Daley Weekly: Austerity, Clarity and the Muddled East

Living the Dream

Well, I have been searching Craigslist for the perfect little place to park my camera gear while in Seattle. I just need a place for three months, furnished, with a deck so I can smoke and a kitchen so I can burn the toast while I am out on the deck. Found the perfect place. Got a written and signed lease and ignored the warning not to send money. Idiot. I am on the street again living out of a suitcase, out a couple of grand, and nearly penniless. But I do have health insurance to help cover the cost of my hypertension prescription.

What’s Next?

Everything that the Congress left hanging in the air when they left for their August recess is still hanging in the air. The Transportation Department lessened the emergency around the need for money for the Highway Trust fund by announcing that the fund was going to be just fine well into next year. And the Treasury Department thrust the Debt Lid back on the agenda by announcing that the U.S. borrowing limit would be reached as early as next month. Tea Baggers in Congress who apparently are willing to shut down the government rather than provide funding to Planned Parenthood may get their chance soon.


The steady stream of refugees driven into Europe by violent conflicts in Iraq and Syria has become a river. Frightening scenes of the police beating back crowds, terrified children, and folks trapped in train stations are juxtaposed with efforts by other countries to deal with the fleeing masses. The U.S. just agreed to take in 10,000 and France, Germany, and England also are offering accommodation. But Hungary and Macedonia are not so open to all this. Perhaps they are waiting for Donald Trump to make the inevitable candidate visit overseas to establish his foreign policy credentials. While there, perhaps he’ll help the Hungarians design the border fence they are proposing and perhaps even convince the Syrians to pay for building it. (Whoever the Syrians might actually be these days.)


The Senate Democrats gave the President a major victory when they blocked Republican efforts to stop the nuclear deal with Iraq. They defeated the effort by refusing to give the 60 votes needed to proceed to debate on their measure reversing the deal. Big leadership kudos on this go the Sen. Dick Durbin of Illinois who took charge of the effort to prevent a reversal of the agreement when Sen. Harry Reid of Nevada dithered and Sen. Chuck Schumer of New York, the supposed next Democratic Leader, opposed it.

Muddle East

We thought that an essential bit of intelligibility about the situation in the Land of Perpetual Conflict had finally emerged when the U.S. apparently gave the Turks tacit approval to attack the Kurds, the most effective military force against ISIS. Another little bit of clarity came this week when a fellow known as Ayman al-Zawahiri – the post-Osama leader of Al Qaeda – attacked the top leader of ISIS for “sedition” because he had proclaimed himself Caliph. It must be good for us that these two are not joining forces and it certainly reduces the level of confusion.

ACA Enrollments

ACA enrollments reached 9.9 million by mid-year. Eighty-four percent of these were receiving subsidies.

Protecting Our Heritage

When the Heritage Foundation attacked the Obama Administration for incompetence over a cyber security breach at the Office of Personnel Management, they apparently did not realize that someone was hacking into their own web site and stealing personal information about their donors.

Interest Rates

The Federal Reserve seems poised to make some kind of an increase in interest rates, but cannot find the right time to do it. Just when everything looks peachy, China goes in the ditch or Greece decides it’s had enough and tries to rebel against austerity, or the jobs numbers are blah. I’m not sure I care. The stimulus that the Fed has given to the U.S. economy over the last few years has kept us from falling into the austerity trap, in spite of the very best efforts of some in Congress.

Klepto Bankers Beware

The U.S. Justice Department this week announced that it has a new policy – corporate officers will now be held personally culpable for criminal offenses committed by their companies. You will have noted to your chagrin the past practice of fining the company, but letting the criminal behavior of the people who work in the company go without prosecution. This is a critical step forward in efforts to stem the criminal behavior of multi-national financial institutions that have bilked investors and consumers out of billions, laundered trillions of dollars for the drug cartels, and manipulated currencies to bring themselves massive profits. I knew I liked that Etta who took over as Attorney General – at last, my love has come along.

The Boehner Suit

Remember that during one of last year’s interminable budget fights, Speaker John Boehner used the threat of bringing a lawsuit against the Administration over the ACA to quiet some of the dissent in his Caucus. Alas, this week a federal judge ruled that the House of Representatives does have standing to bring this suit. No telling where this might go, but it is yet another threat to subsidies under the ACA. The judge allowed the part of the suit that challenges the right of the Administration to fund the mandatory subsidies without having to get an appropriation directly from the Congress.

Presidential Stuff

The candidate lineup for the next Republican Debate is out and it includes some new faces – Carly Fiorina and Gov. John Kasich are now in, as are Donald Trump, former Florida Gov. Jeb Bush, Wisconsin Gov. Scott Walker, Texas Sen. Ted Cruz, Kentucky Sen. Rand Paul, Florida Sen. Marco Rubio, retired neurosurgeon Ben Carson, former Arkansas Gov. Mike Huckabee, and New Jersey Gov. Chris Christie.

Interesting to note that Ben Carson has tied Donald Trump in a recent Iowa poll. We thought that that Trump has peaked out at just over 20 percent, but he seems to have reached 37 percent in a South Carolina poll.

Jeb Bush seems completely befuddled by the destruction of his Front Runner status. Befuddlement must be the state of a whole bunch of candidates over there – the plan went off the tracks.

Chris Christie is looking over his shoulder again because three leading executives of United Airlines have resigned as they are facing a criminal investigation centered on David Samson, Christie confidant and the former Chair of the New York, New Jersey Port Authority. The charge is that the airline established a special, money-losing flight route to accommodate Samson’s vacation travels while they were asking for major investments in the Port-operated Newark Airport.

Rick Perry’s second run for President is over. He was running out of money. Given that Perry barely made a dent in the polls, it won’t make much of a difference, big picture.

On the Dem’s side, Martin O’Malley also is cutting staff. Never a positive sign when you are already in a deep hole. No word on staff cuts from what’s his name from Virginia or from Lincoln Chaffee. No real sense that either of them actually have staff to cut. A week or so ago Conan O’Brien, the talk show host, decided to try to move Chaffee from zero to one percent in the polls. So far, Chaffee is still at zero.

Puerto Rico, My Heart’s Devotion

Looks like Puerto Rico may be about to sink back in the ocean – ocean of debt that is. Much like Greece, Puerto Rico is one of the victims of the great fraud induced Recession. Less growth plus fewer tourists equals bankruptcy. The hedge funds that own a whole bunch of Puerto Rican debt are suggesting that while states might be able to default on loans but not so a mere Territory. The hedgers are suggesting that the Puerto Ricans would be much more prosperous if they destroyed their economy by laying off a bunch of teachers, reducing health care benefits and cutting their minimum wage. But, the hedgers tell them, no restructuring of the debt.

This austerity prescription will lead to economic lassitude, just as it has everywhere else. The hedgers will lose their money anyway while imposing even further impoverishment on the Puerto Ricans. What is the point here?

We are waiting for some hedge fund manager to leap before the karaoke mike and inform us in song: “I feel petty, oh so petty.”

Medicaid Expansion

It looks as though Alaska’s Gov. Bill Walker may be going to pull it off. Remember, the legislature dithered around with his request to expand Medicaid so he decided to go ahead and do it anyway.

Naturally he got sued, but a judge just gave his plan the OK.


It gives me spinal shudders and nervous twitches, but the Congress has returned and is set to be in D.C. for the next couple of months with the exception of the week of September 21 and the week of October 12.

Bill Daley, National Legislative Director

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Bill Daley

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.

Take Down the Confederate Flag – And Raise Up Medicaid Expansion

This opinion piece by LeeAnn Hall was originally published in Huffington Post.

It’s tempting, this summery week, to sit and savor the sweet victory that was handed us by the Supreme Court in late June with the King v. Burwell decision. The court’s ruling protected the health care subsidies that allow 6.4 million people to afford their health insurance.

Many of those are people who have health insurance and routine health care for the first time in their lives because of the Affordable Care Act. Now they can breathe a little easier, knowing they can go to the doctor when they are sick, get immunizations, medications and preventive care.

The Supreme Court’s ruling came a week after the horrifying news that nine people were killed while praying inside the Emanuel AME church in Charleston, South Carolina.

One of those killed was Rev. Clementa Pinckney, a South Carolina senator who was a tireless advocate for Medicaid expansion in his state. Some called him the “moral conscience of the South Carolina legislature.”

The killings in Charleston spurred the long overdue call to remove the Confederate flag from public buildings and from license plates. Removing the symbols of racism and inequity is a significant step. Just as critical is the need to remove racist barriers to quality health care.

We must continue to fight for the nearly four million people who still don’t have access to health care because of their state lawmakers’ refusal to expand Medicaid. Nearly 90 percent of those in the health care coverage gap live in the South, and they are disproportionately people of color.

It’s time to stop debating the right to health care – that discussion is done. Now it’s time to make quality health care a reality for everyone. The Affordable Care Act is here to stay.

Billions of dollars in federal funding is in place for legislators to extend health care to everyone in their states. Yet, lawmakers in 19 states have refused to accept that funding – 13 of those states are in the South.

It’s time to end policies that perpetuate systemic racism. I ask these legislators and governors – what are you so afraid of that you would deny a mother a visit to the doctor, or a father medication he needs to be strong for his children?

Refusal to expand Medicaid and provide quality health care to all remains a stark and shameful example of our nation’s failure to overcome persistent racial disparities.

President Obama, in his elegant eulogy in Charleston, said: “It would be a betrayal of everything Reverend Pinckney stood for, I believe, if we allowed ourselves to slip into a comfortable silence again.”

We must all remain uncomfortable – and outspoken – until racism, fear and hate are erased, in our symbols and in our policies. One step must lead to the next step.

Taking down the Confederate flags would be a bold symbolic statement that reconciliation has at long last begun. Expanding Medicaid to millions of people would show that we really mean it.

LeeAnn Hall is the executive director of the Alliance for a Just Society, a national policy and organizing network that has produced pivotal reports for 20 years on national health issues.

A Question for Lawmakers Who Backtrack on Expanded Health Coverage: Seriously?

With two weeks left in the second enrollment period for Affordable Care Act health coverage, marketplace enrollment is projected to reach between 9 million and 9.9 million people this year. That’s a net increase of between 2 and 3 million people gaining coverage through the marketplaces. Millions more will gain coverage through Medicaid expansion.

That’s something to celebrate – but the celebration could be short-lived for many people. Instead of figuring out how to get more people health coverage in 2015, many newly-elected and re-elected state legislators and governors are actually plotting how to take health care away from people who just received it for the first time.

It’s a real threat to people who’ve just gained coverage through Medicaid expansion – especially in states where incoming lawmakers are openly hostile to anything related to the Affordable Care Act. Those at greatest risk of losing coverage are women and people of color.

In Arkansas, where 211,000 people recently gained coverage, the state legislature must reapprove the Medicaid expansion plan by a three-quarters majority again in 2015. The incoming Republican governor is unenthusiastic about the plan – and expansion opponents won seats in the legislature. That doesn’t bode well.

In Ohio, where more than 400,000 people have coverage under Medicaid, the state legislature is also required to reauthorize the program in 2015. And in New Hampshire, where more than 20,000 people enrolled in just three months, the new Republican majority in the NH House of Representatives will also take a fresh vote on the program as well.

The continuing failure of more than 20 states to adopt any expansion plans at all, and the prospect of newly elected legislators revoking expanded coverage for hundreds of thousands of residents, represents a serious health threat to women.

A recent 50-state report card on women’s health by the Alliance for a Just Society clearly shows that most of the states that rejected Medicaid expansion have poor or failing records on women’s health. When it comes to ensuring that women have access to health care, the majority of legislators in these states have turned their backs on women.

The 2014 Women’s Health Report Card ranks and grades every state in the country on 30 distinct measures of women’s health. The results: 17 of the 21 states that rejected Medicaid expansion received final grades of C, D or F – and 13 of those states received a D or F.

Politicians in these states are failing women, but they are especially failing women of color who are more likely to be working low paying jobs, not covered by health insurance, and are least likely to have access to medical care.

The number of black women without health insurance is at least 20 percent higher than for women overall in 17 states. The uninsured rate for Latina women is at least 50 percent higher in 44 states. Black, Latina, and Native American women without access to health care have dramatically higher rates of hypertension, diabetes and infant mortality than other women.

While it’s encouraging news that Wyoming, Montana, and even Idaho seem to be moving toward Medicaid expansion, it will also leave our nation with a disturbing illustration of how alive and well racial segregation is in America. Take a look at the map of states that are refusing coverage to their most vulnerable residents: being denied access to health care is the latest Jim Crow.

Lawmakers in states that haven’t expanded Medicaid yet should move quickly to adopt expansion plans this year. If they don’t, they will bear the responsibility for their states falling even further behind on women’s health, and worsening racial disparities in our health care system.

As for lawmakers considering a vote to take health care away from thousands of their constituents, all I can ask is: Seriously? Do you really want to do that?

It’s one thing to stand in the way of people gaining access to quality, affordable health care. But it’s something else when people have just experienced quality, affordable health care for the first time, and then you snatch it away from them.

I can’t imagine that many will take kindly to it. And just in case anybody’s forgotten, there’s another election just a couple years away.

LeeAnn Hall is the executive director of the Alliance for a Just Society, a national policy, research and organizing network focused on racial and economic justice. The Alliance has produced pivotal reports on state and national health issues including Medicaid, prescription drugs, and insurance industry practices for 20 years.

Report Card: States Rejecting Medicaid Expansion Get Poorest Grades on Women’s Health

The Alliance for a Just Society has released a Women’s Health Report Card that reveals which states get poor and failing grades when it comes to women’s health and to ensuring access to quality, affordable and timely health care – important measures of states’ public health infrastructure.
Tuesday, October 14, 2014
Contact: Kathy Mulady,


Report card highlights persistent racial disparities in women’s health in every state

Seattle, WA—Seventeen of the 21 states that rejected federal funds to expand health coverage through Medicaid received final grades of C, D or F in a new 50-state report card on women’s health – and 13 states got a D or F grade. Even in states with better overall grades, persistent racial disparities indicate that most states are failing to meet the health care needs of women of color.
States with the worst grades when it comes to women’s health are Mississippi (ranked #50), Oklahoma (#49), Texas (#48), Nevada (#47) and Arkansas (#46). States with the best rankings are Massachusetts (#1), Connecticut (#2), Hawaii and Vermont (tied for #3) and Minnesota (#5).
The Promise of Quality, Affordable Health Care for Women: Are States Delivering? is a 50-state report card on women’s health released today by the Alliance for a Just Society. The report card provides an important measure of states’ records on women’s health as politicians court women voters ahead of the November elections, and continue to debate whether to accept federal funds to expand Medicaid coverage in more than 20 states.
The 50-state report card is available at:
“This report card shows that most of the states that are still refusing funding for Medicaid expansion have poor or failing records on women’s health. These states are failing women and the families that depend on them,” said LeeAnn Hall, executive director of the Alliance for a Just Society. “It’s time for governors and legislators in these states – from Texas to Maine and Florida to Montana – to move forward with expanding health coverage to uninsured women through Medicaid.”
Representative Jan Schakowsky (D-IL) credits the Affordable Care Act with helping improve women’s health through expanded coverage, cost-free access to contraception and other preventive health services, and the elimination of gender-based insurance discrimination.
“While many states are making critical progress on women’s health thanks to the Affordable Care Act, this Report Card underscores that we must do more, starting with getting every state to cover low-income women through Medicaid,” said Schakowsky.
States with poor records have the opportunity to improve women’s health coverage by accepting federal money to expand Medicaid, said Judy Waxman, vice president for Health and Reproductive Rights at the National Women’s Law Center.
“But if leaders in these states continue to drag their feet, they’re only going to fall further behind. No woman should be denied health care for any reason,” said Waxman.
The report card shows that all 50 states are failing to meet the health care needs of women of color. Latina women are uninsured at much higher rates than other women in almost every state. Black, Latina, Asian/Pacific Islander and Native American women have worse outcomes on key health measures in most states.
“These race-based differences are shocking – and unacceptable. These disparities make it clear that the debate over Medicaid expansion must end,” said Jessica González-Rojas, executive director of the National Latina Institute for Reproductive Health. “It’s time for politicians to stop bickering and take action to improve health for all women – including women of color – by moving forward with Medicaid expansion.”
With women making up an increasing share of primary breadwinners, women’s health is of critical importance for family economic security.
“Low-income women in more than 20 states who are doing everything they can to support their families are being denied access to affordable health care because of state leaders’ stubborn refusal to accept the federal funding to expand Medicaid,” said Yael Foa, outreach director for Working America.
“This is a national issue, and it hits working class people the hardest. In some cases, women are patching together a living through 2, 3 or 4 part-time jobs that don’t offer health care,” said Foa. “Our families and our economy depend on women. Women should be able to depend on their states for quality, affordable health care.”
The Promise of Quality, Affordable Health Care for Women: Are States Delivering? report card uses the latest available data from government and other sources to rank the 50 states on 30 measures relating to women’s health. It generates state rankings and grades in three subject areas (health coverage, access to care, and health outcomes), an assessment of race-based disparities, and a final rank and grade for every state. It includes specific recommendations for improving women’s health.
The Alliance for a Just Society is a national policy, research and organizing network focused on racial and economic justice. The Alliance has produced pivotal reports on state and national health issues including Medicaid/CHIP, prescription drugs, and insurance industry practices for 20 years.

Daley Weekly: People, Politics, and an Ebola Warning


Some 2.7 million children may lose coverage they now have under the federal Children’s Health Insurance Program. CHIP is scheduled to expire at the end of 2015. Some kids will be absorbed into Medicaid. Some will find a way into the subsidized markets. But a bunch could fall through the cracks. Most of them will face increased copayments and reduced benefits.

When the ACA initially was debated, many lawmakers wanted CHIP just to end – “put them in Medicaid or let the exchanges handle them.” But Sen. Jay Rockefeller (D-W.V.) insisted that a CHIP extension be included, so they authorized it through 2015. The money starts to run out next October.

Advocates want to try to get this program extended in the November Lame Duck session. If the Rs take over the Senate all this could get dicey. But even some fairly conservative states have CHIP programs –and kids are popular.

Children’s advocacy groups are encouraging anyone who might be worried about these kids or the fate of their state’s children’s health programs, to contact their Senators and ask them to take this up in the Lame Duck Session. Do not hesitate to ask Republicans to support this extension – CHIP has had bi-partisan support.

The Congressional Budget Office has scored the cost of extending CHIP in two ways. If there is a straight extension with no changes, it saves money. If they extend it and include the little kicker that was added to the reimbursement rates by the ACA, it could cost from $5 billion to $10 billion. This might sound like a lot of money, but it is not much in D.C. terms these days.


The Weekly has tried to stay ahead of the curve on Ebola, but we did not anticipate that it would hit the U.S. so quickly. You no doubt noticed that an infected man from Liberia ended up in Dallas. He was loose on the world long enough possibly to infect others. Texas will wish that it had expanded Medicaid if this thing starts running through the population. They will soon learn that the hospitals are not ready for this, especially in large numbers. Practitioners are inexperienced and fearful. Pray that it has been contained.

Watch out for an anti-African frenzy to develop. There are lessons to be learned from what has happened in Africa. One is that many refused to come to treatment or isolation for fear of being made into pariahs and this helped the disease spread. Some wild anti-immigrant Texan will start tying all of this to kids from Central America. You can see it all coming. If we get an Ebola problem and let some of the all too common anti-ethnic racism surface it will make things worse. It’s time for Texas to grow up.


The unemployment rate fell to under 6 percent for the first time since the Great Recession. Is this a boost for Democrats who are struggling to get traction? It certainly cannot hurt to have this news as the election enters the home stretch. Obama has begun campaigning on this theme in recent weeks.

Dynamic Scoring

A while ago these pages featured a narration about how the Republicans might use “budget reconciliation” if they win a Senate Majority. It’s time you learned about another little idea that might become a part of the budget world – “dynamic scoring.”

Why wouldn’t we want our scoring to be dynamic, for heaven’s sake? Surely we would not want our scoring to be apathetic?

The problem is that this idea will be used to hide the effect of tax cuts on the national revenues. Dynamic scoring claims that big tax cuts have an effect on economic growth and therefore will increase rather than diminish revenues. The Republicans have long been pushing for this kind of scoring, but the Central Budget Office has refused to use it because it is ideology rather than economics.

Bloggers are hearing that a Republican Majority in both Houses will lead to the firing of Doug Elmendorf, the CBO Director, and the insertion of dynamic scoring into the budgeting process. This would let them do things like cut taxes for the corporations without having to take any responsibility for increasing deficits – at least on paper.

One other little note: they insist that this type of scoring be done for tax cuts, but resist using it to assess the economic benefits of such things as Medicaid spending, food stamps, or unemployment insurance.

The Staff

You just knew that there would be trouble when they brought in a Chief of Staff named Daley, William Daley, yet. Though that Daley quickly fled, things still are going a bit a-skitter over at the White House.

These are not great big things, but important little ones. The most worrisome have let the President step on his own message. He moves on Syria and then spends days explaining his statement that he doesn’t have a strategy. He has a strong week as an international leader and then opines that the intelligence community dropped the ball on ISIS – another week explaining. All this stuff merely hands flame throwers to Obama’s enemies.

There is a lack of discipline here. Obama needs to change it.

Toward the end of The Prince, in a chapter entitled “How Flatterers Must Be Shunned,” Machiavelli makes suggestions about staff. He ends with this: “Thus it is that the wisdom of the Prince is not dependent on the quality of his advice, from wheresoever it may come, rather the quality of his advice depends on the wisdom of the Prince.”

The A.G. Succession

The last Weekly observed that Eric Holder’s resignation as Attorney General came in time for Obama to nominate a successor available for confirmation in the Lame Duck session. Everybody in D.C. must be reading these columns because a controversy about this possibility immediately broke out among legislators and commentators.

The timing of this is critical.

Holder has been strong on important things. The House even voted to indict him for Contempt of Congress, a crime that surely all of us have committed.

Holder held firm on the enforcement of civil rights laws, including actions against states that suppress votes or develop their own immigration policies. The sentencing guidelines were eased. He strategically abandoned support for the Defense of Marriage Act. The Department of Justice has recently started a significant initiative on policing and race.

Will a Republican Senate confirm someone with the same determination to lead on civil rights? What deals will they extract in the confirmation process? Is it possible that, in the dim anterooms of the Senate, a confirmation compromise might be fashioned that helps preserve the racist oligarchies by shielding white politicians of the South from black voters?

If Obama judges that he cannot get an effective nominee confirmed by a Republican Senate, will he force the issue in Lame Duck where he might have the votes?


Remember the guys who made George Bush President? They’re baaack. In a 5-to-4 decision the Republican Supreme Court decided to delay early voting in Ohio. Lower courts ordered early voting reinstated after the Ohio lawmakers had eliminated it in order to suppress the minority vote.


Tremble with us as we worry that the Supremes will take up an issue involving the fate of the ACA. A judge in Oklahoma invalidated premium subsidy credits in federally facilitated exchanges – an echo of an earlier decision in D.C. Even though the D.C. opinion was reversed at the full court level, the Oklahoma ruling may give the Supreme Court a rationale for taking the case. Recall that, should subsidies be invalidated, many employers will escape the penalties they should have to pay if they fail to supply adequate health care coverage to their employees.


The National Immigration Council reports that some 250 U.S. counties have stopped honoring ICE detention requests. Requests to hold people suspected of immigration problems are not mandatory and the sheriff has discretion about whether or not to cooperate. The brief report, featuring the work of our friends at Make the Road New York, can be accessed by using the link below. See what your local sheriff is doing by clicking through to the map showing each county’s policy. Most sheriffs are elected. and

Too Big to Jail

The crime spree continues.

Regulators in Britain are investigating banks for foreign currency manipulation. The banks do not seem to be arguing about it very much. A multi-billion dollar settlement is being discussed. According to the New York Times, banks tied up in this investigation include Citigroup, JPMorgan Chase, Barclays, United Bank of Scotland, HBSC, Goldman Sachs, and Deutsche Bank. These fine, upstanding institutions are accused of colluding to fix international currency benchmarks used by investors. They also changed their own currency speculations based on orders from their customers – the currency market version of insider trading.

On another front, in a heartfelt expression of gratitude, a former AIG executive is suing the U.S. government over the bailout that saved AIG from bankruptcy. This was the company that the Bush Administration rescued because its demise would bring down the world economy. A fellow named Hank Greenberg ran the company until he was forced out by the New York A.G. for audit violations. Greenberg then formed a business that became a major investor in AIG as it helped usher the economy into the abyss. The U.S. bailout forced AIG to restructure and Greenberg objects that the new structure favored Goldman Sachs, a company associated with Bush’s Treasury Secretary, Hank Paulson. Greenberg wants $40 billion.

Ad of the Weekly

As we grow weary of misleading advertising, we all need an outlet for our indignation. The Weekly is here to help. Hence, a new feature for these timeless pages – Ad of the Weekly.

We rarely encounter ads outside of D.C. and Washington State, so we solicit nominees from around the country. All media qualify. Email them to: We have a lot to do, so keep it short or the note will be ignored.

Outrage is the main theme here, but pretty much anything is fair game. Humor helps.

Pharmaceutical ads will not be accepted. We know that this cuts the field pretty much in half, but all Rx ads would qualify. After all, they seek to attract customers to drugs that could cause liver failure, internal bleeding, vision loss, stroke, or suicide. Skip ‘em.

Musical Chairs.

Julia Pierson, Director of the Secret Service, resigned amid growing turmoil. Her performance before a Congressional Committee was truly horrid and revelations of security lapses just kept coming.

The Schedule

The elections are on November 4.

Hospitals and Clinics Feel the Pain of Medicaid Expansion Politics

This article by LeeAnn Hall, executive director of Alliance for a Just Society, was originally published in Huffington Post.

Is your state refusing to expand Medicaid? If so, it could be putting your health at risk, whether you’d qualify for Medicaid or not.

That’s because the Affordable Care Act (ACA) – the health reform bill — is about more than covering the uninsured. It’s also designed to strengthen the health care system for everyone. As a major source of health system funding, Medicaid – which covers low-income families, seniors, and people with disabilities — is a key part of that effort. You may not need Medicaid, but your hospital sure does.

As passed by Congress, the ACA made Medicaid expansion automatic. This expansion was slated to reach up to 15 million newly eligible working poor and near-poor adults and an additional 4 million who were previously eligible, but had not enrolled, injecting much-needed dollars into hospitals that had seen finances strained with growing uninsured rates.

However, when the Supreme Court ruled on the ACA in June 2012 it allowed states to opt out of expansion. With a stroke of the pen, the Court drove a gaping hole through health reform. Medicaid expansion would no longer be guaranteed across-the-board – it would now be the victim of contentious health-reform politics.

This decision proved disastrous for the families who had counted on Medicaid expansion for coverage and now find themselves in a terrible Catch-22. They earn too much for the meager Medicaid programs in states that have refused expansion. But, they also don’t make enough for coverage on the new health exchanges.

Yet these working-poor families aren’t the only victims of Medicaid expansion politics – hospitals and clinics are, too.

The costs of refusing Medicaid are staggering. Non-expansion states are passing up $423.6 billion in health care funds from 2013 through 2022. From 2014 through 2016, accepting Medicaid expansion would have provided $88 billion in health care funds. That’s $88 billion hospitals sorely need.

Meanwhile, the 27 expansion states will bring in an estimated $83.6 billion in additional health care funds.

Refusing Medicaid dollars is also a bad fiscal decision for states. That’s because the federal government will fully fund the expansion through 2016, with a gradual decrease over the next few years. Beginning in 2020, the federal government will provide 90 percent of funding — a matching rate that any investor would love.

The sad irony is that residents of opt-out states are contributing to the expansion through their taxes even if they can’t benefit from it. Meanwhile, residents of expanding states are seeing the investment in health care pay off.

Already, according to health-care rating agency Fitch Ratings, nonprofit hospitals and health care systems in expanding states are seeing benefits. Conversely, there’s already been a negative impact on hospitals in non-expanding states. This squeeze on hospitals is felt by all their patients.

The divergence between Medicaid-expansion states and refusing states will only grow. Under the ACA, the federal government is scheduled to scale back subsidies to hospitals with many low-income patients and high uncompensated care costs.

With automatic Medicaid expansion, the reduction in these “disproportionate share hospital payments” would have been offset by coverage gains — the hospitals wouldn’t need subsidies for the uninsured because almost everyone would be covered.

States that opt out of expansion are putting their hospitals at a double disadvantage.

There’s no reason to allow politicians to play these kinds of games with our hospitals and clinics. We should stand together to demand that the promise of Medicaid expansion — and a strong health care system — become reality in each of our fifty states.

Legislators Who Block Medicaid Expansion Are Stiffing Veterans Out of Health Care

** This article by LeeAnn Hall  first appeared in Huffington Post **

r-VETERANS croppedThe scandal over long wait times for veterans in the Department of Veterans Affairs health system has grabbed a lot of headlines and elicited a lot of righteous anger – as it should. America’s veterans deserve so much better.

But as Ezra Klein pointed out in a piece in Vox, there’s another health care scandal that also deserves its share of righteous anger, and it also has a big impact on veterans with health care needs: the self-destructive refusal of lawmakers in 20-plus states to accept federal funds to expand their Medicaid programs.

Klein catalogued “24 health-care scandals that critics of the VA should also be furious about” (that is, the 24 states that have rejected the Medicaid expansion). Thanks to lawmakers’ kneejerk opposition to expanding health coverage in those states, there are huge numbers of uninsured veterans who should be eligible for coverage, but aren’t: 41,200 veterans in Florida, 24,900 in Georgia, 48,900 in Texas… and the list goes on.

All in all, about 250,000 uninsured veterans are getting stiffed out of eligibility for health coverage by lawmakers who have blocked Medicaid expansion, according to Pew’s Stateline. As it turns out, those lawmakers are also stiffing their own states out of economy-boosting jobs – health care jobs that are overwhelmingly good-paying jobs. Medicaid expansion would create thousands more of these jobs.

Read more

Civil Rights, Human Rights, Obviously Don’t Extend to Health Care in Georgia

Screen shot 2014-07-08 at 2.14.01 PMI got to thinking about the State of Georgia a few weeks ago when the Atlanta City Fathers proudly announced the opening of the National Center for Civil and Human Rights. It is right there in Atlanta next to the Aquarium and the World of Coca-Cola.

Martin Luther King grew up in Atlanta and his life and other achievements of the Civil Rights Movement are celebrated in this new institution.

Georgia takes pride in its attraction to outside visitors – it ranks third in the nation in tourism. Tourism is the 5th largest employer in the state with an annual economic impact of $53.6 billion, including $2.8 billion in direct and indirect tax revenues.

Surely the opening of the new Center will burnish Georgia’s reputation and add an additional attraction for tourists. Folks like me, whose lives have been so influenced by the Civil Rights Movement might just want to pay it a visit.

But I could not stop thinking that these folks, who project to the world the image of a refurbished, modern part of the “New South,” live in the Capitol of a state that refuses to expand Medicaid. Read more

ACA Enrollment Figures Show More Focus Needed On Latino Communities

HHS must do more to close the Latino coverage gap; state officials who’ve resisted ACA implementation bear responsibility for making it worse.

For Immediate Release: Friday, May 2, 2014

Contact: Kathy Mulady, Communications Director,, (206) 992-8787

Seattle, WA – The Alliance for a Just Society released the following statement from executive director LeeAnn Hall in response to the Department of Health & Human Services’ first release of race and ethnicity data yesterday for enrollees in the Affordable Care Act’s federally-facilitated marketplace:

“While we commend HHS for releasing data on the racial and ethnic breakdown of enrollments, we are gravely concerned about the deficit in Latino enrollment. Only 10.7 percent of enrollees in the federal marketplace who reported/race ethnicity were Latino, compared to an estimated 14.5 percent in the marketplace-eligible population. We can and must do better. Read more