Last weekend, the RGJ published an "Economic Wishlist for Northern Nevada". And for this piece, they interviewed Food Bank of Northern Nevada CEO Cherie Jamason. Here's what she said.
My first economic wish for Northern Nevada is for more jobs that pay a livable wage. A good job is the fastest way to end hunger. It is impossible for people to live sustainable lives without adequate income to support their families. We work with people every day who have returned to work but are making significantly less income than in prior years. Many are working part-time rather than full-time, or for a significantly decreased salary. It’s not easy to make ends meet on $8 per hour. Even more are still unemployed and in real financial trouble.
I also wish for the skilled work force necessary to excel in these jobs. Education and job training are difficult to obtain when people cannot meet their basic needs. One in four of the children in Nevada do not have access to adequate nutrition. They are likely missing more than just meals. The ability for a child to concentrate and excel in school increases with a safe place to live and enough to eat. Without food and shelter, we are spending valuable resources on education and training programs with little chance of success.
My third wish for our region is an increase in economic mobility and opportunity for all members of our community. Easy to say but much harder to achieve. It takes a change in thinking and there is no better time than now. Daily, an increasing number of people sink into the grip of poverty. We can’t do things exactly as we always have and expect a different result. While meeting the basic needs of our clients at the Food Bank is an outstanding goal, we also want to do whatever we can to work ourselves out of a job. Our work now includes steps that will help our clients create a better life in the long term.
Frankly, I couldn't agree more. But really, you should already know that. After all, how many times have we talkedaboutthishere?
And she wasn't the only one talking about it. Here's Washoe County Manager Katy Simon.
Wish #2 — expanded investment in Science, Technology, Engineering and Math in K-16. The school district, Truckee Meadows Community College and the University of Nevada, Reno are all doing a great job of working to focus on this, and we need to give them our support, internships, partnerships, etc. We need to support the educators, and provide our STEM students with the facilities and equipment they need to stay at the leading edge.
The only way we will succeed as a state is if we actually invest in our people. And yes, that means we need to better invest in our public schools. And yes, that also means we need to prevent unnecessary suffering that prevents many Nevadans from contributing more into our economy.
This is something that our legislators must remember as they make their way to Carson City later this month. When we invest in our people, we invest in our economic success. When we educate our kids, we're investing in a smarter and stronger workforce that companies will want to employ. When we ensure a living wage, we're ensuring consumers will have more available income to spend. And when we insure our people with good health care, we're also creating jobs.
This is the kind of "big picture thinking" that Nevada needs more of. Hopefully, our state legislators will have this in mind as the nest session is about to begin.
He also will ask the Nevada Legislature to begin charging Medicaid patients a co-payment for health care visits.
“It’s a co-pay. It’s going to be a small one,” he said. “But I believe that is the appropriate way to go on this.”
Really? Really?
There's a reason why people need Medicaid. They're poor. And yes, some Nevadans are so poor that they can't afford any kind of health care after paying the bills for everything else (housing, food, utilities, etc.). Medicaid is supposed to provide a way for the poor to access health care they otherwise can't afford. There's a reason why it's not like a HMO.
Bob Fulkerson, executive director of the Progressive Leadership of Alliance, praised Sandoval’s decision as “humane.”
“It’s the right direction that we need to go in Nevada, and we commend him for pointing us in that direction,” he said.
But he had strong words for a co-pay.
“The reason they’re on Medicaid is because they’re broke. They have no money,” said Fulkerson, who supports higher taxes on Nevada’s mining and casino industries.
“We can’t ask the poor in this state to pay any more,” he said. “That’s what this state does. We soak the poor.”
I can sense why Sandoval is trying this. He wants to "split the difference" with conservatives and make it seem like he's "finding the right balance" on Medicaid. But again, the problem here is that it's inherently unfair to keep demanding more from the working poor while continually defending bailouts for multinational corporations and the super-wealthy in our tax code.
As we've discussed before, expanding Medicaid won't really cost Nevada as much as rejecting this program would have. In the long run, expanding access to health care like this will save the state money. So why screw it up just to "soak the poor"?
What's so grotesquely funny about this is that Sandoval continues to say he wants "lower taxes". Yet in seeking this, Sandoval essentially wants to raise taxes on the working poor. If he's really seeking new revenue, why not just go about it the right way by asking those who can pay to start paying their fair share for a change?
“Though I have never liked the Affordable Care Act because of the individual mandate it places on citizens, the increased burden on businesses and concerns about access to health care, the law has been upheld by the Supreme Court,” Sandoval said in a written statement. “As such, I am forced to accept it as today’s reality and I have decided to expand Nevada’s Medicaid coverage.”
The federal government will pay 100 percent of the medical costs for the expansion for the first three years —resulting in $712 million in federal funding coming to Nevada. The state, however, must share in the cost to administer the program. And in four years, Nevada will begin footing the bill for a portion of the medical costs as well.
“That’s a massive leverage of federal dollars,” Sandoval’s budget director Jeff Mohlenkamp said. “Considering how much federal dollars we are leveraging, the cost (of expansion) is fairly small.”
The decision to opt into the Medicaid expansion will actually cost the state’s struggling general fund less than if Sandoval had rejected the expansion.
Because the Affordable Care Act mandates individuals to carry health insurance, officials expect nearly 70,000 low-income Nevadans who are already eligible for Medicaid to enroll in the program. That will cost the state $84 million.
By expanding Medicaid — to cover another 78,000 Nevadans — the state will be able to move some indigent mental health and substance abuse patients off state-funded programs and into the federally funded Medicaid, saving close to $17 million. That means the total expansion will cost the state $67 million.
Again, remember that the federal government pays all the medical costs for the first three years. And after that, Nevada will gradually be eased into paying for only 10% of the medical costs. So essentially, Nevada will only be footing a dime for a dollar's worth of health care!
And as we discussed before, by expanding Medicaid and fully implementing the Affordable Care Act, health care costs will fall for nearly all consumers. And economic activity will rise as a result of more investment in health care. So this truly is a win-win for everyone in Nevada.
And Governor Sandoval truly made the right choice this week.
So far this fall, Governor Brian Sandoval (R-Mystery) has been quite elusive. Last month, he missed the Republican Governors' Association conference... In his own state! He still has yet to announce whether he will agree to fully implement the Affordable Care Act by expanding Medicaid. And he has yet to fully weigh in on the brewing brouhaha over election reform and driver's licenses for undocumented immigrants.
Perhaps we should expect this from a Governor who probably has his eyes on the prize of national prominence and an even higher level of political prestige. However, no one should ever expect this. So what's he hiding?
Gov. Brian Sandoval's administration is keeping secret millions of dollars in spending requests submitted by state agencies for the next two years, breaking precedent set by prior administrations and possibly violating state law, legislators suggested.
Indeed, even Sandoval held to the practice two years ago, submitting the so-called “items for special consideration” to lawmakers and the public well before releasing his final recommended budget to the Legislature in January.
This year, however, Sandoval has elected to publicly release only the agency requests that fit within strict caps he issued as part of his budget instructions, and not what agencies said they needed to properly operate. [...]
“I think legislators and the public should know what the requests are from agencies, what the real needs are,” said Sen. Debbie Smith, D-Sparks, the chair of the Senate Finance Committee. “It puts our staff, and ultimately legislators, at a severe disadvantage to not have that information.”
And it's not just Democrats in Carson City asking this. Even some Republicans are wondering what's going on. The details in the Governor's budget proposal are almost certain to answer the question of what he intends to do regarding the ACA & Medicaid expansion. And one Senate Republican is clamoring to see for himself what's in there.
Sen. Ben Kieckhefer, R-Reno, referred to the possible expansion of Medicaid, the state health insurance for the poor. It’s a provision under the Affordable Care Act which the U.S. Supreme Court said could be optional for states, and a decision Sandoval is still weighing.
“My concern is this: Medicaid expansion has been penciled out, calculated, but if it’s not part of the governor’s budget, (that information) would not be public?” Kieckhefer said. “I have a problem with that.”
And since Ben Kieckhefer tends to be a solid Sandoval ally in the Legislature, that makes his call for more transparency from Sandoval all the more attention grabbing.
Kudos to Elizabeth Crum for reminding everyone of this. What Brian Sandoval is doing is likely illegal. Nevada's public records law (NRS 239) requires disclosure of the executive branch's budget requests. And NRS 353 details what the executive branch is supposed to do when filing budget requests.
1. On or before October 15 of each even-numbered year, the Chief shall provide to the Fiscal Analysis Division of the Legislative Counsel Bureau:
(a) Computerized budget files containing the actual data regarding revenues and expenditures for the previous year;
(b) The work programs for the current year; and
(c) Each agency’s requested budget for the next 2 fiscal years.
So what's he hiding? The Sun's David McGrath Schwartz speculates that what's hidden may be items as banal as new computers and cars for state agencies in desperate need of them. So if that's the case, why be so secretive about it? And why hide details on even more important matters, like health care to many thousands of Nevadans, aid to military veterans, and funding for public education?
What's he hiding? Why is Brian Sandoval playing fast and loose with state law to keep his budget a secret? Why won't he let legislators or the public see these funding requests? All he's doing is confirming the worst assumptions Nevadans have about their state government, which is that it's thoroughly corrupt and stubbornly unresponsive to the demands of the public. If Sandoval wants to change that perception, then he needs to come clean.
Over the weekend, The Sun's Anjeanette Damon interviewed Larry Matheis from the Nevada State Medical Association for her KSNV/KRNV weekend show ("To the Point"). Of course, they were discussing the Affordable Care Act and whether Governor Sandoval will agree to expand Medicaid & fully implement the new health care law.
The Nevada State Medical Association is now one of many voices calling on Sandoval and the Legislature to fully implement "Obamacare" by expanding Medicaid. As even some prominent Republicans have recently admitted, Nevada actually does need a program like this to cover more uninsured residents. And by doing so, health care costs decrease for nearly everyone while the state benefits from more economic activity generated by a stronger health care system.
Also remember that the federal government will pay for 100% of the first three years of Medicaid expansion. And after five years, the feds will still pay for 90% of it. So in essence, Nevada only contributes a dime for every dollar of additional health care... And that will likely still save Nevada money!
So what is Brian Sandoval waiting for? So far, that seems to be the $500 million question. Is it Chuck Muth and the "tea party"? Is it Republican legislators? Is it Democratic legislators? Or is there another reason for the wait?
Whatever the reason, it certainly can't be the actual facts and dollar figures of the proposed Medicaid expansion. Again. it just makes good sense and good policy to do it. Sandoval is likely waiting on a final decision for political reasons, so we'll have to wait a few more weeks to see how the politics in Carson City shakes out.
Shortly after the Affordable Care Act (ACA) was (mostly) upheld by the US Supreme Court in June, all eyes turned to state houses to see how they would begin implementing it. So far, Nevada has begun implementing the health care Exchange part of the law. However, there's been uncertainty over the state going along with expanding Medicaid.
[Last Thursday], SEIU Nevada delivered more than 300 hand-signed letters to Gov. Brian Sandoval urging him to expand Medicaid coverage as he crafts his budget for the 2013 legislative session.
“Going forward three years, the state would be paying just one dime for a dollar’s worth of health coverage,” said Mayra Ocampo, SEIU Director of Governmental Affairs. “So often we see our government offer big tax breaks to lure businesses. In this case, we’re getting the incentive and it makes no sense to reject it. We can’t think of any financial reason why the governor wouldn’t expand Medicaid. Rejecting the federal money will just put a greater strain on Nevada’s budget.”
Even uber-insider Republican consultant and Brian Sandoval adviser Pete Ernaut went on Jon Ralston's show last week to express support for fully implementing the ACA.
It's finally starting to look like there's a critical mass in favor of expanding Medicaid. Why is this? Perhaps this is happening because it's good policy that makes sense (and $).
1. Under Obamacare, states no longer have to finance health insurance for people above 133 percent of the federal poverty level. Many states fund health insurance programs which cover residents living at more than 133 percent of the federal poverty level (FPL). Obamacare makes residents at higher than 133 percent of the FPL eligible for subsidized health insurance through state insurance exchanges at no cost to states. For example, Idaho would no longer have to fund health insurance for its 63 percent of uninsured residents who are above 133 percent of the FPL, reducing its $47 million annual uncompensated care cost to $17.3 million.
2. Under Obamacare, states pay billions less to cover people below 133 percent of the federal poverty level. States pay billions in health insurance programs for residents living at less than 133 percent of the FPL. After five years of Obamacare, the federal government will cover 90 percent of insurance costs for state residents making less than 133 percent of the FPL. For the first three years of the expanded Medicaid program, the federal government will cover 100 percent of Medicaid costs. The surveyed states will save $4.2 billion (100 percent of their uncompensated care costs) annually for the first three years, and $3.0 billion annually starting in 2019. For example, Michigan pays $212 million annually in uncompensated care costs. After five years of Obamacare, Michigan would have to pay only $68 million annually in the expanded Medicaid program.
3. By making health insurance universally available, Obamacare slashes the “hidden tax” states pay in health insurance premiums. States pay a “hidden tax” in the form of higher insurance premiums to account for the cost of covering the uninsured. “By greatly reducing uncompensated care,” the Council explains, Obamacare works to “reduce this hidden tax.” For example, North Carolina would see its annual $58.6 million insurance premium “tax” reduced to reflect a much smaller number of people without health insurance.
So in addition to covering more Nevadans, the Medicaid expansion provision of the Affordable Care Act will ultimately save Nevada money if implemented. And since Americans using Medicaid are overwhelmingly happy with their health care, it's not as if the state will be adding people onto a troubled program. Again, it just makes sense.
And here's another way this makes sense: The $300 million that Nevada will be receiving under the ACA to expand Medicaid is money that will be injected into our economy. And this will mean more jobs in the health care sector. So even when looking at the economics of expanding Medicaid, it just makes sense.
So what is Brian Sandoval waiting for? Perhaps some politically convenient excuse to do it (a la the last budget)? Or is there something else? Whatever the case, he eventually has to look at the numbers and realize that it just makes sense to expand Medicaid and fully abide by the ACA.
You can't say I didn't warn you. Surely enough, the New England Journal of Medicine now has new evidence from a study conducted by Harvard's School of Public Health showing we'd be incredibly stupid to turn down the Medicaid expansion program of the Affordable Care Act.
The study compared Arizona, which expanded Medicaid coverage to adults without dependent children in 2001 and to parents of children earning up to 200 percent of federal poverty in 2002, to Nevada and New Mexico, which did not opt for expansion.
“State Medicaid expansions to cover low-income adults were significantly associated with reduced mortality as well as improved coverage, access to care and self-reported health,” according to the paper. [...]
The study estimated that 2,840 deaths per year were prevented for every 500,000 people who received additional Medicaid coverage. According to those statistics, Nevada could potentially prevent 700 deaths a year if it opts to expand Medicaid coverage to 140,000 currently uninsured Nevadans under the Affordable Care Act. [...]
“Our study suggests that expanding Medicaid enables people to access the care they need and their health improves, even to the point of potentially saving lives,” said [Benjamin Sommers, the lead author of the paper]. “While states have many factors to weigh in deciding whether to expand Medicaid, it should be clear from our study and others ... that this is a program that succeeds in its goal of helping improve health care and health for poor Americans.”
It is now painfully obvious that Nevada gains absolutely nothing from turning down ACA Medicaid expansion. Rather, we just get more deaths and a more inefficient & costly health care system. Yes, you heard me right. Ultimately, we pay more by NOT expanding health care coverage for more working poor Nevadans!
So why are we still debating this? It's just plain shortsighted not to go through with ACA Medicaid expansion. We save money and save lives by simply fully participating in the new health care law.
Perhaps it's time for Nevada to finally cut the penny wise/pound foolish nonsense and join civilization for a change. Again, remember that the feds fully pay for the first three years of the program, then pay for 90% of it from 2016 onward. Despite what some on the radical right want us to believe, it's really not that costly. Rather, we waste more money by forcing uninsured Nevadans to access "primary care" in the hospital emergency room. And of course, there's the social cost of letting people die for no reason.
Why again are Brian Sandoval and state legislators still debating this?
Many of the governors threatening to stymie implementation of the Affordable Care Act preside over states with high uninsurance rates, according to data from the Kaiser Family Foundation. [...]
[... M]any of the states with high-profile conservative governors vowing to stand athwart the ACA’s progress, by refusing to expand their Medicaid programs and erecting hurdles to establishing insurance marketplaces, would stand to gain the most from successful implementation of the law.
With a 21 percent uninsured rate, Florida is tied with Nevada and New Mexico for second to last place in the country. But conservative Gov. Rick Scott is vowing to opt out of a Medicaid expansion, almost fully financed by the federal government, now that the Supreme Court has ruled that the feds cannot threaten states with the loss of all their Medicaid funds for refusing to expand the program.
Wow. We're tied with Florida and New Mexico for second to last place. We're (again!) at the bottom of the list, and our Governor wants to torpedo the very program that can fix this very serious problem? What is he thinking? Oh wait, I need not ask again.
Seriously, this is another reason why Nevada can NOT afford to turn down ACA Medicaid expansion. We have far too many uninsured people. And the more we work to bring this number down, the lower we can bring down health care costs for everyone.
So Nevada is finally entering the civilized world...
But not fully. Certainly, it's a start that the state is implementing the biggest component of the Affordable Care Act. However, the state is still threatening to blow up the proposed Medicaid expansion that's necessary to cover another 91,000 Nevadans, move us closer toward a truly universal health care system, and ultimately lower health care costs for everyone. Funny enough, Brian Sandoval and some shortsighted legislators are complaining about the cost!
Well, supposedly they're concerned about "the cost". In reality, I suspect they're really afraid of the "tea party". Yes, I said it. This is really about politics.
The response from Republican governors and state legislators has been predictable. Essentially, the court handed Republican politicians a high-profile opportunity to define themselves in opposition to President Obama’s signature accomplishment, a law for which their party’s has particular contempt. So there’s an element of posturing here. The question is how many GOP governors and state legislatures will ultimately relent and take the federal money.
Logic says that most, if not all, of them will. After all, the federal government is offering a pretty good deal to the states, and some powerful interests –hospitals that now end up providing free emergency care for patients who would be eligible for Medicaid under the expansion and insurance companies offering Medicaid managed care plans –figure to exert considerable pressure on state leaders to go along. Particularly for a governor like Christie, who leads a blue state and is facing reelection in 2013, it might not take much pressure to convince him to implement the expansion.
That said, the value to an ambitious Tea Party-era Republican politician of defying the Obama administration and rejecting money from Washington shouldn’t be underestimated. Since Obama came to office, we’ve seen Jindal make a show of turning down stimulus money for his state, Christie blow up a long-planned and badly needed rail tunnel, and Scott turn down federal dollars for high-speed rail, to cite a few examples. Whether these sorts of stunts play well with general election audiences is debatable, but within the GOP, they’re winning moves.
Intraparty Republican politics, in other words, are the main threat to the ACA’s Medicaid expansion. Right now, a Republican elected official at the state level who signals his or her readiness to expand the Medicaid rolls is giving ammunition to a potential primary challenger from the right –a threat that every Republican office-holder has to take seriously in the Tea Party-era.
How else can one explain denying health care to at least 91,000 Nevadans? How else can one explain driving up health care costs for everyone by continuing to force people to use the emergency room as "primary care"? And how else can one explain "half ass-ing" health care reform?
Since Nevada has already begun to implement the Affordable Care Act, it only makes sense to fully comply and accept the expanded Medicaid program. More Nevadans will have the health care they need, and the new system will ultimately work better for everyone. And in the end, neither progressives nor "tea partiers" (or even those in the middle, for that matter) will appreciate "half ass-ed" health care reform.
So The Beltway's favorite gossip rag, Politico, has a breathless piece this morning about the new G-O-TEA plan to sell Paul Ryan's "Doom of Austerity" plan to America: Just don't talk about what's actually in it!
Last year, they were blindsided by the backlash to the Wisconsin Republican’s plan. It was immediately framed by Democrats as ending Medicare, crushing Medicaid while keeping taxes low for the rich. Ryan, who was being pitched as a presidential prospect for the party, receded as his plan came under attack from all sides.
The 2012 plan is — simply put — to not talk about the plan too much. [...]
GOP leaders are suggesting members use props. In a presentation, the NRCC said members should try to “inoculate” themselves in a campaign season by using “credible third-party validators (mom or seniors),” according to a party document.
Above all, the Ryan budget rollout was designed to conform to a new political reality for Republicans: Changing entitlements is difficult, not popular but necessary. And even the true believers — like Ryan himself — need to build coalitions when they pitch big ideas.
To ensure the plan landed well nationally, Ryan personally reached out to presidential candidates to brief them on it. Romney endorsed the plan this week.
And DC Republicans are pointing to Mark Amodei's win in NV-02 last year as living proof of their plan working (politically, that is).
Amodei gave up talking about the particulars of the Ryan budget. He started saying the status quo was unsustainable. He tagged Marshall as supporting Obama’s health care bill, which he said cut from Medicare. When talking about the Republican plan, he said it would “save and protect” the senior health care program.
Amodei sent out direct mail that branded him as the “the one candidate working to protect Medicare.” They enlisted his mother to star in an advertisement vouching he would protect the program.
The contrast worked. [...]
“Here’s what I’m real comfortable telling people,” Amodei said in an interview in Washington on Wednesday. “I’ll tell you the truth about your program, and I’ll fight to save it, but in order to tell you the truth and to fight to save it, you can’t continue to do nothing. Can you fix it all in a year? Absolutely not. Can you fix it in five years? No you can’t. But you better start now.”
Here's what Politico is missing. First off, Barack Obama isn't behaving like Kate Marshall. Secondly, it doesn't look like Shelley Berkley, John Oceguera, or Steven Horsford plans to behave like Kate Marshall. Thirdly, Paul Ryan's plan would still destroy Medicare if enacted. And finally, Mitt Romney and Rick Santorum have wholly embraced Paul Ryan and his plan to destroy Medicare. That's why House Republicans are spinning this like crazy now.
Beginning 2023, the guaranteed Medicare benefit would be transformed into a government-financed “premium support” system. Seniors currently under the age of 55 could use their government contribution to purchase insurance from an exchange of private plans or traditional fee-for-service Medicare. But the budget does not take sufficient precautions to prevent insurers from cherry-picking the the healthiest beneficiaries from traditional Medicare and leaving sicker applicants to the government. As a result, traditional Medicare costs could skyrocket, forcing even more seniors out of the government program. The budget also adopts a per capita cost cap of GDP growth plus 0.5 percent, without specifying how it would enforce it. This makes it likely that the cap would limit the government contribution provided to beneficiaries and since the proposed growth rate is much slower than the projected growth in health care costs, CBO estimates that new beneficiaries could pay up to $1,200 more by 2030 and more than $5,900 more by 2050. Finally, the budget would also raise Medicare’s age of eligibility to 67. Some seniors who would no longer be eligible for Medicare would pick up employer coverage—but they would pay more in premiums and cost sharing. And since the budget would scale back or eliminate other coverage options, hundreds of thousands of seniors would become uninsured.
The budget would eliminate the exiting matching-grant financing structure of Medicaid and would instead give each state a pre-determined block grant that does not keep up with actual health care spending. This would shift some of the burden of Medicaid’s growing costs to the states, forcing them to — in the words of the CBO — make cutbacks that “involve reduced eligibility for Medicaid and CHIP, coverage of fewer services, lower payments to providers, or increased cost sharing by beneficiaries—all of which would reduce access to care.” The block grants would reduce federal Medicaid spending by $810 billion over 10 years, decreasing federal Medicaid spending by more than 35 percent over the decade. As a result, states could reduce enrollment by more than 14 million people, or almost 20 percent—even if they are were able to slow the growth in health care costs substantially.
Joe Heck has to do this. On one hand, he has to look "moderate" in order to win reelection in NV-03. But on the other hand, he's still expected to mostly be a loyal follower of Paul Ryan and "Tea Party, Inc." So what's someone like Heck to do? Oh, just lie about Medicare and lie about Democrats' position on Medicare!
When House Republicans unveil their 2012 budget on Tuesday, they are expected to include a Medicare privatization plan endorsed by one Democrat — Sen. Ron Wyden (D-OR). That, Republicans will claim, proves their controversial overhaul proposal has bipartisan support.
Leading Democrats say they won’t let the GOP get away with it.
“We don’t see a difference in principle between the original Ryan plan and the so-called Wyden-Ryan plan,” Rep. Jan Schakowsky (D-IL) a party surrogate on health care issues, told reporters on a conference call Monday morning. “It’s equally bad or only marginally different but still would end Medicare as we know it.” [...]
“They [seniors] don’t want Medicare itself to be diminished in some way,” Schakowsky said, “or to become too expected and therefore ruined.”
So no matter how hard both the national G-O-TEA and Nevada's G-O-TEA representatives try to spin Paul Ryan's new budget proposal as a "bold, courageous, bipartisan plan to save Medicare", it's really just another attempt to pass the same old plan to destroy Medicare and take away needed health care from many Nevadans.
Recently, Bruce Springsteen released his new single, "We Take Care of Our Own". And just last week, President Obama announced this song will be part of his reelection campaign's playlist.
And interestingly enough, one won't just hear this song on the campaign trail. In a way, the spirit of this song can also be found in the President's new ten year budget plan.
In his 10 year budget, set to be released to the public late Monday morning, Obama will advocate a series of tax and spending policies that emphasize near-term economic growth, long term investments in education and research, an enduring social safety net, and over a trillion dollars in new revenue over 10 years taken from wealthy individuals and corporations, based on tax reforms that enshrine the so-called “Buffett rule.”
The document is intended to stand as a moderately progressive alternative to the infamous budget House Republicans adopted overwhelmingly last spring — and are set to readopt with some tweaks later this year. That budget calls for reducing taxes on high-income Americans, and for filling the revenue hole by slashing or phasing out key support programs — most notably Medicare.
For Congressional Republicans, this is just another effort to prove to their "TEA" (party) infused base that they don't care about poor people while they do care about opposing anything and everything President Obama proposes. That's all this is about. They're playing raw primary politics. They're worried about the "enthusiasm gap" now plaguing their party, so Republicans are willing to pull the budget brinksmanship card yet again to get the "tea party" base revved up and behind them (and avoid more primary challenges).
Oh, and don't forget the G-O-TEA's BFFs on Wall Street. The big financial firms are set to spend record amounts of money in this next election, and G-O-TEA leadership expects the big Wall Street firms to "make it rain" on its candidates. Of course before that happens, the big Wall Street firms expect Congressional Republicans to continue delivering on obstructing financial regulatory reform and progressive tax reform before asking for more campaign donations and supportive Super PAC formations.
So basically, this may be 2011 Budget Battle Royale redux... Except that President Obama has already wizened up to the G-O-TEA games, and that the American public is getting sick and tired of Congress doing nothing to help improve the economy. And remember, this is an election year. This time if/when Republicans in Congress yet again threaten to blow up the federal government over ridiculous pandering to the radical right, they will face consequences this fall. And even though President Obama's budget plan may not be implemented this year, it's still important to let Americans know his vision and give voters a clear choice for November.
May this be the ultimate defining moment of The Obama Administration? Will it really all come down to this?
President Obama will call for shrinking the nation's long-term deficits by raising taxes on wealthier Americans and requiring them to pay more into Social Security, drawing a barbed contrast with a Republican plan to save money by deeply slashing Medicare, Medicaid and other domestic spending.
Obama will offer some spending cuts, including trims to the Pentagon's budget, but his speech Wednesday is likely to provide Americans with a vivid choice between higher taxes or fewer benefits, issues that will color the national debate straight through the 2012 election.
So what will President Obama say? The LA Times may be offering a hint...
Democrats hope to repeat the experience of 2005, in which President George W. Bush's proposal to privatize parts of Social Security proved to be a staggering miscalculation that cost his party heavily in the next year's election. They think voters will not accept a Republican proposal put forward by Rep. Paul D. Ryan (R-Wis.) that would replace guaranteed Medicare benefits with a limited voucher. [...]
"We strongly disagree with the lack of balance in Congressman Ryan's approach," [White House Press Secretary Jay] Carney said. "It simply is not appropriate and it would not be supported by the American people to have a fiscal plan that relies on dramatic restructuring, reform of the kind of programs that provide security and health security to seniors and to poor people and to disabled people, and at the same time gives enormous tax relief, tax cuts to the wealthiest Americans."
Or is this something else? Ezra Klein tweeted that The White House directly told him so, and Greg Sargent is suddenly... GASP!... Feeling more hopeful about tomorrow evening's Presidential Speech.
At the White House press briefing today, spokesman Jay Carney hinted that all the reporting out there today is wrong, and insisted Obama’s vision would not be based solely on any particular plan.
“He has said very clearly that he supports the efforts of the so-called Gang of Six and others who are addressing these challenges in a very serious way,”Carney said. “That’s a healthy, good thing, and it’s reflective of the environment that was created by the president’s fiscal commission after it reported last year...He will provide his vision tomorrow.”
I could be wrong, but that sounds to me like the White House actively doesn’t want Obama’s eventual vision to be seen as anything but his own, despite commentary to the contrary. Obama intended the fiscal commission to start a conversation, not set his final blueprint for him. “It will be his,” Carney said. [...]
As The Post reports today, “letting others take the lead on complex problems has become a hallmark of the Obama presidency.” But it’s also a hallmark of the Obama presidency for him to step in just when such chatter is at its peak and articulate a vision that, by his lights, represents the best of what others contributed to the debate while he waited in the wings. So we'll see.
So what can we expect tomorrow? Maybe we need to stop reading into Obama what we want to see?
Honestly, I think it was the biggest mistake far too many voters made in 2008. They looked at the nebulous promise of "hope" and "change", and read into it whatever they wanted: that Obama would be a great "Progressive Messiah" ushering in a golden age of public works programs, single-payer health care, and marriage equality; or that Obama would be some "Crazy Communist" out to socialize everything in sight; or that Obama would be playing hoops with Lamar Odom and doing photo shoots with Scarlett Johansen all day. Seriously, Barack Obama isn't the kind of politician that likes to be boxed in by ideological labels or branded as some part of some specific DC clique.
Rather, what Obama has been trying to do this whole time he's been in office so far is to make his own unique mark on the major legislative hurdles of our time. And he wants to do so on his terms. That's why I'm willing to hear him out tomorrow.
After all, this may be the pivotal moment of truth for Obama. Does he want to be known as the President conveying the wrong message at the wrong time? Does he want to be known as someone who threw the country back into total economic misery by cutting the poor, disabled, and elderly to death? Or does he want to be known as someone who brought about lasting change that put America firmly into economic recovery and beyond the doldrums of "Bush's Great Recession"?
This may really be President Obama's Rubicon Moment. And believe it or not, I'm thinking he will put extra thought into what he does and understand we can't forget what we value the most.
If Nancy Pelosi is willing to stop with the "Chicken Little" games and forge a game plan for finishing health care reform, then there's still hope. Now we just have to convince Harry Reid to ignore the naysayers and move forward.
At this point it seems the best option is for the House to pass what the Senate passed last month, then finish it off with both chambers of Congress moving forward with a reconciliation bill including things like the public option that most Americans want. Nancy Pelosi gets this, so we just need for Reid and Obama to get it as well.
I don't know what's in Obama's head right now, but judging from the phone call I just had with one of Reid's Las Vegas staffers he's open to it. The staffer was very friendly with me and appreciated my call of support and my urge for Reid to keep moving forward on health care, so long as he includes the public option and the Medicare buy-in, and uses reconciliation to do it if necessary.
So if you can, please call Harry Reid's office and tell them this:
Americans need real reform and access to affordable healthcare. We can move in the right direction with RECONCILIATION.
What can we pass through reconciliation? The public option. The Medicare expansion. The Medicaid expansion.
And what about the Senate bill as it currently stands? It might not pass the House because of the excise tax on Cadillac Plans, and over 190 House members are against this tax. It's why we need to PUSH for reconciliation to let Democrats know that we support it, and will back them to the hilt on real health care reform.
Let's wipe the grin off those Republicans' faces by showing them that Democrats CAN and WILL go for RECONCILIATION.
We'll deliver your message, loud and clear, to Speaker Pelosi and Senator Reid in D.C.!
Harry Reid's Offices to Call
Carson City 600 East William Street, #302 Carson City, NV 89701 Phone: 775-882-7343 / Fax: 775-883-1980
Las Vegas Lloyd D. George Building 333 Las Vegas Boulevard South, Suite 8016 Las Vegas, NV 89101 Phone: 702-388-5020 / Fax: 702-388-5030
Reno Bruce R. Thompson Courthouse and Federal Building 400 South Virginia Street, Suite 902 Reno, NV 89501 Phone: 775-686-5750 / Fax: 775-686-5757
Washington 528 Hart Senate Office Building Washington, DC 20510 Phone: 202-224-3542 / Fax: 202-224-7327 Toll Free for Nevadans: 1-866-SEN-REID (736-7343) -Restricted to calls originating from area codes 775 and 702
The only thing I differ on is that the Senate bill doesn't need to be scrapped. The House can pass it, so long as a companion reconciliation bill with the public option and Medicare buy-in is done ASAP. Of course, I also wouldn't mind scrapping the Senate bill altogether if it means we'll only see good reforms (like the new insurance regulations and Medicare/Medicaid expansions) without the HMO & PhRMA bailouts. I'm just saying that as long as we either see health care done, done right, and done soon with things that people actually want, we can turn these lemons into good lemonade that people will appreciate. :-)
Separately, however, the bill includes $100 million for hurricane-hit Louisiana — an extra Republicans pounced on Thursday as special treatment for Democratic Sen. Mary Landrieu, whom Reid has been courting as one of the final votes needed to advance the bill during Saturday’s vote.
Actually, as ABC News first reported, the $100 million goes for “certain states recovering from a major disaster” in the past seven years, noting that only one state fits that description.
In the halls this afternoon, the provision was being called the “Louisiana purchase.” [...]
Reid’s office dismissed the criticism, saying the Republican campaign arm is trying to have it both ways — criticizing Reid when he secured the deal, and again now for delivering full funding for all states, including hard-hit Louisiana.
“As a result of his work for Nevada, he was able to help the entire country,” [Reid spokesguy Jon] Summers said.
Oh, wow! I just want to see the Republicans whine and bitch and moan and complain about aid for Hurricane Katrina victims in Louisiana. What, are we supposed to forget how Dumbya Bush f*cked up the response to Katrina? Or that it's taken the federal government so damned long to deliver the aid promised to revive New Orleans?
I'm sure that will kill off whatever remaining appeal the Republican Party has to anyone with any sort of capacity for compassion.
Oh, and don't worry, the other states aren't being left out, either.
The increased Medicaid funding Senate Majority Leader Harry Reid initially scored for Nevada is now being proposed for all 50 states in his new health care bill.
The bill also includes a separate, $100 million bonus for hurricane-stricken Louisiana, the state whose senator is one of the Democratic holdouts on advancing the legislation.
Reid came under fire earlier from Republicans for having secured the special Nevada deal last month. But the majority leader proudly defended the move saying repeatedly he made “no apologies” for helping his home state with full Medicaid funding. Reid helped Nevada and three others suffering from high unemployment. [...]
Now, in the bill unveiled this week, Reid is offering 100-percent funding for Medicaid expansion in all states for the first three years of the program.
“As he worked on this issue for Nevada, he saw other states needed help as well,” said Reid spokesman Jon Summers. “The fact that he took action for Nevada and was able to extend it to other states is significant.”
Of course, known Nevada hater John "McBush" McCain whined and bitched and moaned and complained about the Medicaid funds for Nevada. So guess what? Arizona will be getting help, too! What say "Mr. Faux Maverick" now? Will he oppose help for his own state again like he did when he voted against the stimulus earlier this year?
I just can't wait for Rethuglicans to try to turn this into "corruption!" or somehow twist this into "ACORN!" Considering how Reid's designed this bill, the GOoPers look likely to self-destruct over trash-talking something that their very own states (especially Louisiana) so desperately need.
Heh. I love how Harry Reid takes the nasty attacks on him and turns it back on the Republicans. Yeah, yeah, I know political games are being played. But come on, at least our senior Senator is actually doing something to help us.
Throughout all my years of public service, I've never apologized for standing up for Nevada. And with far too many of our citizens out of work, our economy in recession, and middle-class families concerned about their future - I'm not about to start now.
When I reviewed the health care bill currently moving through the Senate and discovered that the expanded Medicaid costs were going to hammer Nevada at a time when we can least afford it, I took action. Republicans who are attacking me for looking out for our state need to get their story straight, and stop trying to score political points at the expense of a health insurance reform effort that's brought us as close as ever to finally fixing our broken system.
As the New York Times reported, it's my position that Medicaid in Nevada has been tragically under-funded. Forcing our state to pay drastically more to accomplish reform now would only exacerbate that burden, putting health care for those that need it most - at risk. I did it in this bill, I've done it in the past, and I'd do it again tomorrow, next week, or next year. Protecting the people of Nevada is the reason I go to work every day, and that's never going to change.
Nevada has had the highest home foreclosure rate in the entire country for 31 months in a row. You and I know, it's just common sense that when the people of your state are struggling, you fight as hard as you can to help.
So in coming days you may see the pundits and partisans ranting and raving on cable TV about my work for Nevada in the Senate, but I will never apologize for standing up on behalf of the Silver State.
Cheese louise! No matter what Harry Reid does, the radical right complains. I'm sure if he were to even walk on water, they'd complain about why he doesn't swim.
So anyway, Harry Reid just ensured full federal funding for the Medicaid expansion that Nevada will need to undergo once health care reform is implemented. Once again, Johnny Casino pursued yet another laughable sideshow and "Luv Guv Gibbons" kept acting like a silly clown while Harry Reid actually got something done for Nevada. More people will have health care coverage and the state won't go broke in joining with the feds to make that happen.
And what are the righties saying? Just peek at The Sun's comments. Of course, they hate him for doing it and for caring about the people in this state. And of course, they're completely mum about Ensign's childish demands for attention as he keeps trying to distract us from his sordid affair.
Hopefully, this is just the start of Reid's efforts to improve the health care bill. I'm sure if he includes a strong public option that most Nevadans support, he'll have no problem making the case for reelection next year.
Reid is concerned about the cash-poor state's inability to boost Medicaid spending as would be required under the bill.
“While this draft bill is a good starting point, it needs improvement before it will work for Nevada," Reid said in a statement. "During this time of economic crisis, our state cannot afford to shoulder the second highest increase in Medicaid funding."
Reid said he received assurance from the chairman, Sen. Max Baucus of Montana, that the formula would be changed before the bill goes to committee next week.
"I spoke to the Chair of the Finance Committee and he assured me that this bill will be improved for Nevada," Reid said.
"Let me be very clear, I will not bring a health insurance reform bill to the Senate floor that is not good for Nevada.”
Honestly, I'm just glad that Reid wants to get rid of this unfunded mandate and replace it with real aid to ensure that Nevada's Medicaid program can cover more people. However, there's another reason I'm celebrating right now.
The Baucus Bill is becoming increasingly hated by just about everyone other than the HMOs. As it is, it's pretty much dead on arrival. And with Harry Reid now placing a nail on that coffin, we have a chance to get a better bill on the Senate floor, a better bill with better financing, better subsidies and assistance for the working poor, and a better public option that we can all opt into.
