the young and healthy.  If they were to save what they would have to pay for insurance premiums for a year or two, they could afford just about anything that human illness could throw at them.  Not always, but almost always.  

Even now, the price of an open heart surgery in Oklahoma City at a physician owned cardiac hospital (with outcomes as good as the big names) is $26,000.  A total hip replacement?  $18,000.  A cervical fusion (including hardware) at my facility (easily over $100,000 at a typical "not for profit” hospital), $21,500.  These numbers are very near one year’s insurance premiums in Massachusetts, home of Romneycare.  

This increase in the price of insurance, in excess of the care it would buy, was going to lead to only one place:  fewer and fewer people playing this game.  Answer?  Have the gunvernment make everyone buy this crap and put most of the companies (leaving only a few giants in business) out of business in the process, preventing the competition that would keep these corporations honest.  Obamacare was nothing more than a bailout.  The insurance companies were bailed out of a situation they had created with their gunvernment pals, one that did not bode well for them.  

I like Thomas DiLorenzo’s term, fascialism.  This combination of fascism and socialism perfectly describes the operation of this gunvernment, one which brings us crony capitalism coupled with massive wealth redistribution.  We are left without the freedom to not buy something we don’t think we need.  Think about that and what it means.  Lew Rockwell has characterized the GM bail out in the same way.  We basically all bought GM cars against our will but never took delivery.  We were made to buy their cars with our money yet no car was in the bargain.  

Obamacare is no different.  We are all now forced to buy a product that many don’t need or want.  The insurance products that we might want will not be allowed on the market as there is not enough profit in it for the insurance companies.  Little health care will be available as the pressure to deny care in order to increase profits will be manifest soon enough.  Pay against your will, coupled with a contract breach.  That is the nature of a bail out and the nature of Obamacare.

G. Keith Smith, M.D.

7 Things Pro-Lifers Need To Do If They Want To Be Taken Seriously

I’ve been on both sides of the abortion issue. I was raised pro-life and I still think the world would be better if abortions never happened. However, I’ve also worked in a maternity hospital and saw first-hand the legitimate and heart-breaking reasons women choose to have abortions.

Having been on both sides of the camp, I can tell you that pro-choicers do not take pro-lifers seriously at all. They are seen as ignorant panicky hypocrites at best, and as woman-hating fascists at worst. There are good reasons that they are viewed this way. The Republican party in the US has harnessed the power of the single-issue voter. They convince pro-lifers that they are the only party saving the “poor unborn babies” and then they use those votes to create policies that indirectly cause more abortions to happen. Because of this, pro-choicers no longer even believe that pro-lifers care about the unborn. Their hypocritical and contradictory beliefs and behavior continually undermine their own movement.

There are a few things that pro-life supporters could do (and probably won’t) that would make the pro-choice side take them more seriously.

1. Start actually giving a shit about genuine murder. We hear you talk about abortion being murder, but you are silent at best in the face of actual murder. When 12-year-old Tamir Rice was murdered by the police, half of my “pro-life” friends were completely silent and the other half supported the officer who murdered him. We see you protesting abortion clinics, but where is your protest when your government is waging war and killing innocent people all over the globe? You demonize women who seek abortions and the doctors who perform them, and then you worship the US military. How can we believe that you genuinely care about the death of a fetus when you don’t genuinely care about the deaths of fully-developed people? Your silence about unjust deaths speaks much louder than you think.

2. Support children. You insist that every child who is concieved should be born, but then you support politicians who cut welfare spending and WIC, and who fight against access to healthcare for the poor. If you want women to finish every pregnancy, you have to step up and vote for people who will provide the access. Stop electing those who privatize and underfund education and childcare. You cannot demand that children be born, and then stop providing any support once they take their first breath.

3. Support comprehensive science-based sex education. People who have proper and complete sex education, taught without shame and prohibition, are more likely to decide to have safe sex or even no sex at all. States that have mandated science-based sex education continually have lower teen pregnancy rates and lower abortion rates than those which teach abstinence or nothing at all. This is a practical step that can reduce the number of abortions that happen, and conservatives lose credibility and respect every time they vote against it.

4. Support access to contraception. States that have mandated insurance to cover birth control have lower abortion rates. It is that simple. People who can afford to prevent unwanted pregnancies don’t have to terminate unwanted pregnancies. This is another simple measure that could reduce abortions across the board that conservatives continually fight against, which makes pro-choicers doubt whether you actually care about unborn babies as much as you care about controlling the choices of their mothers.

5. Stand up against poverty and quit supporting politicians who work only for the wealthy. One of the leading reasons for abortions is poverty. If you support a higher minimum wage and tax cuts for families instead of tax cuts for corporations, people will be able to afford to complete their pregnancies. When you punish the poor, you are causing more abortions to happen. Reducing income inequality will reduce abortions.

6. Support the LGBTA+ community. If you want to insist that every pregnancy should end in birth, those children need families. There are already hundreds of thousands of orphans and children in foster care and not enough parents for all of them. If you want to tell people they can just give their unwanted children up, you have to allow able and willing couples and single people to adopt those children, regardless of sexual orientation. You can’t push more children into the adoption system and then push willing parents out of it.

7. Stop calling for an abortion ban. Wait! Hear me out. Countries all over the world have banned abortion. Abortion has not stopped in any of those countries: it just moves underground and makes it much more dangerous for the frightened women involved. If abortion is banned, you will not stop women from seeking abortions; you will only criminalize them for it. Look at the war on drugs. Has it ended drug addiction? Did prohibition end alcoholism? The American tendency to just make things illegal instead of trying to combat the roots of the problems is what has led you to have the highest incarceration rate in the world. Don’t turn abortion into yet another way to feed corporate prisons.

If pro-lifers want to be taken seriously, they need to start taking rational and practical steps to reduce the demand for abortion and to support all children. No one on the other side will believe that they care about unborn children until they do.

The Staples story illustrates the environment of so many contemporary American workplaces, where employees are treated with contempt and suspicion while being told how much they’re loved. The original Buzzfeed story contains a Staples memo threatening part-time employees with discipline up to termination if they clock in for more than 25 hours in a week. The memo ends with, “I appreciate and value you.” I’m sure that warmed the workers’ hearts.

There may be some part-time workers who find that in response to the ACA’s insurance mandate, their employers try to limit their hours in the way Staples is doing. That’s why Republicans want to change the mandate’s definition of full-time employment from 30 to 40 hours. But we should be clear about what would happen if Republicans got their way. Some number of people like those at Staples might be able to work a few more hours (though if Staples is telling the truth, it wouldn’t matter for their part-timers, because they’re adamant about keeping them below 25 hours regardless). But a much larger group — full-time hourly workers — would then be in danger of losing their health coverage.
usatoday.com
Supreme Court agrees to rule on birth control insurance mandate
The U.S. Supreme Court agreed Friday to rule on a dispute between religious non-profits and the Obama administration over birth control insurance coverage. The new challenge asks the court to overturn decisions that would force the groups to take action to opt out of the requirement to pay for employees' contraceptives rather than receive blanket exclusion.

Follow this story on Breaking News.