Category Archives: SCHIP

The Moderate Heller Myth: Health Insurance Edition

Senator Dean Heller (R-NV) has cultivated his “moderate” image to the point that this adjective is attached to him with remarkable consistency — when if a person does even a perfunctory piece of research on his actual voting record what emerges is the model of a hard line conservative.  There is a pattern.  The Senator expresses “concerns” with a bill; then announces with ranging degrees of fanfare his opposition to a bill “in its current form,” then when the rubber grinds on the road surface the Senator votes along with the Republican leadership.

Why would anyone seriously believe he would support fixing the Affordable Care Act’s problems and not ultimately support what is now being called the “skinny repeal” version in the Senate based on the following voting record:

In 2007 then Representative Heller voted against the Medicare Prescription Drug Price Negotiation Act (HR 4).  Then on August 1, 2007 he voted against HR 3162, the State Children’s Health Insurance Program reauthorization.  The next day he voted against HR 734, the Prescription Drug Imports bill.  On March 5, 2008 he voted against HR 1424, the Mental Health Coverage bill.  Further into 2008 he voted “no” on HR 5501, the bill to fund programs fighting AIDS, Malaria, and Tuberculosis, and “no” again on the concurrence version of the bill in July.   If he had a ‘flash’ of moderation during this period it happened in the summer of 2008 when he voted in favor of HR 5613 (Medicaid extensions and changes), HR 6631 (Medicare), the latter including a vote to override the President’s veto.  By November 2009 he was back in full Conservative mode.

He voted against HR 3962 (Health Care and Insurance Law amendments) on November 8, 2009, and HR 3961 (Revising Medicare Physician Fee Schedules and re-establishing PAYGO) on November 19, 2009.

In March 2010 Heller voted against HR 4872 (Health Care Reconciliation Act), and HR 3590 (Patient Protection and Affordable Care Act).  He also voted against the concurrence bills.

January 19, 2011 he voted in favor of the Repealing the Health Care bill (HR 2).  He also signaled his stance on Planned Parenthood when he voted in favor of H.Amdt. 95 (Prohibiting the use of Federal funds for Planned Parenthood) on February 18, 2011.    He was in favor of repealing the individual mandate (HR 4), of repealing the Prevention and Public Health Fund (HR 1217).  May 4, 2011 he voted to repeal funding of the construction of school based health centers (HR 1214).

There was another “soft” period in some of his initial Senate votes in 2011, especially concerning the importation of medication from Canada (interesting since many prescription drugs are manufactured in other overseas sites).  See S. Amdt 769, S. Amdt 2111, and S. Amdt 2107 in May 2012.  On March 31, 2014 he voted in favor of HR 4302 (Protecting Access to Medicare).

He was back riding the Republican rails in September 2015, supporting an amendment to defund Planned Parenthood, (S. Amdt 2669) which failed a cloture vote.   Then on December 3, 2015 he voted in favor of another ACA repeal bill (HR 3762).    If we’re looking for patterns in this record they aren’t too difficult to discern. (1) Senator Heller can be relied upon to vote in favor of any legislation which deprives Planned Parenthood of funding for health care services, (2) Senator Heller can be relied upon to vote in favor of repealing the Affordable Care Act, and (3) Senator Heller’s voting record, if it illustrates any ‘moderation’ at all, comes in the form of dealing with prescription drug prices, but even that is a mixed bag of votes.

Thus, when he makes comments like the following:

“Obamacare isn’t the answer, but doing nothing to try to solve the problems it has created isn’t the answer either,” the statement read. “That is why I will vote to move forward and give us a chance to address the unworkable aspects of the law that have left many Nevadans — particularly those living in rural areas — with dwindling or no choices.

“Whether it’s my ideas to protect Nevadans who depend on Medicaid or the Graham-Cassidy proposal that empowers states and repeals the individual and employer mandates, there are commonsense solutions that could improve our health care system and today’s vote gives us the opportunity to fight for them. If the final product isn’t improved for the state of Nevada, then I will not vote for it; if it is improved, I will support it.”

We should examine them with some caution.   If he is referring to rural Nevada voters as ‘victims’ of the Affordable Care Act he might want to note that before the ACA there was one insurer in the northern Nevada rural market and if there is only one now that’s really not much of a change, much less a “nightmare.”  Nor is he mentioning that the proposed cuts to Medicaid will have a profoundly negative effect on rural Nevada hospitals. [DB previous]

That Graham-Cassidy proposal isn’t exactly a winner either:

“The new plan released Thursday morning and written by Republican Sens. Lindsey Graham (S.C.) and Bill Cassidy (La.) would block grant about $500 billion of federal spending to the states over 10 years to either repeal, repair or keep their ObamaCare programs.”

We have no idea if the number is an accurate estimate of what would keep the health care systems of all 50 states afloat — no one seems to want to ‘score’ anything these days.  Additionally, Americans should be aware by now that when Republicans chant “Block Grant” they mean “dump it on the states, wash our hands, and walk away” while the states struggle to keep up with demands to meet needs and provide services, operating on budgets which cannot function on deficits.

Then, there’s that perfectly typical Hellerian comment: “If it is improved, I will support it,” leaving the issue entirely up to Senator Heller’s subjective assessment if “it” has improved his re-election chances enough to go along with it while not upsetting his very conservative base.  Meanwhile, the media persists in repeating the “Moderate Heller” mythology, and we haven’t even begun to speak of his actions to thwart and later repeal any common sense regulations on the financial sector.

 

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Filed under conservatism, Health Care, health insurance, Heller, Medicaid, Medicare, Nevada Test Site, Politics, public health, Republicans, Rural Nevada, SCHIP

Romney’s Pig in A Poke Tax Plan: Robin Hood In Reverse

Let’s be blunt and tactless about this — the numbers don’t add up. They have never added up. They never will add up.   We could be having a very honest debate about whether or not to privatize Social Security, or whether to transform Medicare into a voucher/coupon program in which Seniors would revert to buying their own private health insurance plans.  But, we won’t.  We could be having a discussion about spending for education, for nutrition programs, for veterans health care … but we probably won’t.  Let’s take a look at a handful of specifics.

Social Security

The Romney campaign won’t say “let’s privatize Social Security.”  Instead, he’s offering a plan which: “Would increase Social Security’s eligibility age by one month per year beginning in 2022 and index future program eligibility to life expectancy. He also wants to slow the rate of benefit growth for high-income recipients.”  [KCStar]

Who is living longer? The “people are living longer” theme is catchy.  However, it’s not a universal trend.  For example, we’ve known since 2006 that the life expectancy of most Americans is 77.9 years, but the life expectancy of a low income white person in Appalachia and Mississippi is 75 years.  For African-Americans in middle America the life expectancy is 72.9 years, however for African-Americans in high risk urban areas the life expectancy is 71.1 years.  Unfortunately, for Native Americans in South Dakota the life expectancy was reported at 58 years.  [DNCentral]   The trends are holding; a white male has a current life expectancy of 75.9 years, an African-American male 74.3 years. A white female can expect to live 82.4 years, but a black female can only expect 79.2 years.  [Census pdf] Thus, for white people in the U.S. the increasing longevity rate would tend to support raising the tables — however, for non-white citizens the numbers aren’t that congenial.

Then there’s the slow the rate of benefit growth for high-income recipients part — that’s a polite way to say means testing.   The AARP explains its opposition:

“The notion that the benefits are an earned right separates Social Security from means-tested income-support programs. Social Security can help everyone. Means testing is a feature of taxpayer-funded welfare programs designed to help the poor. A means test would inevitably erode the universal and contributory nature of Social Security and some of the popular support that has sustained it for nearly 75 years.”

Imposing new limits for the well-off could backfire in various ways. A means test could adversely affect retirement planning and lower the personal savings rate if people concluded the program would penalize them for having higher retirement incomes or larger nest eggs. It would discourage older persons from continuing to work beyond eligibility age, depriving them—and the economy—of additional money. It would create incentives for people to take lump-sum distributions from pension plans, strategies that could prove shortsighted and harmful.”

That just about sums it up.

Medicare

There’s nothing harder to analyze than a moving target.  If the Romney Campaign is incorporating “savings” into its tax formulation by assuming reductions in Medicare costs — good luck with that.  The campaign appears to have settled — for the moment — on the revisions made to the Ryan Plan for FY 2013.   However, the campaign hasn’t released the details necessary to make a thorough examination of the impact of the plan.  [Politifact]

“…there are two big differences between the new plan and the earliest one: The newer version allows beneficiaries under 55 a choice of using their payment to buy private insurance or a plan that acts like traditional Medicare. The amount of their payment would be set by the price of the second-cheapest plan.”  [Politifact]

Acts like traditional Medicare?  What is that?  Medicare Advantage?  Are Medicare Advantage really more cost effective — or do the plans tend to attract healthier (and wealthier) participants, and to avoid costs included in traditional Medicare such as supplemental payments to hospitals which take Medicare patients?  This is one topic in which numbers and terms are often massaged to present the ideology in the best possible light.  Enter the Free Market Fairy.

Aides to the GOP candidate say the plan would rely on competition — without caps or a cost-cutting board — to control spending and avoid cost shifts to seniors.”  [ABC]

IF competition were the magic answer to cost savings in medical programs for the elderly — then why doesn’t the Medicare Advantage program (the free market alternative to traditional Medicare) eschew the federal subsidy paid to insurance corporations to offer health care insurance to elderly people?  IF the Free Market Fairy could dust our landscape with health care insurance at lower cost than the traditional Medicare, why have any subsidy at all?

However, when the Affordable Care Act (Obamacare) sought to reduce the subsidies to the Medicare Advantage offering corporations, Republicans squealed about “cutting Medicare” to every elderly audience who would listen.

Medicaid

The cuts to Medicaid are far more profound than those for Medicare.   The Romney/Ryan plan could slash $1.4 billion over the next ten years — a cut of approximately 34%.  [Philly.com]   The discretionary spending cuts in total would look like this:

The CBPP explains:

“Medicaid and the Children’s Health Insurance Program (CHIP) would face cumulative cuts of $1.5 trillion through 2022 if Medicare is subject to cuts and $1.9 trillion if Medicare is exempt.  Repealing health reform’s coverage expansions, as Governor Romney has proposed, would reduce Medicaid spending by $618 billion over the next ten years and account for 30 to 40 percent of the reductions.  Repealing health reform by itself would leave uninsured 30 million people who would have gained coverage under health reform, according to CBO.  Analysis by the Urban Institute suggests that the additional Medicaid cuts would likely add at least 14 million to 19 million more people to the ranks of the uninsured.”

Medicaid now provides health care coverage for approximately 52 million Americans.  Over 13 million of these are individuals who are elderly or disabled.  It pays about half of all nursing home expenses, about 60% of nursing home residents are covered by Medicaid. 26% of Medicaid spending is for services to the elderly, 43% is for low income disabled persons, 12% is for low income adults, and 19% is spent for low income children.  [Kaiser pdf]  Now, which of these categories do we want to cut? Do we want to cut pre-natal care for low income women?  Cut funds for the care of the elderly in nursing homes?  Cut funding for the care of the disabled?

This is the program confidently cited by Governor Romney as the “safety net” for low income Americans this week:

ROMNEY: Actually, we had health care in America before Obamacare came along. And we still have health care in America…Each of us today in America has a choice of the type of health care plan we might choose. People who are poor are able to get Medicaid, which is a government support effort for those who can’t afford to have insurance. And these things aren’t going to disappear without Obamacare. [emphasis in original] [TP]

Really?  There’s that 47% again?  With the discretionary spending cuts illustrated the little graph from CBPP what chance do we have to maintain program services for Medicaid?  How do we accomplish this by cutting $1.4 billion, or 34%, over the next ten years.

SNAP

Thus much for being a Food Stamp President, actually the number of people enrolled in the SNAP program has declined since the Recession ended.


This hasn’t stopped the Romney Campaign from suggesting that the way to preserve the income of the top 0.1% is to reduce the SNAP program further  by $135 billion, or 17% in the next decade.   Note that when the economy is growing, as it is now, the SNAP spending is reduced:

The CBPP has done an extensive analysis of what the Ryan Budget proposal would do to, not for, 99% of the American people.   Governor Romney’s rhetorical flourishes about wanting prosperity for 100% notwithstanding, the budget and tax plans he is advocating knock the props out from under families with an elderly relative in a rest home, children of a family with one or more wage earners unemployed at the moment, elderly Americans seeking basic cancer screenings, middle class families trying to keep their offspring in college.  Unemployed Americans seeking job training to upgrade their skills and employability.  Or, veterans’ health care services. [CBPP]

And all this to protect the incomes of the top 0.1% of American income earners…

 

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Filed under 2012 election, Medicaid, Medicare, Republicans, Romney, SCHIP, Social Security, Taxation

Heller’s Write Offs

Really?  Senator By Appointment Only  Dean Heller on Governor Romney’s remarks to the infamous fundraising dinner: “Keep in mind, I have five brothers and sisters. My father was an auto mechanic. My mother was a school cook. I have a very different view of the world,” Heller said. “And as United States Senator, I think I represent everyone, and every vote’s important. Every vote’s important in this race. I don’t write off anybody.” [HuffPo]

Senator Heller’s not written off anyone?  Ever? His voting record implies another perspective — one much closer to Governor Romney’s than Senator Heller would be enthusiastic about admitting.

Remember S-CHIP?  The SCHIP program provides health insurance coverage to middle class families who do not meet requirements for programs depending on poverty designations, and  who have seriously ill or injured children.  In short, it was designed to prevent lower middle income families from going bankrupt trying to provide health care for their children.

However, in the interest of “fiscal responsibility,” Representative Heller voted against any expansion of the program — paid for in the legislation by an increase in cigarette taxes: “But there is little expectation Heller will change his mind. He said he thinks he will be lobbied in the coming weeks but won’t support the legislation unless the program is pared to its existing level. Heller said in August, ” This Congress is seeking to create a massive and unnecessary federally funded health program.” [LVSun Oct 2007]

Representative Heller continued to vote against the expansion of the children’s health insurance program in 2009.   On January 14, 2009 he voted against the CHIP reauthorization. [roll call 16]  As he had voted to sustain the Bush Administration veto of the bill in 2008. [DB]   Not to put too fine a point to it, but then-Representative Dean Heller was perfectly happy to write off middle income Nevada families  in favor of so-called ‘fiscal responsibility’ and the interests of the tobacco lobby.

Remember the Pell Grants?  Senator Heller hasn’t been supportive of middle income families whose children need financial assistance to go to college.  Perhaps he believes along with Governor Romney that a person should get all the education he can afford — and no more?

“In February 2011, Heller voted for a Republican spending bill that would have drastically lowered the amount of aid that 9.4 million college students receive. Under the bill, students would see their Pell Grants fall by an average of $845 (from the current maximum of $5,550 to $4,705).  [CBPP, 3/1/11; HR 1,  Vote 147, 2/19/11]” [link]

Remember the Student Loan Rate?  The one that was set to double last Summer for middle income students or those who were trying to secure the middle income status by getting a degree…

May 24, 2012: “In a Senate vote today, Dean Heller voted against a measure to prevent student loan interest rates from doubling in July.  Heller’s vote today would force over 26,000 Nevada students to pay an average of $1,000 more next year in interest for student loans, putting an extra burden on the budgets of millions of middle-class families across the country.  While Heller voted today to double interest rates for Nevadans trying to obtain an education…” [link] [vote 113]

Voting to tack on another $1000 to the student loan bills for millions of middle class families sounds like a write off from this perspective.

Remember the HAMP vote?  The underfunded HAMP program sought to allow homeowners who were not unemployed to get assistance with mortgage modification.  On March 29, 2011, Representative Heller voted in favor of eliminating the program (H.R. 839). [VoteSmart]

Remember Wall Street Reform?  The middle class in America took the brunt of the Housing Bubble collapse, for the logical reason that the wealth of most middle income Americans  is tied up in the value of their homes.  The Dodd Frank Act sought to (1) prevent regulator shopping by financial institutions, (2) prevent abuse in the trade of derivatives, (3) provide oversight of banking institutions to prevent the need for bail outs, (4) separate commercial and investment banking to prevent conflicts of interest, and (5) prevent unscrupulous mortgage generators from preying on middle income home-buyers — and on June 30, 2010 Representative Dean Heller voted against it.  [Vote No. 413]  His rationale was particularly specious.  [DB]

It’s also instructive to look at those groups Senator Heller has NOT written off —

Big Oil: Heller Has Voted At Least NINE Times To Protect Tax Credits For Big Oil Companies. [Vote 63, 3/29/12; Vote 72, 5/17/11; Vote #153, 3/01/11; Vote 649, 9/26/08Vote 78, 2/27/08; Vote 80, 2/27/08; Vote 1140, 12/06/07; Vote 835, 8/4/07; Vote 40, 1/18/07]

Health Insurance Corporations, Drug Companies:  Senator Heller has proven himself to be the health insurance corporations BFF, and he proved his loyalty to the pharmaceutical industry by voting against H.R. 4, on January 12, 2007,  to allow the Department of Health and Human Services to negotiate with drug manufacturers for lower prices.  [VoteSmart]

Big Banks

The Bigger the Better [ExaminerLV]

Pious recitals of family history and protestations of concern are insufficient in Senator Heller’s case to offset the voting record he has compiled in Washington, D.C.   Paying lip service to the concerns of middle income Nevadans in regard to health care, education, financial reform, mortgage modification, and promoting alternative energy investment and jobs in Nevada, while voting against measures designed to promote those interests says far more about Senator Heller’s allegiances than his flight from the candidacy of Governor Romney.

These issues are further explored in “It’s not about the candidate…” which is well worth the click ‘n read.

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Filed under 2012 election, Economy, financial regulation, Health Care, Heller, Nevada economy, Nevada politics, Politics, Republicans, SCHIP, subprime mortgages

The Great Bamboozle: Plutocracy or Democracy?

Return with us now to the Great Deficit Debate, the one which resulted in the Budget Control Act of 2011. (PDF)  S. 365 passed the House of Representatives on a 269-161 vote, August 1, 2011,  [roll call 690] with Nevada Representatives Heck and Berkley both voting in the affirmative.  The “promise” at the time was that Democrats would agree to shaving funds from social programs while Republicans would agree to cuts for the Defense Department.   Thus much for promises.

On May 10, 2012 the House Republicans pulled the plug on the agreement in H.R. 5652 which restored the funds for the Department of Defense and kept or increased cuts in economic automatic stabilization programs and social services.  Representatives Amodei (R-NV2) and Heck (R-NV3) were pleased to vote in favor of the bill, Representative Berkley (D-NV1) held to the initial bargain and voted against it. [roll call 247]

The Congressional Budget Office reported that H.R. 5642 would, “Assuming enactment by July 1, 2012, CBO and JCT estimate that the legislation would yield net deficit reduction of $242.8 billion over the 2012-2022 period. That figure reflects gross reconciliation savings ($315.0 billion through 2022), partially offset by the cost of sequester replacement ($72.2 billion through 2022). ”  That $242.8 billion over a ten year period looks good IF you don’t look at what it contains.

Generally speaking, “The Sequester Replacement Reconciliation Act would cut $7.7 billion in federal food stamp spending in the first year, require federal workers to contribute more to retirement plans, end grants for health insurance exchanges, put limits on Medicaid payments and impose various reforms aimed at trimming federal spending.”  [The Hill]

Now, let’s get down to specifics.  The Sequester Replacement Reconciliation Act would:

End help to states that do the best job of finding uninsured low-income children and getting them into health care programs.

Wipe out a new Prevention Fund, created by the Affordable Care Act, that helps women get mammograms and helps children get screened for diabetes.

Repeal rules ensuring that states don’t cut people off of the Children’s Health Insurance Program (CHIP) and Medicaid as families continue to struggle economically while our economy recovers.

Halt funding to states to set up new, more consumer-friendly marketplaces for health insurance.

Strip protections for families receiving tax credits used to buy health insurance under the Affordable Care Act.

Slash benefits from the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) that ensure low-income families are able put food on the table.

Eliminate the Social Services Block Grant, which funds child care, Meals on Wheels, and other important community services for low-income and disabled Americans.

What would cuts to some of these programs look like in Nevada?

Medicaid: At last count there were 5,080 Nevadans with cancer who were being served by the Medicaid program, 150 of these were children, 2,290 were elderly.   178,240 Nevadans have diabetes, and 17,380 are relying on Medicaid for their medical needs. Of the 17,380 relying on Medicaid 930 are children under the age of 18, and 6,490 were seniors.   243,570 Nevadans have chronic lung disease, and 32,280 rely on Medicaid for assistance.  Of the 32,280 reliant on Medicaid 15,880 are children under 18 years of age. 4,250 are elders.   An estimated 42,000 Nevadans rely on Medicaid for treatment of heart disease or strokes, of these 2,590 are children, and another 15,960 are senior citizens. [FamUSA pdf]

To be eligible for Medicaid in Nevada a person must meet low income criteria, and the categories for eligibility include families with dependent children, children, pregnant women, disabled adults, and the elderly.  [NDH pdf]  Eligibility is one thing, coverage is another.  The AAP reports: “An estimated 134,000  Nevada children — 18.6 percent of Nevada children — are uninsured.  Sixty-four percent of these uninsured children are eligible, but not enrolled in Medicaid or the Children’s Health Insurance Program.”  The bottom line here is that under the current levels of funding we’re  not meeting the health care needs of Nevada children living in poverty — and the House Republicans want to cut funding even further.   Under the House Republican proposal if Nevada did, in fact, do a better job of locating and providing health care for poor children, the state would get no reward for doing so.

Nevada Check Up:  “The Mission of the Nevada Check Up program (Children’s Health Insurance Program) is to provide low-cost, comprehensive health care coverage to low income, uninsured children (birth through 18) who are not covered by private insurance or Medicaid; while (1) promoting health care coverage for children; (2) encouraging individual responsibility; and (3) working with public and private health care providers and community advocates for children.”  [NVHHS]   Rules insuring that children are not cut from the SCHIP programs (and Medicaid) while Nevada families are still facing economic issues would be eliminated by the House Republicans.  Youngsters in Nevada are now eligible if they have not had health insurance for the past six months, if the family has lost insurance for reasons beyond their control, are under 19 years of age, and in the case of a family of four the annual income is between $22,350 and $44,700.   The good news about kids is that most of them are easy to insure because sprains, strains, abrasions, and breaks are their specialties.  However, a child with a serious illness or medical condition can deplete family resources very quickly.  One of the major benefits of the Check-Up or SCHIP program is that it is designed to prevent working families from falling into medical bankruptcy.  This, however, doesn’t appear to be a House GOP priority.

Nevada Prevention Fund:  This is the funding discussed previously which the Speaker of the House dismissed as a “slush fund.”  There’s nothing terribly slushy about it.  Nevada has received funding for some very specific programs.  Projects for heart disease, stroke, diabetes, and cancer prevention are funded via this program, as are tobacco use cessation programs and immunizations.  Projects to reduce childhood obesity are funded from this category.  There’s even a category which should appeal to Nevadans in the wake of the Hepatitis C scare in Clark County not so long ago — funds are available for “new resources to prevent, detect, and respond to disease outbreaks, including those caused by influenza and foodborne pathogens. It also funds programs that prevent healthcare-associated infections.” [HHS] Grandma was right, “An ounce of prevention is worth a pound of cure,” but the House GOP doesn’t appear to have been listening.

SNAP:  Formerly known as Food Stamps.  Nothing so enrages those with empathy deficits as the Supplemental Nutrition Assistance Program.   The usual complaint is that 50% of the really true American Hard Workers are paying for food for the 50% really unpatriotic Slackers.  The statistics are rather different.  Of those are eligible for SNAP assistance 48% are children, and another 8% were elderly.  The national program participation rate is about 67%, meaning that only about 2/3rd of those who are eligible actually avail themselves of the program.

Those who are working, but eligible because of low incomes, participate at a 54% rate, meaning that just a bit over half of the working people who could use SNAP really do.  [USDA pdf] And, contrary to popular rumors, most SNAP recipients are not receiving TANF assistance.  In fact, less than 10% of SNAP recipients were also receiving TANF benefits.  The typical SNAP family has about $711 in monthly income or about $8,500 in  annual income.   A minimum wage job ($7.25/hr)  should yield $1,160 monthly, so our typical SNAP family isn’t earning enough to make the bare-bones $13,920 annual earnings level, but 90% of the SNAP recipients are indeed working.

Nor, should we imagine, as some do, that the SNAP benefits are “enough to live on.”  The maximum benefit for a family of four averages about $638.  This figure comes close to the USDA estimates for a “thrifty” household budget for a family in which there are children between the ages of 6 to 12 ($624.60) but is well under the amount needed to fit in the “low cost” grocery plan ($816.70). [USDA pdf] The maximum benefit number isn’t even close to the ideal food budget figure ($1,235.00) for a family of four.  I wouldn’t even care to guess what it really costs to feed just one adolescent male, and I don’t particularly want to find out what eating on the Nevada average SNAP benefit of  $4.06 per day would be like. [LVCityLife]

However, facts-be-damned, the House Republicans, Heck and Amodei included, voted to scuttle the Budget Control Act, and cut approximately $36 billion from the SNAP program.  This should be of some interest to the following Nevadans: “329,105 people received benefits through the program (in March 2011.) The 21 percent jump follows a 47 percent increase in 2009 and a 27 percent increase in 2010.” [LVSun]

Have I mentioned — almost to redundancy — that the SNAP program is an economic automatic stabilizer?  These are programs which kick in when the economy takes a tumble and help to soften the landing on local economies.  It’s certainly helped in Clark County, Nevada:

The USDA published a report on SNAP’s impact on local economies. For every $1 spent in SNAP benefits, $1.80 is generated through local economic activity. This activity creates and sustains jobs through the purchase of goods and services. In FY2010, SNAP recipients in Nevada received $414,596,369 in benefits which stimulated the economy by $746,273,464.  [SNAPexp]

It’s no secret that the best economic stimulus programs are those which put money into the national, state, and local economies as quickly as possible, and which are likely to be spent.  SNAP benefits fill the bill.  Although the $1.80 per dollar spent may be a bit high, the usual economic return for every $1 spent on SNAP is calculated at $1.73, the message is the same.  Food expenditures flow out into groceries, transportation services, farming, and farm support suppliers.  [CNN]

So, while the Nevada unemployment rate is still an unacceptable 12.0% statewide, and it would be nice if more grocery clerks, truck drivers, and farm workers could be employed … the House GOP has decided to “solve” the deficit problem by cutting back on the best economic stimulus program we have.

And, What Do We Get For Our “Savings?”

The House Republicans are essentially offering us Austerity on Steroids, but some people appear to be More Equal Than Others.

“In offsetting the costs of cancelling the scheduled sequestration of discretionary programs, the new House legislation does not close or narrow any tax expenditures, and does not secure any savings from much-criticized programs like farm price supports.” [CBPP]

So the local grocer isn’t getting any immediate benefit, but large industrial farms are doing well.  Thank you very much.  The rest of the economic ideology is just so much ethereal pie-in-the-sky theoretical posturing with precious little tangible data in support.  The Financialists on Wall Street have decided that “the Debt” is really really really the most important problem we have.  Ergo, we must address their problem before we can discuss anything other economic issue, like housing, or hunger, or employment, or energy.

Evidently, it’s also essential that we resolve the Financialists’ issues, and military-industrial complex’s desires, prior to addressing any topic of immediate interest to the average American worker or small business owner.  To suggest that employment comes from little businesses that sustain our means of manufacturing, transportation, and exchange is “socialism.”  To suggest that small retail business owners and local contractors would be better served by investing in infrastructure is to ask for the creation of “unreal” jobs — apparently the only “real” ones are on Wall Street.

To assert, as the original Republican President once did, that ours is a country “of the people, by the people, and for the people,”  is now called  “class warfare.”

Meanwhile, the Plutocrats and their Financialist brethren are content to serve themselves first — abetted by their loyal followers in the Republican controlled House of Representatives who cheer them on as “Job Creators” while they ship American jobs overseas, and encourage them to greater recklessness by supporting de-regulation under the guise of “freedom.”

Perhaps it is time to focus more of our attention on the 3rd and 4th freedoms listed by Franklin D. Roosevelt: Freedom from Want, and Freedom from Fear. What, after all, is there to fear if the top 0.5% of U.S. income earners should be asked to contribute to the reduction of the debt, while we protect 15,960 elderly Nevadans who need Medicaid to get treatment for heart disease or strokes.? What is there to fear if the top 0.5% of U.S. income earners help pay down the debt while we allay the fears of working parents who are uncertain if Nevada Check-Up can help them with their child’s medical expenses?  What is there to fear if the top 0.5% of American income earners pay a tad more towards the deficit their Mortgage Meltdown helped create, while we do what we can to enable families to have at the very least $4.06 for the days’ groceries?

What we should fear is the cavalier rejection of responsibility for maintaining agreements so evident in our House Republican leadership.  What we should dread is a nation so callous that the accretions of Credit Card Conservativism should be borne by the weakest among us.  What should precipitate cold sweat is a nation so beholden to the Plutocracy that we are ready to forsake our Democracy.
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References and Resources:  Department of Health and Human Services, “Nevada: ACA Prevention Fund in Your State.” Families USA, “House Budget Bill Is A Great Leap Backward.” American Cancer Society, et. al. “Medicaid in Nevada.” (pdf) USDA: Fact Sheet on SNAP. (pdf) USDA: Cost of Food, March 2012. (pdf) USDA: Food and Nutrition Program. “Living on $4 a day,” Las Vegas City Life, Feb. 2, 2012.   Nevada, Department of Employment and Training, Research & Analysis.   CBPP, “House Budget Bills Would Target Programs for Lower Income Families,” May 10, 2012.

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Filed under 2012 election, Amodei, Berkley, Heck, Medicaid, SCHIP

A Healthy Choice

The race for the Senate seat currently held by appointed Senator Dean Heller (R-NV) should be one of the clearest contests between Wall Street and Main Street in the 2012 election.  Challenger Rep. Shelley Berkley summed it up:

“Instead of focusing on job creation and getting our economy back on track, Washington Republicans like Dean Heller are spending their time pushing a radical social agenda that restricts access to basic women’s preventative health services,” said Berkley.  “Voters will have a clear choice this election between my commitment to putting Nevadans back to work and Dean Heller’s attacks on women’s healthcare and pro-Wall Street agenda.”  [WashoeDems]

Big Pharma  The only quibble with Berkley’s assessment might be that it isn’t just women’s health care that’s gotten short shrift from Senator Heller.  Climbing into the Not-So-Wayback-Machine to January 12, 2007 we find then Representative Heller voting against H.R. 4, a bill which would have allowed the Department of Health and Human Services to negotiate for prescription drug prices with pharmaceutical corporations.   It really doesn’t do to decry “out of control government spending” on one hand, and then vote against measures which would decrease spending on the other.  Representative Berkley (D-NV1) voted in favor of the cost reduction measure. [PVS]

Picking Up The SCHIPS  Senator Heller’s opposition to  SCHIP shouldn’t be forgotten either.  Heller voted against H.R. 3162 on August 1, 2007, a bill to reauthorize the popular children’s health care program.   When the topic came up again on September 25, 2007 (H.R. 976) then Representative Heller voted against it one more time.   Heller found it acceptable to vote against a federal contribution of $2.10 for every dollar Nevada appropriated for its Check Up and Medicaid programs, and against $373 million for children’s health care coverage in a five year period. This might not have been problematic except that in 2007 Nevada had 106,244 uninsured children, 2/3rds of whom would have been eligible for the program.  [Families USA pdf] Representative Berkley voted in favor of reauthorizing the SCHIP program on August 1, and again on September 25th.  [PVS]  When it came time to vote to over-ride the Bush White House veto of H.R. 976 Representative Heller voted with the administration, Representative Berkley voted to over-ride the veto. [October 18, 2007]

The question of providing health care for children bounced back again on October 25, 2007 in the form of H.R. 3963, and again Representative Heller voted against it.  The bill passed the House on a 265-142 vote, with Representative Berkley voting in favor of the reauthorization.   Once again Congress reauthorized the program and one again President Bush vetoed it.  Representative Heller voted to sustain the veto on January 23, 2008.  Representative Berkley voted to over-ride.

The SCHIP subject re-emerged on January 14, 2009, again Representative Heller voted against reauthorizing the children’s health care program, and again Representative Berkley voted in favor. [H.R. 2] Representative Heller’s stalwart position against reauthorizing a program to assist families with children who have serious medical issues should be crystal clear.  Heller joined those House Republicans who argued that the SCHIP program was an unnecessary tax burden on cigarette manufacturers, and would cause families to forgo the purchase of health insurance coverage for their children.  [DB 1/2008] Representative Berkley’s support for helping a family of four (earning about $46,000 annually) with medical expenses should be equally clear.

Mental One portion of H.R. 1424 stated: “States that group health insurance plans offering mental health and substance abuse treatment must offer such coverage with financial requirements and treatment limitations that are no more restrictive than those associated with the medical and surgical coverage provided by the plan.”  In short, group health plans should cover treatment for mental health problems.  On March 5, 2008 Representative Heller voted “no” while Representative Berkley voted “yes.”

Health Care Reform  Senator Heller has made no secret of his opposition to the health care reforms enacted in the Affordable Care Act, and Representative Berkley has made no secret of her support for the following provisions:

# Health care insurance corporations must provide preventive health care services at no cost in the plans they market to customers. (Mammograms, prostate cancer screening, etc.)

# Health insurance corporations may no longer deny coverage to youngsters under the age of 19 for “pre-existing” conditions.

# Health insurance corporations may no longer rescind coverage because a person made an honest mistake on an application.

# We have the right to choose the doctor we want from our plan’s network or seek emergency care at a hospital outside of our health plan’s network.

# Health insurance corporations may no longer offer plans with lifetime limits on coverage.

# The reforms require that health care insurance corporations spend at least 80% of their premium dollars on actual health care.

# The law requires that health care insurance providers be able to justify any rate increase of more than 10%.

Representative Berkley is being entirely too kind.  Senator Heller doesn’t merely object to women’s preventative health care services — he objects to more affordable health care for the elderly taking expensive prescription drugs, for children in middle class families who have serious medical conditions, for families trying to cope with the expenses for a member with mental health concerns, for people denied coverage because of pre-existing conditions, for people whose coverage was dropped when they became ill, for people who have long-term medical needs because of accident or illness.

Nevada voters may well have a choice in 2012 between accepting highly generalized complaints about “socialized medicine” (read: pro-insurance corporation positions) from Senator Heller, and specific health care measures designed to support middle class families and their health care needs as advocated by Representative Berkley.

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Filed under 2012 election, Berkley, Health Care, Heller, SCHIP

>Senate Passes SCHIP Bill: Ensign votes party line for limitation amendments

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Let’s make a long story short. The SCHIP bill (H.R. 2) passed the Senate, with a hefty 66-32 margin. Senator John Ensign (R-NV) was one of the 32 voting in opposition to the expansion of the health care program for children from working families, or (put another way) to exclude about 23,000 Nevada children from the program. Senator Harry Reid (D-NV) voted in favor of the legislation. [roll call 31]

On the way to final passage, Senator Coburn offered his amendment to “ensure that children do not lose private coverage,” shorthand for carrying water for the insurance companies, which was defeated 36-62. Senator Ensign voted in favor of the amendment; Senator Reid voted no. [roll call 24] Undaunted, Coburn tried again, with an amendment to “ensure that children have high quality health care that fits their needs,” or, more accurately fits the needs of the insurance corporations. His second amendment of the day was also rejected, 36-62, with Senator Ensign supporting Coburn, and Senator Reid voting no on the amendment. [roll call 28]

Senator Hatch (R-UT) tried to add his ‘anti-choice’ amendment to codify regulations specifying that an unborn child is eligible for child health assistance. The amendment went down 39-59, with Senator Ensign supporting Hatch, and Senator Reid voting in opposition. [roll call 26]

Perhaps a word of caution would be the polite thing to insert here for parrot owners. Please do not expose your bird to Senator DeMint (R-SC) unless your family can endure endless repetition of “Tax Cut,” “Tax Cut,” “Polly Wants A Tax Cut,” ad nauseam. DeMint’s amendment would have included a tax deduction equal to the federal share of any state benefit offered to children of legal residents who are not citizens. There’s nothing quite like a two’fer: Immigrant bashing and a tax cut all rolled into one amendment. The amendment failed 40-58, with (you’ve guessed by now) Senator Ensign voting in favor, and Senator Reid opposed. [roll call 27]

The Republicans returned to their mantra, “SCHIP was meant for poor people,” with an amendment from Senator Bunning (R-KY) to eliminate any and all exceptions to the prohibition on State’s allowing coverage for families earning over 300% of the poverty line. The amendment was tabled, 54-44. Once more, Senator Ensign voted in favor of the amendment, Senator Reid voted to table it. [roll call 25]

Senator Hutchison offered her amendment that emphasized aid to states with percentages of children without health care coverage above the national average. Thus subjecting aid to a fanciful numbers game with enrollment figures. It failed in a whopping 17-81 vote, with Senator Ensign joining the lonely 16 others who supported Hutchison’s proposal. Senator Reid might want to explain why his was another vote among the Sad 17. [roll call 30]

One amendment was added to the bill, from Senator Bingaman (D-NM), who proposed to clarify that “new paperwork and enrollment barriers are not created in the Express Lane Enrollment option and that income may be determined based on state income tax records or returns.” The amendment cleared, 55-43, with Senator Ensign voting “no” and Senator Reid voting “yes.” [roll call 29]

House Speaker Rep. Nancy Pelosi (D-CA) spoke of the Senate passage: “Tonight, 11 million of America’s children are one step closer to receiving quality, affordable health care through the State Children’s Health Insurance Program, which is critical to supporting hard-working families in these difficult economic times. By ensuring health care for these children, families will get regular doctor visits and preventive care so that minor illnesses do not become more serious, saving parents out-of-pocket medical expenses and avoiding costly emergency room care.” [Gavel]

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>GOP Slow Walks SCHIP Bill: Ensign joins the stroll

>And so it continues…the Senate Republicans, John Ensign (R-NV) included, offer one amendment after another to strip down and otherwise limit S. 181, the SCHIP bill. The McConnell Amendment (40) presented as the GOP substitute failed this morning on a 65-32 vote [roll call 18] (Senator Ensign voting in favor of the Republican substitution measure) and Senator Martinez’s Amendment (65) reimposing the family planning Gag Rule on NGO’s failed 60-37, with Senator Ensign voting in favor. [roll call 19] Next the Republicans tried the Roberts Amendment (75) which would have prohibited SCHIP coverage for so-called “high income” youngsters and prohibiting payments to states in which the Medicaid income eligibility level for children is higher than the income eligibility level under SCHIP. The amendment was rejected by a 60-36 vote. Senator Ensign voting with the minority. [roll call 21]

A motion to table Senator Cornyn’s Amendment (67) which would “ensure funds going to coverage of low income children, rather than going to state that might use the funds to cover children from higher income families” passed 64-33, with Senator Ensign again voting to limit the number of children who might be eligible for coverage. [roll call 20]

The Senate Republicans presented two more amendments along the same theme, “limiting the program to low income children.” It’s evident that this is a catch phrase for limiting the number of children who might be enrolled by pretending that the SCHIP program was ever intended for “low income families.” Again, low income families are to be served by the Medicaid program, middle income families by SCHIP. However, that didn’t stop Senator Kyl from offering his Amendment (46) to reinstate the “crowd out” provisions. This is a thinly disguised measure to prevent middle income families from applying for SCHIP assistance and to encourage them to buy private insurance. The Amendment failed 42-56. [roll call 22]

The last amendment voted on during the Senate session was offered by Senator Murkowski (77) to “develop ‘best practices’ for recommending and ensuring coverage of low income children. Once more, a chorus of “SCHIP was meant for poor families.” The Amendment failed 47-51. Senator Ensign once more voting with his GOP colleagues. [roll call 23]

The Senate will continue working on H.R. 2 tomorrow morning, January 29th at 9:30 AM (eastern). “Roll call votes are expected to occur throughout the day.”

Memo to Republican Senators: Just because you couldn’t convince your colleagues on the floor to vote your way, doesn’t mean you didn’t have any input. Frankly, you had a whole C-SPAN schedule full of input today.

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>Women and Children First, except for Ensign and Heller: Opposition to Fair Pay and SCHIP Bills

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Ledbetter Fair Pay Act: Nevada Representatives Shelley Berkley (D-NV1) and Dina Titus (D-NV3) were among the 250 members of the House who voted in favor of S. 181, the Lily Ledbetter Fair Pay Act of 2009. Congressman Dean Heller (R-NV2) voted against the measure yesterday. [roll call 37] The bill passed 250-177, with 6 not voting. The Ledbetter Fair Pay Act passed the Senate on January 22nd, by a 61-36 margin with Senator Harry Reid (D-NV) voting in favor, and Senator John Ensign (R-NV) in opposition to the bill. [roll call 14]

SCHIP: The Senate also tabled the DeMint Amendment No. 43 to H.R. 2 which would have required cost sharing by the States for any individual whose income exceeds 200% of the poverty line in its administration of the SCHIP program. Senator Ensign voted to adopt the amendment (or, voted against tabling it) during Roll Call 16. DeMint’s amendment was tabled on a 60-37 vote, with two members of the Senate not voting.

In practical terms, the 2009 Poverty Guidelines from the Department of Health and Human Services for the lower 48 and the District of Columbia shows income levels of $10,830 (for one person) to $37,010 annual income for a family of eight as being the cut off line determining poverty. A family of four in Nevada would qualify if their annual income was $22,050. Under the terms of DeMint’s Amendment a Nevada family with two children would not qualify for SCHIP assistance if the parents were earning more than $44,100. An individual earning the Nevada statewide median wage ($14.68/hr) would bring home $117.44 per day in gross income. This means that the breadwinner would have to work 375.5 days per year to earn enough to break the 200% threshold. There might be a new calendar for 2009, but it still only has 365 days in it. Proponents could argue that “the average” family would qualify. However, if we calculate using the statewide mean ($18.43) the picture is narrower. Using the mean, the breadwinner would be bringing in $147.44 per day, and wouldn’t reach the threshold until he or she worked 299 days during the year at the mean wage. Any earnings beyond the 299 day “limit” would disqualify the family for SCHIP assistance under the terms of the DeMint Amendment for which Senator Ensign voted. Thus, it’s equally plausible to argue that the “average” family might be shunted aside by the DeMint provision which is yet another attempt to transform the SCHIP program into a “poverty” bill as opposed to its original working family safety-net intention.

This morning the Senate rejected the McConnell substitute amendment for H.R. 2 (SCHIP) by a 65-32 margin, with two not voting. Senator Reid opposed the measure, Senator Ensign voting in the minority. [roll call 18] This bodes well for the vote on the bill scheduled for 12:10 PM today (ET). H.R. 2 passed the House on January 14, 2009 on a 289 aye, 139 nay, 6 not present vote. Representatives Berkley and Titus voted in favor of the bill, Congressman Heller was opposed. [GovTrack]

No doubt, Senator Ensign and Congressman Heller would have made it off the Titanic.

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>Ensign-ificant Immigrant Bashing: Ensign Opposes SCHIP Bill in Senate

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Senator John Ensign (R-NV) looks to be bent on continuing to shrink the Republican tent. Speaking of a provision in the SCHIP bill that would repeal a five year waiting period for the children of legal immigrants, due for Senate consideration this week, Ensign told NPR, “It would seem to me that we are giving more incentives for folks to come to the United States, not just to participate in the American dream, but to get on the government dole,” said Sen. John Ensign (R-NV). “And I think this is exactly the wrong direction we should be going with this legislation.

Heaven forbid! A perfectly legal resident of the United States should want to come here because we are a nation that supports children’s health services. What next? They’ll want to come because we have clean water provided by municipal water systems? Because we require children from 6 to 18 to be enrolled in schools? Because we enforce child safety seat requirements in motor vehicles? Because our public libraries sponsor early literacy programs for pre-schoolers? Because we have public parks with playground equipment?

Extrapolating Ensign’s logic to its obvious conclusion, we should provide no public services (especially none for children) because somewhere out there is a family which wants to come to this country and use them to improve their lives and the dreams for their children.

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>Overnight Express: Under the Radar News Roundup

>Assembled Wisdom: The Lily Ledbetter Fair Pay Act of 2009 moved a step closer to passing the Senate when a Republican filibuster was broken on a 72-23 vote. Senator Harry Reid (D-NV) voted in favor of the motion to invoke cloture on the Motion to Proceed to S. 181; Senator John Ensign voted “no.” [roll call 4]

S.22, the bill to designate lands in the National Wilderness Preservation System, and to authorize programs in the Departments of Interior and Agriculture passed on a 73-21 vote, with Senator Reid voting in favor and Senator Ensign opposed. [roll call 3]

It seems a little sad that after all these years, the House of Representatives would feel it necessary to enact a rules change requiring each standing committee to hold periodic hearings on the topic of waste, fraud, abuse or mismanagement in government programs which that committee authorizes, but enact it they did. The House voted 423-0, with 11 not voting, to approve such a rule. [roll call 18]

Congressman Dean Heller (R-NV2) has a kindred spirit in Iowa 5th District Rep. Steve King, who called the authorization of the SCHIP program, a “victory for illegal immigrants and wealthy families.” [IowaIndp] When did earning $40,000 a year put a family in the “wealthy” category?

While the Congress continues to debate the TARP program, someone should be reading a recent GAO Report: Financial Regulation – A Framework for Crafting and Assessing Proposals to Modernize the Outdated U.S. Financial Regulatory System.

The Federal Election Commission has made the “Comments received – Notice of Public Hearing on Agency Procedures and Processes” available online. The comments from OMBWatch are available in PDF format, as are comments from the Sunlight Foundation. The Sunlight Foundation again makes its case for improved electronic filing procedures, and it would be nice if Senator Ensign would give up his ill advised opposition to electronic filing for Senate races. [Sunlight]

Economic news
: “Senate releases second half of bailout fund” [IHT] “U.S. to inject $20 billion in Bank of America” [IHT] “Toyota cuts North American production” [Reuters] “Consumer prices in U.S. probably posted first annual decrease since 1954” [Blmbrg] “Freddie Mac eviction plans continue during moratorium” [Blmbrg] “Fannie and Freddie force borrowers to waive legal rights: Housing advocates, Congressional leaders call practice abusive” [WashIndp] “Intel Q4 profit plummets 90% meets forecast” [Wired]

Cleaning Up After the Elephants: “New Pentagon rule tightens revolving door: Pentagon officials who participate in costly acquisitions will now need written approval from an agency ethics officers before taking a job with a Defense Department contractor” [Gov Exec] “Eric Holder: Waterboarding is torture” [ChiTrib] “Democrats sneak Net Neutrality rules into stimulus bill” [CNET] “Gitmo database details 799 prisoner’s cases” [ProPub]

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