Thursday, October 31, 2013

Texas needs an income tax

So Republican candidate for Governor Greg Abbott recently accused Democratic candidate Wendy Davis of wanting to raise Texans' taxes by $35 billion.

Ho hum.

Politifact then suggested that Abbott was full of it.

What else is new?

What Davis suggested that she wanted to do was put together a board of state officials to examine exemptions from current state taxes to see if they were still warranted, most notably the gas tax and the sales tax.  She said she she didn't want to raise current tax rates, but wanted to especially examine the $36 billion in sales tax exemptions.

This is good policy, and I'm supportive of the review (particularly of a several odd-looking exemptions, like those surrounding aircraft....)

But when it comes to taxes, I (as a naive carpetbagging Yankee) would like to see Texas adopt a personal income tax; it's currently one of nine states without one. That might be political suicide for Davis right now, so I don't blame her for not bringing it up. Over the long-term, however implementing an income tax will diversify and stabilize state revenues while redistributing the tax burden to the upper class and away from more vulnerable state residents.

Take the jump for more details.....

Wednesday, October 30, 2013

Millett and Watt confirmations imminent?

I just checked up on the Senate Executive Nominations Calendar, and the following two names appear on the first page:

Melvin L. Watt (Cal. No. 209)
Ordered, That with respect to the vote on the motion to invoke cloture on the nomination of Melvin L. Watt, of North Carolina, to be Director of the Federal Housing Finance Agency for a term of five years, the mandatory quorum required under Rule XXII be waived.
(October 28, 2013.)
Patricia Ann Millett (Cal. No. 327)
Ordered, That with respect to the vote on the motion to invoke cloture on the nomination of Patricia Ann Millett, of Virginia, to be United States Circuit Judge for the District of Columbia Circuit, the mandatory quorum required under Rule XXII be waived.
(October 28, 2013)

(Rule XXII is what gives the minority its filibuster power) 

Both Watt and Millett have been the subject of attacks from Republicans who want to block a more active Federal Housing Agency (which has been without a permanent head for years) and keep the President from placing any more nominees on the D.C Circuit Court. 
The DC Circuit is considered the second-most important court in the country, because it has jurisdiction over all federal agencies and its Conservative appointees have slowed or blocked the ability of federal agencies to protect worker rights, increase oversight on banks and other financial institutions, and protect the environment.

Millett is probably the least controversial of the three appointees for the D.C. Circuit Court, while Nina Pollard is the most controversial (she is known for her strong feminist views and record on Civil Rights; apparently believing in gender equality and civil rights is controversial nowadays)

I wonder if a deal has gone down trading Millett, Watt, Obama's other D.C. Circuit nominee Robert Wilkens, and Tom Wheeler as FCC chair in exchange for Pollard withdrawing her candidacy. I'd hate to lose Pollard's candidacy, but if Obama gets to name another appointee of his choice, it's win-win-win for the Democrats. 

I'm also wondering if Harry Reid has 51 votes to end the filibuster, at least for certain types of judicial nominees. That would explain the GOP's sudden move to surrender on two nominees that they hate a lot.

Either way, if this is true, it is good news for sane public policy.

(Note: please feel free to tell me if I'm misreading the Sen. Executive calendar -- it's entirely possible, though I tried to do my homework here.)  

(UPDATE:  10/31: And Watt just got filibustered. Looks like I was wrong. Nuts.)

Thoughts on Planned Parenthood vs. Abbott

Scott Lemieux has good take on Planned Parenthood vs. Abbott, the case that overturned several of the most controversial provisions of Texas' recent law design to limit access to abortion last summer.

Currently the controlling standard governing states' ability to enact statutes regulating access to abortion is Planned Parenthood vs Casey, which holds that states  can regulate abortion so long as it doesn't provide an "unreasonable burden."

Since Sam Alito and John Roberts joined the court, however, rulings haven't overturned Casey or Roe vs. Wade, but generally have reduced it to a shell by finding that many individual regulations -- notably a ban on so-called "partial birth" abortion don't produce a meaningful burden.

With the wave of state legislation in Kansas, Mississippi, Texas, South Dakota and other states seeking to regulate abortion clinics out of business, we're going to find out if Casey actually means anything. 

What's notable in the Texas case, as Lemieux points out, is that district judge Lee Yeakal's ruling would actually "put some teeth" back in Casey by suggesting that there is no rational basis to require certain "safety" regulations on abortion providers, most notably the requirement that doctors have admitting privileges at a local hospital.

This case is mostly a win  for reproductive rights advocates, but it did uphold a part of the law requiring doctors to adhere to (arguably outdated) FDA protocols for administering abortion-inducing drugs (though it narrowed the requirement considerably).

The ruling doesn't end things, as Texas Attorney General Greg Abbott has already appealed. The next venue, the Fifth Circuit Court of appeals is notoriously conservative and has overturned several district rulings protecting abortion access in the past. (Here's hoping that this winner isn't on the panel that hears the case)

This case, along with others, is probably going to end up at the Supreme Court, where the fate of Roe vs. Wade may hang on what Anthony Kennedy ate for breakfast on the morning of oral arguments.

Ben Hall comes out against LGBT rights

This is not cool. Via Kuffner

I was already leaning one way in this mayoral election. Mr Hall's actions just confirmed that choice. 

Tuesday, October 29, 2013

Overcoming discomfort with the ACA's Individual Mandate

Here's the thing about the individual mandate in the Affordable Care Act: Everyone loves to hate it.

The mandate is a critical part of the ACA. If you want to mandate that an insurer universally issue policies all applicants at similar prices regardless of pre-existing conditions,  you have to prevent healthy people from free-riding outside the system until they get sick. If only sick people purchase insurance, premiums may go up and a spiral out of control. By inducing healthy people into the insurance pool through a mandate to purchase health insurance, we can lower overall costs and keep insurance affordable for everyone.

And yes,  empirical research suggests that individual mandate will come in quite handy in persuading healthy people to buy insurance, as this New England Journal of Medicine study suggests.

Conservatives hate the mandate because they argue that it violates people's freedom not to buy a product. I suspect that many of them also object to it because it makes rich and healthy people ("makers", "job creators" "real Americans") pay insurance premiums that will benefit poorer and sicker people ("takers," "moochers" "the 47 percent.")

Or maybe they just hate it because a group of center-left reformers embraced it after Conservatives first introduced the idea

Some liberals in turn hate the mandate because they think makes people give money to evil insurance companies for lousy products. I also suspect that they find the mandate's narrative emphasis on "personal responsibility" a bit off-putting when they feel that the major idea is creating a universal right to health care.

For more, follow me below the jump.

Monday, October 28, 2013

Thoughts on unemployment (specifically mine)

One of the points of this blog was for me to reflect upon what it feels like to be unemployed. I've gotten away from that over the last month or two as I've focused a lot on health care and a bit on local Houston politics.

But the unemployment frustration continues. Academic hiring processes move on very slow timeline. Even if I get a job, it won't start paying or providing health insurance until July 1, 2014 at the earliest.

Second, is that many institutions aren't looking to give new scholars fresh out of grad school a chance.

For example, there have been 23 jobs posted in American politics on APSA's job site over the last month that are hiring for tenure-track positions. However, one is for a full professor, which indicates that a school is looking for a senior level hire. Three more are for "open-and-multiple" ranks, which mean that the school is nominally looking for anyone who might be a good fit. However, everyone knows that these positions are reserved for mid-career or senior scholars.

That leaves 19 positions hiring for assistant professors, but based on the rejection letters I have received and informal conversations I've had with my colleagues, a substantial number of these slots will go to candidates who are already assistant professors at other institutions. Having had a year or two a research support, salary and other resources will make their CVs much stronger than those of us just out of grad school.

It seems that many institutions (by no means all, but enough) aren't really interested in rolling the dice on developing a new scholar when they can simply raid an established one from another school.

It's understandable -- department rankings in U.S. News and World Report are at stake here. 

So that's what happens in our field. Just like all the other fields, candidates who already hold down existing jobs get preferences, while those struggling to break into the field (or worse yet, those who have been unemployed for a year or two) don't have as much of a chance. The rich get richer and those of us struggling to get into the game lose what little we currently have.

A senior academic with whom I recently corresponded (not on my committee or at a school to which I have sent an application) tried to offer some emotional support. He suggested that the process is full of opaque things that are unobservable to me. He suggested that I should exercise to stay healthy and relieve my stress.

He meant well.

What would relieve my stress is being able to have a salary.

What would relieve my stress is being able to have affordable health insurance.

What would relieve my stress would be having research funding so I have a fighting chance of doing original work before some group of scholars who are better funded and better connected beat me to the punch again.

What would relieve my stress is being able to save for my retirement.

What would relieve my stress is not worrying about having to move my fiance all over the country
when she has her own career to develop.

What would relieve my stress is having a professional identity so I can stop changing the topic when people ask me what I do for a living.

.... which are all things that senior people in academia and other lines of work often take for granted every single day.

Sigh. But I guess, maybe the stress is my fault and if I were to start a regular program of exercise, I would be in a much better state of mind. Maybe like this guy.

This week I'll weigh in on a few ballot measures and some other health care issues. Sometime soon I hope to have a broader post up about the state of play in Texas politics for 2014.

Sunday, October 27, 2013

Houston Half-Marathon blogging

Good day at the Houston Half-Marathon and Relay.

... aside from the one-hour freak flash thunderstorm that arrived at precisely 6:30 a.m. to delay the start by an hour and wreck all our carefully calibrated warm-up and digestive routines. I felt bad for all those runners caught out in the open (I just happened to be on the Sam Houston Heritage's society building's spacious front porch.

Though I must say, running in a rain shower when it's 65 degrees out sure beats running in the sun when its 98 degrees out in this town.  I think I also came home drier too.

But in any case that feeling of flying up the home stretch after a great race is one that every runner craves. I also richly appreciated the strategic and generous application of spectator cow bell on mile 12.

1 hour, 38 minutes, 37.7 seconds. New PR -- and I probably had a bit left in the tank. Sure, it's not going to get me into the winner's circle, but it's pretty darn good for an civilian.

Time for two weeks of down time with lots of stretching and rest for bits and pieces that hurt, then I get to plot my next race. Probably something shorter in December.  I haven't put together a good 5K in two years, and haven't ever put up a 10k time. It'd be interesting to see what I could do at that distance.

Texas Adjustments Part V

So, now we're down to the local level.

I traded in Mayor John Hietfje of Ann Arbor:

And picked up Annise Parker:

Both are interesting. Hietfje may have overstayed his welcome in Ann Arbor, where he was first elected mayor in 2001. I was frustrated with how he treated city employee unions from time to time, as well as some of his budget-cutting moves toward fire and police protection. On the other hand, I was generally pleased with his environmental and transportation initiatives. The central city, which was already a nice place to live, continued to become much more walkable during my time there under his tenure in City Hall. Some (though not all) of the complaints against him were the result of clubby Ann Arbor townie stuffed shirts who had no clue about urban planning or development. And frankly, the opposition candidates who ran against him were absolutely laughable.

Parker is something of a liberal lion in southeast Texas, though a quietly pragmatic one. Houston is light years behind Ann Arbor in sustainability and livability, but Parker has hired a cracker jack sustainability director from San Fransisco, installed and expanded bike share, gotten curbside recycling off the ground, cleaned up a mess at Metro, worked with the county to improve parks, presided over the expansion of light rail and generally kept the metaphorical trains running on time.

I suspect she would make an excellent state comptroller (her old job in Houston) if Democrats can ever win a state-wide election again.

I'll give the edge here to Texas, just because of Parker's shiny (at least to a new resident) sheen.

I skipped over the state legislature as well -- I trade State Sen. Rebekah  Warren and Rep. Jeff Irwin, both solid progressive Dems (and lovely people) for State Sen. John Whitmere and Rep. Garent F. Colman, who seem at first glance to be quite adequate. Time will tell.

Enough with politics -- future installments will include really important things, like food. Texas should be able to do better here than in the political section.

Saturday, October 26, 2013

This week in useful posts of Labor

Not too much today -- I'm kind of exhausted after all the chasing through the parts of the ACA and digging up tax numbers.

But if you have some time, it's always worthwhile reading Erik Loomis' posts about labor, particularly his "This Day in Labor History," the latest installment of which is here.

Loomis breaks down famous strikes and actions, like the Flint sit-down strike, but I think the most valuable part of the series is how in brings the entire labor movement and economic development into the context of American history.

He also beautifully captures the essence of what a labor union is and does in this post, which is my favorite. Here's a sampling:

On October 23, 1976, International Woodworkers of America Local 3-101 in Everett, Washington had its monthly union meeting.
Big deal, you might be thinking. Locals have meetings all the time and nothing much happens at them. And not a whole lot happened at this lunchtime meeting. 34 members attended. President Ken Schott called the meeting to order. Ed Bordsen read the financial report. Standing committees on grievances and safety read their reports. The Labor Council Committee let everyone know what was going on with other unions in the city. They changed the monthly meeting in December to account for the Christmas party. They then appointed new members to various committees and adjourned.
So again, big deal, right?
Well, yes.

The point is that being in a union isn't generally about history-making massive clashes with management (though those happen and are important), but the day-to-day experience of workers democratically working together identify priorities, improve day-to-day working conditions and help each other. Loomis argues that these "boring" things are actually what's truly radical:

Grievance procedures were fought in timber mills and workplaces throughout the nation; again, the idea that employers can’t dictate the terms of employment and act as capricious dictators to workers galls employers to this day. Grievances in the 1970s might revolve around anything from employer attempts to skirt around contract language to sexual harassment cases to unfair discipline against a worker who might have missed work. Sometimes employees won these cases and sometimes they didn’t, but they had to make employers fight it out. That in itself is an incredibly radical action. 
Too often I think modern “radical” actions are committed by those who like to be radical for radicalism’s sake–and this is probably a very old phenomenon. But these actions are so frequently not grounded in any larger movement for social change or an understanding of how working people are empowered. When people are empowered they fight for the things that matter to them. A lot of times that is getting the brakes on the truck loader fixed. And that’s a radical action by almost any measure.

Read the whole series here; it's well worth your time.

Friday, October 25, 2013

Obamacare and tax reform: a progressive double play (part IV)

This is the fourth and final in a series of posts about the paying for the Affordable Care Act. The first three posts can be found here, here and here.

So we’ve talked about how tax increases and closing loopholes generated about $440 billion in revenue to fund a shade under half the costs of the Affordable Care Act.  But we all know that jacking up taxes is for wimps and that Real Men ™ prefer budget cuts, preferably big ones.

Obamacare does that too. Better yet, it does so by cutting pricy subsidies to private insurance companies (who we all love to hate) AND providers (aka hospital systems and doctors) who actually drive much of the health cost inflation in this country. I'll go over the three biggest cuts here, though there are other significant changes to Medicare as well.

Per usual, numbers come from the Joint Committee on Taxation and much of detail comes from John McDonough (really, buy his book – this guy deserves every bit of royalties he can get). So take the jump for more details. 

Thursday, October 24, 2013

Obamacare and tax reform: A Progressive double play (Part III -- now with bonus Ted Cruz and Koch brothers coverage)

This is the third in a series of posts about paying for the Affordable Care Act. The first two posts can be found here and here.
Let’s talk about your dream tax loophole closings.

Would you like to close a narrow subsidy benefiting the paper industry and have the Koch brothers kick in a few bucks to subsidize your shiny new insurance policy you purchased on the exchanges?

Perhaps you’d like to see Ted Cruz and Goldman Sachs negotiate how to split a $5,000 tax increase that will help expand Medicaid?

If you answered “yes” to either of those questions, you’re in luck – the Affordable Care Act does both.

(Maybe the next round of reforms can get the corporate jet loophole – we’ll keep working on it)

Follow me below the fold for a rundown of some of the major tax loopholes the ACA closes to help fund it. As always, numbers come from the Joint Committee on Taxation and much of the inspiration and analysis comes from John McDonough.

Wednesday, October 23, 2013

Obamacare and tax reform: a progressive double play (Part II)

This is the second in a series of posts about paying for the Affordable Care Act. The first post, about expanding FICA taxes on wealthy taxpayers, can be found here.

In many of my posts, I've examined the benefits that the Affordable Care Act will provide (see here for examples). These things are (generally) good things, and good progressives should (mostly) applaud them.

But there's another side to the ACA that should really thrill anyone who believes that economic inequality is a problem: how we pay for it.  Not only is Obama care roughly revenue neutral, but the way it pays for expanding health insurance to disadvantaged Americans is by taxing well-off Americans to the tune of about $1 trillion over the health law's first decade.
The biggest single provision is Section 9015, which both raises the Medicare Hospital Tax on wealthy taxpayers and expands it to unearned investment income, which I discussed yesterday. However, there are several other small to medium-sized levies that the ACA imposes that are worthy of note. I discuss four of the largest ones here.  I get estimates for their relative financial impacts from this report by the Joint Committee on Taxation. Much of the inspiration and background for this post comes from John McDonough’s excellent book Inside National Health Reform. (Seriously, buy a copy if you can afford it – this guy deserves the royalties.)

Follow me below the fold for more details for details on fees assessed to insurance companies, drug-makers, medical device manufacturers and ... tanning salons (?!). 

Tuesday, October 22, 2013

State aid and college tuition costs

So I have a new article up at Thesis Web magazine.

The general conclusion is that cutting state aid for higher ed leads to large tuition hikes.

I know this is shocking to many state legislators.

Obamacare and tax reform: a progressive double play (Part I)

This is the first in a series of posts about paying for the Affordable Care Act

You’ve probably never heard of section 9015 of the Affordable Care Act. A Google search turns up few media hits, mostly uncovering links to really boring official government documents and dry consultant reports.

But that unassuming section contains some of the most far-reaching parts of the ACA. It not only is the single largest item of funding to pay for the law, but its passage is the single most progressive piece of tax reform over the last 20 years – and arguably since the institution of the graduated income tax.

In fact, the ACA as a whole is notable not only for the massive benefits that it showers on middle and lower-income Americans, but also for the progressive way it pays for them – by increasing tax rates on wealthy individuals and large companies, eroding corporate welfare, and closing numerous tax loopholes that tend to benefit narrow sets of businesses and wealthy individuals.

Tomorrow, I’ll examine other new taxes in the ACA, while later posts will discuss tax loopholes that Obamacare closes and changes to government subsidies to health care providers.

But for now, follow me below the fold for a description of section 9015.

Monday, October 21, 2013

Ohio accepts Medicaid expansion

This is very, very good news.  The plan means another 275,000 people get insurance coverage.

Via the Toledo Blade (which by the way, is a great name for a newspaper):

A little known budgetary panel today voted 5-2 to accept $2.56 billion in federal funds to pay for the controversial expansion of the federal-state health insurance of last resort.
Two Republicans joined the panel’s two Democrats and Gov. John Kasich’s appointed chairman to do what the 132-member General assembly would not — expand eligibility for Medicaid to some 275,000 additional Ohioans.
Kasich found himself in a similar position to fellow Republican Michigan Gov. Rick Snyder. He understood that accepting the Medicaid expansion was the right thing to do from a budget standpoint, but had to overcome the ideology of conservatives in the legislature.  Snyder was able to cut a deal between moderate Republicans, Democrats and the Department of Health and Human Services to pass an expansion.

Kasich couldn't get the legislature to take it seriously, so he outflanked them by using this legislative panel that generally acts to review budget grants and accept federal funds that become available after a two-year budget is passed.

Credit where credit is due; I'm no Kasich fan, but he did the right thing here (with a bit of help from moderate Republicans, Democrats and a whole bunch of activists and experts pushing for him to accept the expansion).

A little known budgetary panel today voted 5-2 to accept $2.56 billion in federal funds to pay for the controversial expansion of the federal-state health insurance of last resort.
Two Republicans joined the panel’s two Democrats and Gov. John Kasich’s appointed chairman to do what the 132-member General assembly would not — expand eligibility for Medicaid to some 275,000 additional Ohioans.

A little known budgetary panel today voted 5-2 to accept $2.56 billion in federal funds to pay for the controversial expansion of the federal-state health insurance of last resort.
Two Republicans joined the panel’s two Democrats and Gov. John Kasich’s appointed chairman to do what the 132-member General assembly would not — expand eligibility for Medicaid to some 275,000 additional Ohioans.

A little known budgetary panel today voted 5-2 to accept $2.56 billion in federal funds to pay for the controversial expansion of the federal-state health insurance of last resort.
Two Republicans joined the panel’s two Democrats and Gov. John Kasich’s appointed chairman to do what the 132-member General assembly would not — expand eligibility for Medicaid to some 275,000 additional Ohioans.

A little known budgetary panel today voted 5-2 to accept $2.56 billion in federal funds to pay for the controversial expansion of the federal-state health insurance of last resort.
Two Republicans joined the panel’s two Democrats and Gov. John Kasich’s appointed chairman to do what the 132-member General assembly would not — expand eligibility for Medicaid to some 275,000 additional Ohioans.


Sunday, October 20, 2013

Texas voting #headdesk blogging II: Bring your concealed-carry permit to the polls

So, Texas has a Voter Photo ID law, which is spelled out in great detail on my new voter registration card -- it takes up the entire back of the card. (Maybe that's why they don't have room for extraneous information, like say, the location of my polling place. Sigh.)

Voter ID. OK, so what's acceptable ID, Texas?
"The following forms of voter identification ... may be accepted for voting: Driver's license; election identification certificate; personal identification card or concealed handgun license issued by the Texas Department of Public Safety; United States Military identification card that contains the person's photograph; United States citizenship certificate that contains person's photograph; or a United States Passport."
Right. A photo ID from a state college or university or state agency apparently isn't official enough. But boy, if you have a gun, that sends you right to the front of the line. 

Because it's getting old to detail all of the reasons why photo ID for voting is unnecessary and discriminatory, I'll link to a quick list here.

On the bright side though, at least they accept a passport for the present -- sometimes Texas officials don't really like to acknowledge the authority of the United States.  

May God help this state, 'cuz its political leaders sure won't.

And on a related note Godspeed to the U.S. Department of Justice.

Texas voting #headdesk blogging

So, I got my Texas voting registration card in the mail last week.  I'll be eligible to vote in November, which is great.  The card lists my address, my precinct number and all my district numbers for all my relevant office holders. It does so in English and Spanish.

But - unlike every other election card I've ever received, they don't tell me where my polling place is. And they don't even tell me where to go to find out where your polling place is.

Sure, I can probably do that online fairly easily, but it's an entirely unnecessary step and adds another cost to the voter.

It's like they don't want you to vote here or something....

Texas Adjustments Part IV

Enough with the federal delegations, time to head to the State level.

When I fled south, I got to leave Rick "Governor Nerd" Snyder, Michigan's CEO:

And when I crossed the border at Texarkana, I inherited Rick "Governor Hair" Perry, Texas' CEO.

Ugh. Both men are complete Richards who go by Rick. They are also both obscenely Rich. And, not incidentally, they both have acted like complete Dicks during their terms in office.

I'm thankful Snyder actually understood the need to expand Medicaid in Michigan -- and pushed for it. But I will never, ever, ever forgive Snyder for signing "Right-to-Work" legislation in Michigan. End of story -- the man is dead to me.

Perry, well, there's not enough space here to talk about him. From the death penalty, to guns, to threatening the Chairman of the Federal Reserve, to showing zero compassion and intelligence with regard to health reform, to his stupid secession talk; I sure hope the door smacks his butt hard on his way out in January, 2015. Of course, we're probably going to get some one even worse, so... sigh.

Anyhow, this one is a push -- preferably off a cliff, Thelma-and-Louise-style. Now if you'll excuse me, I need to read a few Molly Ivins columns with a stiff drink nearby.

Saturday, October 19, 2013

Low voter turnout in local elections: an analysis

During their "Houston Matters" weekday show on Monday Oct. 14, KUHF dedicated its first segment to the mayoral election. The station brought in three professors of political science -- Mark Jones and Paul Brace from Rice University and Renee Cross from the University of Houston.

Most of the segment was dedicated to analyzing the resumes and plans of each of the nine(!) candidates for mayor, which got to be a lot of fun when you moved down to the names of the people you had never heard of (who knew the socialist workers party even existed in Texas?).

But a large undercurrent of the show was dedicated to wondering why people don't vote in local elections. I don't disagree with any of the reasons the three gave, (less prominence, people

1. Lack of mobilization resources. Ben Hall and Annise Parker have considerable resources, their campaigns simply don't have the national prominence or organizing ability that a presidential or even a gubenatorial campaign might have to turn out voters.  Mobilization -- through advertisements, door-to-door visits, offers of rides to the polls -- lowers costs for voters

2. It's a non-partisan election. One of the simplest pieces of information to give voters is a Party ID, which cuts voting costs by giving you a cue about a candidate's positions on everything from gay rights and abortion to labor unions, the environment, mass transit and government regulation of the economy and jobs.

Don't believe me?

Take the following ballot:

1. Warner
2. Warner

Do you know what the candidates stand for? Do you know who you are going to vote for?

Probably not.

Now let's make it a partisan election

1. Warner (R)
2. Waner (D)

Now do you have a better idea of what the candidates stand for and who you are going to vote for?

I rest my case.

We love to decry excessive partisanship, but there is something to be said for both the mobilizing capacity and information-provision that well-organized political parties provide.

Friday, October 18, 2013

ACA exchange subsidies: are they sustainable?

As the health care exchanges go online, two major factors work together to keep premium prices down. First, the individual mandate to purchase insurance forces healthy people into the risk pool and keeps rates reasonable (often reducing a $1,500 monthly premium to $300 in many cases). However, even these drastic rate reductions are difficult for many working class and working poor Americans to afford. So we bring in factor II: subsidies that limit premiums and out-of-pocket expenses from a basic silver-level plan to a portion of income for people with incomes between 100 and 400 percent of the poverty level.  In my case, subsidies will reduce my premium by about $140-$185 a month depending on where my final income shakes out.

As a result of the individual mandate and subsidies millions of people who couldn’t afford insurance are going online to the insurance exchanges and making the exciting discovery that they can afford real coverage for the first time.

And there was much rejoicing.

But that’s just the opening chapter. The next part of the story details what happens to the subsidy levels in the future.  Follow me below the jump for potential future problems in the subsidies and the gamble the ACA takes.

Thursday, October 17, 2013

Sequester still biting essential services

So the immediate shutdown/default crisis has passed, but the sequester, which engages in stupid across-the-board cuts is still here until at least February.

Jared Bernstein has been doing wonderful work every week in collecting local media reports on how the cuts are affecting Americans in their everyday lives. You should read him.

Thoughts on the shutdown

I've been making a conscious choice to focus on health reform, in part because it's important and not too many people are covering the nuts and bolts of the law, but also in part because I get so angry when I think about the stupidity of the shutdown and threats to breach the debt ceiling that I don't write straight.

Jared Bernstein conveys most of my thoughts on the Republican majority in the House of Representatives here:

I’ve been put off by most of these “terrorist” and “hostage” analogies, but this is a toddler who wants to be compensated for the anguish she suffered during her meltdown.  It’s a thief arguing that the judge should give him back some of the loot because the damn trial was really stressful.


For those who are curious,  the votes of congresspeople on the bill to end the shutdown and raise the debt limit are here.

As Burnt Orange Report points out, all of the GOP members of the Texas Congressional delegation voted for America to default on its bills. 

It's great to have a bunch of vandals representing me. Just great.

Wednesday, October 16, 2013

Medicaid will help more souls thanks to Obamacare-- even in states that don't take the expansion

Any complicated federal law has a number of features that don’t get a ton of attention, yet turn out to be very important. The Affordable Care Act is no exception. Most of us know about the Medicaid expansion that was made optional by the Supreme Court. But there are many other quiet changes to Medicaid administrative procedures that weren’t touched by the court’s decision, detailed in this Kaiser Foundation Report released in October. These administrative tweaks will go a ways toward streamlining the Medicaid program, and significantly increase enrollment among the currently eligible.

There are two broad factors that indicate how many people have access to any Medicaid expansion. Obviously, the first factor is eligibility. States that don’t expand Medicaid won’t cover broad swaths of adults – about 5.4 million will get left out of Medicaid and not be eligible for subsidies. I might be one of them, at least temporarily.

That might seem like game over, but it’s not the whole story.

First, over time, political coalitions, institutional pressures, and flexibility on the part of HHS will likely shift a few more states in the Medicaid expansion (I’m looking at Maine, Montana, Missouri, and Virginia as potential short to medium-term examples).

This doesn’t help in states like Texas, or the usual suspects in Alabama and Mississippi, which seem hopeless when it comes to any chance of expanding Medicaid in the near or medium term. Millions of adults, disproportionately minority (of course), will be left out of insurance coverage.

But the eligibility is only part of the story. The second factor that helps gain access to services is the ease of with potential beneficiaries can apply. And the ACA helps ease this process considerably.

Currently, Medicaid utilization varies greatly by state. Some states actively try to make sure that all eligible get services, while some states make the application process as difficult as possible to keep enrollment (and costs) down through making applicants submit to multiple in-person interviews, kicking people out of the program for making trivial mistakes. In states like Texas, this means that hundreds of thousands of people who are eligible for Medicaid aren’t enrolled.

The ACA contains a number of federally required administrative changes to the Medicaid application process that weren’t touched by the Supreme Court’s decision to make Medicaid optional. The changes will generally streamline the process for enrollees and can be summarized as follows:

1.      All states must allow registrants to apply through phone, online, in person, or mail
2.      All state must maximize the use of electronic verification of eligibility to speed applications
3.      All states must use a simple form of eligibility calculation based on a recipient’s Modified Gross Adjusted Income
4.      All states must allow applicants to apply for Medicaid through the state health exchanges
5.      States are encouraged to use a single form for applications for SNAP (food stamps), SCHIP (Children’s health) and Medicaid.

True, the states that reject the Medicaid expansion are also more likely to throw up road blocks to helping people enroll for the exchanges, by blocking access of navigators, for example.  However, federal standards that simplify the application process across states will on net ease the access and increase enrollment.

Better administrative procedures aren’t a cure all. According to Kaiser’s numbers, 8.4 million people won’t be covered under the Medicaid expansion in the foreseeable future in states that opted out, thanks to the Supreme Court’s decision.  (As I mentioned earlier, about 5.1 million won't be eligible for the subsidies, on the exchanges, while the rest will at least have those).

But if Kaiser’s analysis is right, standardizing and easing application procedure across the board will significantly increase enrollees – by roughly 2 million people across the states that haven’t yet accepted the Medicaid expansion (more than 500,000 in Texas alone).

That's one heck of a silver lining.

Sunday, October 13, 2013

Texas Adjustments Part III

So let's move to the House of Representatives.

From my old Ann Arbor district, we have John Dingell:

In my new west Houston district, we have Ted Poe.

According to Project VoteSmart, Poe actually received a voting score of above 20 percent from the SEIU on several occasions in the last decade. He also took a recent surprising, yet gratifying stance taken in favor of getting federal funds for the University Light Rail line. Of course, on everything else, he's terrible, but those two facts alone make him Nelson Rockefeller by the usually Neanderthal standards of the Texas House delegation.

But still, Dingell is the real deal -- His dad was an original New Dealer and Dingell has been voting like one ever since, supporting Medicare, Medicaid, worker safety, unemployment insurance, higher minimum wages. He's introduced a universal health care bill on the House floor on the first day of every session he's been in Congress. Some of his stances on guns and the environment weren't perfect, but he's swung quite a bit on greenhouse gas regulation over the last decade. He's also remarkably coherent and thoughtful for a man who's 87 years old -- he might be a bit frail physically but the brain is still working hard.  Advantage, Michigan.

Saturday, October 12, 2013

GOP Stupid shutdown statement contest II: Red-River rivalry edition

So we’re back with our second edition of "stupid shutdown statements"

It’s a big football weekend in the south central states and Texas and Oklahoma face off in their annual rivalry game in Dallas. Frankly, as a Big-10 partisan, I don’t trust all these new-fangled things the Big-12 is using, like the spread offense and the forward pass, both of which I'm certain were inspired by Communists. I also resent Nebraska dragging down my favored conference's collective GPA since it joined in 2011.

Still, the Red River Rivalry is kind of important, so I thought it would be nice to showcase the verbal ineptitude of several of our fine congressional representatives from the great states of Texas and Oklahoma.

Follow me below the fold as the GOP statesmen bring the (economic) pain:

Friday, October 11, 2013

More on Exchange competitiveness

Aaron Carroll over at the Incidental Economist has a blog post up of his own comparisons between the Indiana University's Health Insurance Offerings and the Indiana exchanges. His investigative tactics are a bit different than mine were in my last post, but we come to similar (cautious) conclusions: the exchange plans are very competitive on price and services with their employer-offered counterparts.

This is really, really good news for Obamacare.

Thursday, October 10, 2013

Health Exchanges: employer insurance vs. exchanges, an example

One of the neat things about watching the major parts of the Affordable Care Act roll out over the past few weeks has been experience it both as a wonk-nerd/scholar and on a personal level. It's a good reminder that policy-making isn't just this thing that exists way out in Washington, but something that profoundly affects all of our lives, for better or for worse.

After a week of waiting out the initial craziness, I ventured on to last night to start pricing out options. I haven't signed up for anything yet, or created a formal application. I also suspect the prices will shift slightly to reflect my personal age instead of the large band the basic information section asks for. We'll see what happens when I navigate that part of the process.

Those caveats aside, the prices are a thing of beauty.

In Harris County, I have the option of 12 Bronze plans, 12 Silver plans, 12 gold plans and one platinum plan.

The Bronze plans run from $137 a month to $214 a month.
The Silver plans run from $195 to $256 a month.
Gold plans run from $233 to $312 a month.
The Platinum plan checks in at $283 a month.

Each plan has some differences as to what it covers and how it handles co-pays. They also have considerably different network types and sizes.

But these are EXTREMELY competitive prices.

Let's compare to the University of Michigan's employer-offered insurance. I suspect that most of these plans are probably on a Gold level, but at the very least they are on a Silver.

Premier Care: $511
HAP: $567
Blue Cross/Blue Shield: $597
Comprehensive Major Medical: $468
Grad Care: $239

All of these figures are for single people, and do not include UM's employer contribution or any subsidies on the Federal exchanges -- it's the full monthly premium. For example, employees on Premier Care who earn less than $50,000 pay $32 a month, while based on my 2013 income (assuming I make the poverty line), I would get roughly $185 in federal subsidies to spend on insurance every month, meaning I would pay about $20 for the second-lowest Silver plan.

One factor that makes UM plans look a bit less competitive is that the covered risk pool is older thn the price quoted for 34-year-old me on the exchanges, which will raise UM's prices somewhat. However, it's heartening to note that the exchange plans are still fairly competitive even with Grad Care, which covers Graduate Student Instructors and Graduate Student Research Assistants and is essentially Premier Care with a much healthier risk pool and a constrained network.

It's amazing what a bit of regulated competition will do to a dysfunctional individual insurance market. There are still demons lurking in the details (one of which I'll discuss tomorrow), but this Obamacare thing looks like it's going to work.