LeeAnn Hall: Supreme Court Verdict Assures Unions Can Continue to Help Workers

The Alliance for a Just Society released the following statement from Executive Director LeeAnn Hall in response to Tuesday’s 4-4 Supreme Court verdict in the Friedrichs v. California Teachers Association case. The decision lets stand a lower court ruling upholding public sector unions’ ability to collect “fair share” fees to cover the costs of collective bargaining:

“Today’s outcome is an important victory for teachers, public service workers, and the communities that benefit from the services they provide. Public service unions will be able  to continue helping workers come together in collective bargaining to win better pay, benefits, and work environments.

“This challenge to the long-standing precedent supporting fair share fees was sheer nonsense from the beginning. Brought by the rightwing legal shop Center for Individual Rights, the challenge created a bizarre scenario where people who benefit from the union’s bargaining wouldn’t have to pitch in their fair share to support it. It created a ‘free rider’ scenario that defies both basic logic and stated conservative principles.

“Public sector unions have won important gains toward gender and racial equity in the workplace and created avenues to the middle class for people who have been shut out and discriminated against, especially people of color. It’s important for this work to continue – thanks to today’s decision, it can.

“People coming together in their communities and in their unions to express their opinions is how we build a strong democracy that works for all of us.”

Alliance for a Just Society is a national organization that focuses on social, economic and racial justice issues.

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Cracking Down on Abusive Debt Collectors

This article first appeared in OtherWords

Have you ever picked up your phone to find an aggressive voice on the other end demanding payments on a debt you know nothing about? You’re far from alone.

Once you’re in the sights of a debt collector, the impact on your life can be devastating: Your wages can be garnished and your credit ruined. You might lose your driver’s license, or even your job.

And it could happen over a debt you don’t even owe.

In a recent analysis of 75,000 complaints about debt collection practices submitted to the Consumer Financial Protection Bureau — just a sample of the total number — this was the most common complaint by far. Over 40 percent of people being harassed by collectors said they didn’t owe the debt in the first place.

Other complaints charged that the collectors made false statements or threats to coerce people to pay.

The government created the Consumer Financial Protection Bureau — or CFPB ­— to address abusive financial practices after the 2008 financial crash. This year, the bureau is considering strengthening rules to protect consumers from deceptive and aggressive collection practices.

Abusive collection tactics impact people with all kinds of debt — including credit card debt, medical debt, payday loans, student loans, mortgages, and automobile loans. Collectors often strike when people are most vulnerable, such as when they’re recovering from illness or desperately seeking work. They aggressively target the poor, immigrants, and people of color.

About 77 million people — or 35 percent of adults in the United States with a credit file — have a report of debt in collections. That alone makes a compelling case for the bureau to crack down on abusive tactics.

When my organization, the Alliance for a Just Society, analyzed the complaints for ournew reportUnfair, Deceptive, & Abusive: Debt Collectors Profit from Aggressive Tactics — we tallied the complaints in the database and built a list of the 15 companies with the most complaints.

The list is topped by heavy-hitting debt buyers like Encore Capital Group and PRA Group, whose business models hinge on buying portfolios of consumer debts for pennies on the dollar and then wringing payments out of alleged debtors. Both of these companies more than doubled their profits from 2010 to 2014.

Major student loan servicer Navient (formerly Sallie Mae) also makes the top 15 list for complaints about its debt collection tactics.

But it’s particularly worth noting that six out of the top 15 offenders on this list are original creditors, not third-party collectors. They include Citibank, JPMorgan Chase, Capital One, Wells Fargo, Bank of America, and Synchrony Financial (the largest issuer of private label credit cards).

This is important, because the primary protection most consumers have against unfair collection tactics — the federal Fair Debt Collection Practices Act — applies only to third parties, not original creditors. This is a troubling double standard.

The new rules must also to apply to the original creditors — including payday lenders, credit card companies, and big banks — along with third-party collectors and debt buyers.

The rules should limit phone calls to prevent harassment and require collectors to have complete documentation before attempting to collect. The rules should prohibit selling, purchasing, and attempting to collect old, paid, or expired “zombie” debt.

Finally, the bureau should toughen the penalties for collectors breaking the rules.

Living with debt isn’t a personal failing — it’s a national crisis. The bureau needs to stand up for everyday people and put a stop to abusive collection tactics.

LeeAnn Hall is the executive director of Alliance for a Just Society, a national research, policy, and organizing network working for economic, racial, and social justice. AllianceForAJustSociety.org
Distributed by OtherWords.org

It’s a Matter of Life and Death: Insurers Must Cover Language Services

A 14-year-old girl accompanies her Somali-speaking father to his medical appointment. Because the clinic doesn’t provide an interpreter, the girl has to inform her own father than he has been diagnosed with cancer. She remains his interpreter through eight years of treatment, sometimes hiding information to protect him from the bad news.

A group of Spanish-speaking farmworkers enters a pesticide-laden field and soon, sickened and vomiting, must rush to the hospital. No medical interpreters are provided, and one of the farmworkers must handle communications between her coworkers and health care providers – while she is suffering from her own symptoms.

A Vietnamese-speaking woman is admitted to the hospital. When doctors or nurses need to talk with her, they call in an orderly with no training as an interpreter and no familiarity with medical terminology.

Cases like these are far from isolated. Every day, children, other relatives, friends, and even untrained hospital staff are asked to step in to do a job only competent, professional medical interpreters should be performing.

These dangerous practices persist despite federal law requiring hospitals and other health care providers to offer language services.

These institutions should be meeting their obligations. But it’s also long past time to require insurance companies to make medical interpretation available just as they cover exams, prescription drugs, and other health care essentials.

So far, we’re not holding insurers to that kind of requirement.

As we continue transforming our health care system through the Affordable Care Act (ACA), we need to incorporate professional medical interpretation into those efforts. The federal government should require insurance companies to make medical interpretation available to all patients who need and want it in their course of care.

Letting insurance companies off the hook puts people’s health at risk, allowing insurers to deliver substandard care to people whose health they’re supposed to protect.

Ample research shows that medical interpretation is a necessary component of health care for people with limited English. Without proper interpretation, doctors can misunderstand patient complaints, inaccurately diagnose their conditions, and prescribe inappropriate treatments. Patients receive medications but may not know how to take them.

Often, patients with limited English don’t even make it to the doctor’s office at all. Studies show that patients with limited English are less likely than other patients to have a regular source of health care.

Thanks to the ACA, insurance companies are signing people up in record numbers. They’re marketing health plans to many new enrollees in languages other than English. They’re also enrolling new patients in languages other than English. They should also be able to make health care available in those languages – rather than just pocketing the premiums from those enrollees.

The ACA gives us new tools for holding insurers and providers to their language services responsibilities. We need to do a better job of using all of these tools.

In early September, the federal Department of Health and Human Services (HHS) proposed long-awaited rules to implement the ACA’s ban on discrimination in health care, including discrimination faced by patients with limited English proficiency.

The proposed rules make it clear that oral interpretation is key to combatting that discrimination. They also establish that the new anti-discrimination rules apply to health insurers offering coverage through the ACA. And they require entities covered by the rules to make sure they’re relying on qualified interpreters.

With this language, HHS is building on longstanding civil rights law recognizing people’s right to oral interpretation. But HHS is also building on a history in which that right has been violated, again and again, with violators abetted by inadequate enforcement mechanisms. Patients still are receiving substandard care because of the language they speak.

In a health system increasingly concerned about quality, insurers should make sure all their patients are receiving good health care.

There’s precedent for requiring insurers to step up. Under California’s SB 853, insurers must provide language services at all access points, including the doctor’s office. And, in many states, Medicaid pays for interpretation to help make sure providers are offering it.

If Medicaid programs can cover medical interpretation, so can private insurers. The federal government shouldn’t be letting insurers off the hook while also letting them collect premiums. Patients with limited English have a right to quality health care – and we need to make sure they’re getting it.

(This article was originally published in Huffington Post.)

Defending Planned Parenthood is Essential for the Whole Progressive Movement

(This opinion by LeeAnn Hall was originally published in Common Dreams)
Planned Parenthood is an easy target for rage and righteousness as we saw too plainly in the shootings in Colorado Springs late last month.
The ongoing conservative attack on Planned Parenthood funding depends on the same extreme rhetoric but, it’s also part of a broader trend, a strategy by the right to dismantle progressive infrastructure.
As destructive as we know right-wing operatives to be, we shouldn’t be surprised by their tactics – and we can’t allow ourselves to be divided or defeated by them, either.

Progressive groups and our members must reach across our issue silos, and our membership bases, whenever one of us comes under attack. Our support of Planned Parenthood provides a good example of how we can and should support each other.

This week I joined with a hundred other community leaders, organizers, and small business owners to place an advertisement in The Hill to tell lawmakers directly that we stand with Planned Parenthood. This followed a day of solidarity on December 5, when organizations and individuals around the country stood up for Planned Parenthood.

By speaking up and speaking together we are helping build a new kind of solidarity essential for today’s progressive movement.

A right to an abortion was upheld by the highest court of the land and is supported, in some or all circumstances, by 80 percent of the public. But abortion rights, and women’s health more broadly, are under greater attack today than ever. Why?

Many states have created bureaucratic hurdles and funding schemes that have made clinics that provide abortions and other essential women’s health services harder and harder to find. At the federal level rhetorical and policy attacks on Planned Parenthood have further jeopardized these rights.

Sure, it is largely because the rightwing politicians have been able to vilify Planned Parenthood and utilize their power at the state and federal level to limit access to abortions.

But it is also because for many years our movement for progressive social change has been too divided-up and focused internally on a narrow set of issues. We have tended to stay in our silos.

For my organization, the decision to stand up for Planned Parenthood was our first significant public foray into reproductive justice. Our decision came after a lot of discussion among organizers and grassroots leaders.

Ultimately, we knew we had to recognize the connection between attacks on women’s reproductive rights and many other issues affecting the lives of everyday people.

Low-wage workers, poor people, people of color, and immigrants depend on Planned Parenthood – 2.7 million women and men every year – for birth control, family planning and abortion services, cancer screenings, and testing and treatment for sexually transmitted disease.

At a time when working people, and especially working women, are increasingly struggling to make ends meet, Planned Parenthood and other women’s health centers are providing essential services. Seventy-nine percent of Planned Parenthood health care center patients have incomes at or below 150 percent of the federal poverty level.

It’s no accident that the same politicians plotting to defund Planned Parenthood are leading the charge to eradicate the Affordable Care Act (ACA). Last week, just days after the Colorado Springs shootings, conservatives in the Senate were still debating legislation to dismantle both health care pillars.

If the attack on reproductive justice is part of a broader right-wing agenda, the singling out of Planned Parenthood also points to a prime right-wing tactic to advance that agenda: destroy progressive institutions.

Unfortunately, the right-wing has had success in the past with this tactic.

Just a few years ago, right-wing demagoguery, distortions, and budget cuts broke up ACORN, a national network of community organizations that was one of the strongest voices of low-income people in the country. Far too many progressive groups and individuals stood on the sidelines when ACORN was under fire. We lost strength as a result.

The latest legal challenge to the right of workers to collectively bargain and build unions will be heard by the U.S. Supreme Court in January in the case of Friedrichs v. California Teachers Association which could dismantle public sector unions as we know them.

In recent weeks black student activists at the University of Missouri faced threats of violence in the wake of their successful organizing effort to unseat the University President. More recently five Black Lives Matter supporters were shot and wounded in Minneapolis by purported white supremacists.

Meanwhile, political leaders continue to make hateful comments about — and propose continued racist policy against — refugees and Muslims. Some voices may be more extreme than others, but xenophobia is widespread, as we saw in 30 governors’ reaction to Syrian refugees. Along with these rhetorical attacks, we’re seeing efforts to gut the programs that help refugees.

This is all infrastructure that we, as progressives, care about and need.

As community organizations, unions, grassroots activists, and faith leaders we must look to the shows of support for Planned Parenthood as an example of our ability to stand together. If there’s one thing we need lots of these days, it’s solidarity.

LeeAnn Hall is the executive director of the Alliance for a Just Society, a national organization that advocates for health, economic and racial justice. 

Next Attack on Workers – Will Conservatives Champion “Free Riding” to Justify It?

Building power through strength in numbers. It’s one way regular people can overcome opposition from corporate and wealthy special interests to win concrete improvements in our everyday lives.

We may not be able to match opponents who can write seven-figure checks dollar for dollar, but by banding together, articulating collective demands, and negotiating with powerful interests (whether corporate CEOs or elected leaders) from a place of shared strength, we can build the leverage to win changes that benefit our families and communities.

This – building strength in numbers and banding together to negotiate with power holders – is a core component of what community organizing is all about. It’s also a critical part of what unions do for the workers they represent in collective bargaining.

But now, the ability of unions – in particular, unions that represent teachers and other workers in public service – to help workers come together in collective bargaining to win better pay, benefits, and work environments is under threat in a case that will go before the U.S. Supreme Court in January.

The case is called Friedrichs v. California Teachers Association. It is, in a nutshell, a brazen attempt to overturn what has been a settled Supreme Court precedent since the 1977 Abood decision reaffirmed the right of public sector unions to collect “fair share” fees to cover the costs of collective bargaining.

The fact that the Center for Individual Rights (CIR), the rightwing legal shop leading the case, asked lower courts to rule against it without even presenting an argument underscores the drastic departure from the settled precedent they’re seeking.

On its website, CIR explains: “The speed with which the case moved through the lower courts reflected a deliberate litigation strategy. From the beginning, CIR argued that the lower courts do not have the authority to overturn existing Supreme Court precedent.”

We all have something at stake in this case – the teachers whose ability to band together and have a shared voice on the job is on the line; the students who benefit when their teachers negotiate for smaller class sizes; the local businesses that benefit from the middle class customer base teachers and firefighters and other public service workers represent.

But it’s also true that women and people of color have the most to lose from a bad decision in the Friedrichs case. Unions have won important gains toward gender and racial equity in the workplace; public sector unions in particular have created avenues into the middle class for people who have been systematically shut out and discriminated against, especially people of color.

It should not be too surprising, then, that CIR has counted among its benefactors not only a range of conservative funding conduits that are connected to the Koch political network, but also a group identified with white supremacist ideas.

Maybe one of the biggest ironies in this case, though, is how conservatives will have to tie their own professed values up in knots to argue their position. Because the whole case rests on creating a “free rider” problem – where people don’t pitch in their fair share to support the shared benefits they receive – for unions. The “free rider” idea stands in sharp contrast with conservative narratives about personal responsibility.

If CIR is to win, it will have to convince a majority on the Supreme Court that an organization should be forced to give the benefits of membership (like better deals through group bargaining power) to any individual without asking that individual to pitch in even a dime to support the bargaining the organization does on his or her behalf.

Here’s the thing: what if the organization in question wasn’t a union representing workers, but instead a business association – like, say, the U.S. Chamber of Commerce?

Would the U.S. Chamber stand for a legal ruling where any corporation could take advantage of the benefits of Chamber membership – like discounts on products and services, legal documents, business resources, or networking events – without pitching in even a dime to support the costs of securing those benefits?

Of course not. That’s a free rider problem the Chamber and other anti-worker business lobbies would get up in arms about in a hurry.

So here’s the bottom line – unless five justices on the Supreme Court are ready to stand up and argue the U.S. Chamber should have to give free lunch to any Fortune 500 “free rider” that wants it, they should dismiss the Friedrichs case for what it is: nonsense. Case closed.

This article was originally published by LeeAnn Hall in Huffington Post.

http://www.huffingtonpost.com/leeann-hall/next-attack-on-workers–w_b_8683766.html

Let’s Block Too-Big-To-Fail Insurance Mergers

By LeeAnn Hall and Wendell Potter

This article was originally published in Roll Call.

If you thought too-big-to-fail banks were dangerous, watch out for too-big-to-fail health insurance companies.

This summer, the country’s top insurers announced a spate of merger plans, lighting up the business pages nationwide. Health insurance giant Anthem unveiled its intention to absorb competitor Cigna, while Aetna put in a bid for Humana — mergers that, if approved, will cut the country’s big insurers down from five to just three. Add to these proposals Centene’s plan to scoop up Health Net, and it looks like a feeding frenzy.

The bad news is that we’re the bait.

On Sept. 29, the House Judiciary Committee brought company CEOs into a hearing on the deals. There, committee members raised questions not only about competition, but also about the impact of such mergers on both affordability and quality of care.

Meanwhile, the health insurance companies have put their PR in high gear.

In prepared testimony, Anthem CEO Joseph Swedish claimed the merger is about “complementary platforms” and “better value.” But this kind of lingo can’t hide what the proposals are really about: They are not about making quality care more affordable, but about amassing profits in an industry where companies such as Anthem boast profits of $2.5 billion or more a year.

We certainly shouldn’t buy the argument that bigger-than-ever health insurance companies will make our health insurance better or more affordable. If insurance giants grow even larger, we can expect premiums to rise — not go down. Take the example of UnitedHealth’s purchase of Nevada’s Sierra Health Group, triggering premium increases 13.7 percent greater than they would have been without the merger.

There’s also the risk that insurers will squeeze more doctors, hospitals and other providers out of their networks, adding extra hassles and costs for patients. This danger is even higher for those living in low-income communities or rural areas where it’s already hard to find doctors.

As the Sierra example shows, there’s nothing new about insurance company mergers. Anthem attained “megaplan” status 11 years ago when it snapped up WellPoint.

As a result, in many of our cities and towns, a small group of insurers — or even just one — has a real grip on the market. A recent American Medical Association report found a high concentration of insurance markets in 72 percent of metropolitan areas studied, with a single insurer claiming 30 percent of more of market share in 90 of these areas.

Yet, neither the House nor the Senate has a say in these deals. That’s why we need the Department of Justice and our state watchdogs — whether attorneys general or insurance regulators — to take action against these proposals.

Halting the mergers would be consistent with the Affordable Care Act, which gives us the tools to change the terms of competition among health insurance companies. Before the ACA, insurers competed for “good risk” — meaning covering people who were young and healthy and dumping anyone with higher health care needs. Now they can’t turn you down or charge you more for a pre-existing condition. But that doesn’t mean that they’re not still driven by the quest for profits and will try to bend or mold the rules to bolster those profits.

Health Insurance Is Great – Navigators Needed to Help People Use It

This spring, Adriann Barboa and her colleagues at Strong Families New Mexico went on a five-county tour, fanning out across the state to share findings from the Breaking Barriers study they’d conducted on progress under the Affordable Care Act (ACA).

The report is part of a ten-state series by the Alliance for a Just Society.

“In all the towns we went to, many people said it was great to finally have insurance, but they didn’t know how to use it,” Barboa said.

“The Breaking Barriers report recommends using navigators to help people understand what a primary care provider is, what preventive care is, and how to get those services using their insurance,” Barboa said. “Across the five counties people pointed to that recommendation and said ‘That’s what we need.'”

Since passage of the ACA, the United States has seen a record decline in the uninsured rate. In 2013, more than 13 percent of people in the country were uninsured. By 2014, that figure had dropped to 10.4 percent.

These gains were achieved thanks to the ACA’s Medicaid expansion and subsidies for coverage through state and federal marketplaces. The new law made millions of people eligible for health coverage when they’d been shut out in the past.

But, even with these changes, it took real people to get so many new enrollees through the door – these are the navigators mentioned by Barboa.

In the first open enrollment period alone, navigators and other enrollment assisters helped more than 10 million people apply for coverage. These navigators provided information about plans, assisted people with forms, helped them submit documents, and showed them how to make their payments.

This help was – and continues to be – key to the ACA’s success, which is why the federal Department of Health and Human Services is increasing its investment in navigator programs.

We all know how apt the term “navigator” is, since the process of enrolling in health insurance is so complicated. But those complications don’t end once you’re signed up for insurance and have sent off your first premium payment. Using health insurance can be very confusing, too.

Many of us have had questions about our coverage. How do I select a doctor or other practitioner from my health plan’s list of providers? What kind of care comes free of additional costs, and when may I be charged out-of-pocket payments – and how much will those payments be? How do I find out what services or prescriptions are covered? If I’m denied a service, what are my rights to challenge that denial?

These questions are hard enough when you’ve had health insurance your whole life. It’s that much harder if you’re getting coverage for the first time. In that case, you’re entering a new world of formal terminology, provider lists, and paperwork.

That’s why navigator-type programs should be there for us after we enroll, too.

Without an effort to make sure coverage translates into care, we run the risk of missing out on the promise of health reform – which, we should remember, is about transforming our health sector so people can get the care they need. Enrolling all those millions of formerly uninsured people is just the first step.

As the Alliance for a Just Society’s recent Breaking Barriers reports show, many people – especially people of color and low-income people – still aren’t getting into the doctor’s office even after they have coverage.

Some community-based organizations provide good models for how an integrated assistance program can help people move into coverage and then turn that coverage into care.

The Community Service Society of New York (CSSNY) provides one such model. Drawing on funding from New York State, CSSNY has established an innovative coverage-to-care approach – using both a navigator network and a community health advocates program – that helps people obtain coverage and put their coverage to use.

A New Yorker needing help can call CSSNY’s toll-free helpline, where advocates connect people to enrollment assistance, answer questions about coverage, or help troubleshoot insurance issues (such as coverage denials or billing problems). Using a hub-and-spoke structure, CSSNY also works with a broad, statewide network of community group and small business groups, offering help in almost 200 languages.

We need more programs like this one if we hope to truly transform our health care system and make it work for everyone. We need to make sure a person’s insurance card is worth much more than the plastic it’s printed on. Good coverage-to-care navigator programs are key to achieving that goal.

To Fight Racism, Protect Voting Rights

The cold-blooded murder of nine people at a Charleston church made it impossible to deny the persistence of racism across the nation. So do the symbols of support for slavery and segregation that remain emblazoned on public property throughout the South, and scattered among some Northern states as well.

What will it take to bring real racial justice to our country? For starters, protecting the right to vote.

A century after the end of the Civil War, Southern segregation thrived because of lynch laws, poll taxes, and other institutional restrictions on African Americans. One of the great achievements that finally broke the back of Jim Crow was the Voting Rights Act of 1965, which enshrined the right to vote in federal statute for the first time.

The Voting Rights Act mandated federal review of any new voting rules in 15 states, most of them in the South, with histories of discrimination at the polls. Two years ago, the Supreme Court’s 5-4 decision on Shelby County v. Holder effectively gutted the enforcement tools of the federal voting law.

The right to vote is still the law of the land — in principle — but the Supreme Court ruling turned the protection of those rights over to state and local authorities.

Since the ruling, states such as Arizona and Kansas have passed restrictive voter ID laws. And North Carolina ended early voting and same-day registration.

They’re far from alone, and this voter suppression isn’t limited to the states that joined the Confederacy. But I can’t help wondering how jurisdictions that still wrap themselves in the rebel flag can be counted on to safeguard fair voting rights.

To protect against discrimination, Congress must pass the Voting Rights Advancement Act. The bill would repair the damage the Supreme Court inflicted two years ago on voter protections.

The Senate version, introduced by Vermont Democrat Patrick Leahy, would provide federal observers where necessary. It would also require federal permission for states to change their voting laws, and it mandates bilingual voting materials where appropriate.

You’d think that following a tragedy like the one that struck the Emanuel African Methodist Episcopal Church, a bill protecting voting rights would sail through Congress. Sadly, you’d be wrong.

What are the stonewalling legislators so worried about? The answer is clear: The black vote threatens them.

Black voters accounted for 12 percent of the national electorate in the 2014 elections, up from 11 percent in 2010 but below the significant 13 percent in 2012. That year — when President Barack Obama was running for reelection — black turnout eclipsed white turnout by about 2 points.

In some Southern states, such as North Carolina, African-American voters make up over 20 percent of the electorate. Black voter turnout in that state has increased dramatically in the last 15 years.

With the 2016 election right around the corner, maybe that’s something Southern Republicans are worried about. After all, they’ve already denied residents of most Southern states access to Medicaid expansion and a living wage. Now they’re threatening their voting rights too.

By all means, take down those Confederate flags. Move the monuments to museums. But more importantly, begin addressing the deeper issues those symbols represent — both in the South and throughout the country. Legislators must raise a flag guaranteeing the right to vote for everyone.

Celebrate 50 Years of Medicaid by Expanding It to Cover More People

Persistence pays off. Let’s remember this as we celebrate 50 years of Medicaid on July 30.

In 1965, Medicaid entered the world as a Medicare add-on for low-income families. Now, the program provides comprehensive coverage to more people than any other insurer in the United States. Almost 70 million people in the U.S. turn to Medicaid for their health coverage.

But Medicaid is much more than the country’s top health insurer. It’s also a key battleground for the future of our country.

As we stake out this future, we have big questions to answer about who will benefit from all our country has to offer — and who will wind up excluded from those benefits. We also have big questions about how such decisions are made.

Will we be a United States where we all enjoy the security that contributes to a happy and healthy life? Or, will be a country where the economy is based on indebtedness and limited options for the majority, with snowballing enrichment of the hyper-affluent? No less important, will we be a country where billionaires answer these questions, or will we renew our democratic principles?

For 50 years, Medicaid has been doing the hard work of expanding our national community. It has provided health care to people of limited means and people of color — people who have long found themselves shut out of quality employment and, along with it, health insurance. For years, Medicaid has saved lives that the private sector didn’t find profitable enough to save.

The power of Medicaid is more than symbolic. In practical terms, Medicaid demonstrates the difference that government can make in our families and communities. According to the Commonwealth Fund, adults covered by Medicaid report getting high-quality, timely health care at — but at much lower rates of medical debt.

That’s why the billionaire-backed far right put Medicaid in its crosshairs. What could be more frightening to this bloc than a government program that invests in the lives of people of limited means and, in terms of both quality and cost-effectiveness, gives the private market a run for its money? This is also why the progressive fight for Medicaid expansion — now being waged across the country — is so important.

The battles are far from easy. Nineteen states still haven’t taken up Medicaid expansion available under the Affordable Care Act (ACA), despite effective grassroots campaigning – and despite desperate calls for expansion from those among the nearly four million shut out of the benefits of the ACA because of this refusal.

This rejection of Medicaid expansion is so cruel and callous — and so steeped in racial injustice — that it’s easy to forget how far we’ve come.

From the very start, nothing about Medicaid — or Medicare, for that matter — was fated to be. In 1965, both programs came as the fruit of cresting movements for economic and racial justice. The powerful American Medical Association threw its weight against the legislation, fearing “socialized medicine.”

Meanwhile, the National Medical Association (representing African American physicians), the NAACP, the labor movement, and many others voiced the need for a government role in health care – including taking to the streets with their demand.

From this victory, we’ve made Medicaid a keystone of our health care system — turning back three major attempts to block-grant the program between 1981 and 2004 — thanks to committed, effective grassroots organizing and activism.

We’ve had losses along the way — eligibility barriers targeting immigrants being the most significant — but our victories have been greater than the losses. Since 1965, we’ve expanded Medicaid to bring in millions more children, pregnant women, and people with disabilities. People from all walks of life now count on Medicaid to cover everything from asthma treatment for kids to assisted living services for parents and grandparents.

And let’s not forget that our current fight for Medicaid expansion is also the outcome of progress — the ACA’s historic opening of Medicaid to adults without children. This was and continues to be tremendous win. To make it possible, hundreds of thousands of community leaders marched in the streets, called their lawmakers, and raised their voices on social media and in the press. Most states have responded by picking up the Medicaid expansion.

In short, thanks to ongoing grassroots pressure, more people turn to Medicaid than could ever have been imagined back in 1965. We stand to win even more as we push for full Medicaid expansion in all 50 states — each and every one of them.

The fight is about vision and values, but we shouldn’t see it in partisan terms. Many states have adopted Medicaid with bipartisan support or under the leadership of Republican governors. Take Nevada, New Mexico, and, most recently, Montana as examples.

The Republicans who have come out in support of Medicaid expansion know that it’s right thing to do, both morally and in terms of good government. Even in states stalled on Medicaid expansion – states like Alabama, Idaho, and Mississippi — most people agree. (This includes 62 percent of residents of the Deep South.) They want Medicaid expanded.

But they face an astroturf, billionaire-funded opposition so mired in a government-is-bad ideology that its adherents would rather see people die than see a public program succeed. This opposition is fueled by Koch brothers’ dollars funneled through Americans for Prosperity (meaning prosperity for billionaires). When nervous Republicans look over their shoulders, it’s AFP suits they see, making threats.

They should look more broadly. It’s our cause that has the support of the public, of the businesses in our communities, and the doctors that keep us healthy. We — and not those who don’t care if their fellow humans die for lack of health care — offer an inclusive vision. It’s a vision that everyone can get on board with and that — with 50 years of success under our belts –we know is going to win.

Winning on Student Loan Reform … From CT to MT

Across the country, student loan borrowers and their allies have been organizing to make college more affordable and push for state-level reforms that address the mountain of student debt that’s weighing down students and families. And they’re winning… all the way from Connecticut to Montana.

In Connecticut, where the 2015 legislative session ended at midnight on June 3rd, Alliance affiliate Connecticut Citizen Action Group (CCAG) co-convened and provided staff support for the Higher Ed, Not Debt – CT coalition, a coalition of community and labor allies that formed last fall and championed affordable higher ed and student loan reforms in the legislature this year.

CCAG’s work with the coalition – including releasing the Connecticut version of the Alliance’s A Mountain of Debt report last fall, mobilizing its grassroots membership through public events and calls to action, and driving under-the-dome engagement at the legislature – helped push some breakthrough wins on student loans before the session gaveled out.

The Alliance congratulates the Higher Ed, Not Debt – CT coalition for these exciting wins, including:

Passing a Student Loan Bill of Rights that gives borrowers somewhere to turn for help and gives the banking commissioner the authority to investigate and take action against bad-acting loan servicers. This bill of rights creates a dedicated student loan ombudsman position in the state Banking Department to review and act on borrower complaints, to compile and publicize complaint data, and to educate borrowers and the public about student loan issues. It establishes licensure requirements and standards of conduct for student loan servicers. And it authorizes the banking commissioner to conduct investigations and examinations and take enforcement action against servicers who violate licensing provisions.

Passing in-state tuition for DREAMERS – immigrant students who attend high school in Connecticut but, despite having residency in the state, have been barred from paying in-state tuition because of immigration status. With out-of-state tuition often coming in at triple in-state rates, this made the costs of higher education prohibitive for many. Passing in-state tuition is an important step toward justice and educational opportunity for immigrant students.

Passing a landmark student loan refinancing bill. This bill allows the Connecticut Higher Education Supplemental Loan Authority (CHESLA) to refinance qualifying student loans. Crucially, the bill gives CHESLA the authority to refinance private student loans (which often come with punitive interest rates) into public CHESLA loans with lower rates and better protections. This bill also reforms CHESLA’s lending practices to ensure that it provides more aid to low-income students who have the greatest financial need.

This progress in Connecticut is exciting. So is the news from Montana, where the Montana Organizing Project (MOP) has been collecting stories and organizing around student debt issues, too (MOP released the Montana edition of A Mountain of Debt last fall). This year, MOP took on a longshot fight in the legislature to roll back the criminalization of student debt – and won!

The criminalization of student debt has been a troubling – and growing – trend nationwide. Going into this year, 22 states (including Montana) had laws on the books that allow the state to revoke a state-issued professional license (like a nursing license) if a borrower defaults on student loans.

But Montana went even further: under a statute passed in 1997, the state could suspend a driver’s license indefinitely if a borrower failed to pay back student loans.

In a sprawling state like Montana where public transportation infrastructure is poor and driving is a practical necessity to get to work, members of the Montana Organizing Project concluded this law was just plain kicking people when they’re down… so they kicked into action to do something about it.

MOP engaged the state Department of Justice around the issue, analyzed the Montana Code to develop a fix, and worked to build support both inside and outside the legislature to reverse this punitive law. The resulting bill, HB 363, passed the Montana House and Senate with bi-partisan support and was signed into law by Montana Governor Steve Bullock – a promising victory for efforts to roll back the criminalization of student debt.

Hats off to the teams in Connecticut and Montana for winning these fights, and putting forward models that can inspire action and catalyze new campaigns for affordable higher education and student loan reform across the country.