Thursday, July 26, 2012

An angry reader writes on taxes and Medicaid -- July 26, 2012 column


Rants from readers are nothing new to me, but one angry email recently grabbed my attention.

“Lady,” it began, “are you so rich that you don’t even realize what you are saying?”

What? The question took me aback but also made me smile. It ain’t me, babe.

Disagree with me, sure. Accuse me of spouting gibberish, if you must. But, please, don’t confuse me with the one percent. My only car is an 11-year- old Subaru. I don’t own a horse and have no clue about dressage. I buy Grey Poupon with a coupon.

But my correspondent, a woman from rural Virginia, imagined I cared nothing about higher taxes for whatever purpose, wherever they might arise, hers or mine.

“Go ahead and pay those taxes,” she wrote, “and pick up mine while you are at it.”

Her gripe was with my column last week on the Medicaid expansion under the Affordable Care Act, a.k.a. Obamacare. The law was supposed to bring 16 million people under Medicaid by expanding the program to include adults under 65 without children who are not disabled and whose income is up to 138 percent of the poverty line -- $26,344 for a family of three this year.

But Medicaid, the nation’s health care program for the poor, is a joint federal-state program in which the states set eligibility and decide which benefits will be covered. Southern states tend to be the stingiest, but under the expansion, the stingiest would benefit the most. The new law sets minimum standards that every state would meet.

In its decision last month, the Supreme Court upheld the law but essentially made the Medicaid expansion a state option. About a dozen governors, mostly in the South, are weighing whether to participate at all in the expansion. They contend the costs are too high, even though the federal government will pay 100 percent of the Medicaid expansion costs for the first three years and 90 percent after that.

I understand that it’s all taxpayers’ money, and I get it that nobody likes paying more. I’m not crazy about taxes myself. But I don’t shield my assets in offshore accounts.

I figure that compared with a lot of other things my tax dollars go for, health care is a worthy cause. It’s more humane and more cost effective in the long run for as many Americans as possible to have health insurance. The costliest care, spread among all payers of insurance premiums, is in emergency room. That drives health care costs ever higher.

Besides, it ’s not as if the choice is between expanding Medicaid and cutting taxes.

As Congress dithers about the federal deficit and whether to end the Bush era tax cuts, it’s worth remembering that much-maligned Obamacare actually lowers the federal deficit. This is not a news flash. Budget analysts have been saying so for years, but critics of Obama never believe it.

The nonpartisan and highly respected numbers crunchers at the Congressional Budget Office reaffirmed the deficit finding this week.

In a letter to House Speaker John Boehner, CBO said the latest House bill repealing Obamacare would increase the deficit by $109 billion between 2013 and 2022. That’s right, were the Republicans to succeed and kill Obamacare, the deficit would rise $109 billion by 2022.

That’s because the net savings from eliminating some of the law’s provisions would be more than offset by spending increases and decreases in revenue. Repealing the law would reduce direct spending by $890 billion, but it would also reduce revenues by $1 trillion between 2013 and 2022, CBO said. To repeat, repealing Obamacare would add $109 billion to federal deficits.

Medicare and Social Security are both in trouble with numbers that aren’t sustainable. The Affordable Care Act nibbles at Medicare costs, but we’ve not begun to work on Social Security.

We need to do more. We need to take care of each other.

“Go back and reread your column,” my reader said, “and rethink your so-called editorial.”

And so I did. Now, I’d love to hear from you and other readers about what you think we should do about health care and Social Security.

© 2012 Marsha Mercer. All rights reserved.

Thursday, July 19, 2012

Supremely kicking the uninsured -- July 19, 2012 column


When the U.S. Supreme Court upheld almost all the Affordable Care Act last month, analysts gushed that it was a stunning victory for President Barack Obama.

It’s becoming clear, though, that the court’s ruling on the Medicaid provision may be a bitter disappointment for low-income workers who are uninsured, especially in the South.

A central promise of the Affordable Care Act is that it will relieve the anxiety and financial insecurity of having to live without health insurance. Most of the uninsured have jobs or live in a household with someone who does, but their employers don’t offer health insurance, they aren’t eligible because they work part-time or they can’t afford the premiums.

Obamacare, as the law is known, provides carrots and sticks for people to obtain affordable health insurance. That’s where Medicaid, the nation’s largest health program in terms of participants, comes in. About 60 million Americans receive health care through Medicaid. About three-fourths are poor children and families and one fourth are elderly or disabled. Seven in 10 nursing home patients are on Medicaid.

The idea was to bring coverage to about 16 million more Americans by 2019 by adding a new category of Medicaid eligibility: adults without children who are under 65, not disabled, and whose income is near the poverty line.

The law presented states with an offer they couldn’t refuse: Expand Medicaid in 2014 to people whose incomes are within 138 percent of the federal poverty level -- $26,344 for a family of three in 2012 -- or forgo all existing federal Medicaid funding.

But Chief Justice John G. Roberts Jr., writing for the majority, said such “economic dragooning” left states no real choice but to participate in the expansion. The court struck down the funding restriction, and states now have the option of rejecting the expansion and sticking with their current Medicaid program without penalty.

Sadly, that means health coverage now depends on geography, with many low-income Americans who can’t afford insurance in limbo and at the whim of their governors.

So far, only a handful of governors will definitely implement the expansion. About a dozen governors, many in the South, have said they may or will reject expansion.Republicans Rick Perry of Texas and Rick Scott of Florida will reject. Those leaning against expansion include Alabama Gov. Robert Bentley and Virginia Gov. Robert F. McDonnell, both Republicans. Tennessee Gov. Bill Haslam, a Republican, is mulling whether to ask for a block grant to run his state’s program. A lump sum payment would come with fewer strings as to how the program operates.

The governors say their main worry is cost, and yet the federal government will pay for expanding Medicaid at first. Uncle Sam will pay 100 percent of the costs for new enrollees for the first three years. After that, states would begin sharing in the new costs, up to 10 percent.

Turn down free money? Highly unlikely, the Obama administration thought. Some veteran political watchers still predict balky states won’t turn down the money come the 2014 election cycle.

The court has left the decision up to each state at a time when the fiscal and political forecast is stormy. A new report on states’ fiscal health by respected economists predicted financial woes that will last long after the economy finally rebounds.

Complicating the matter is a provision in the health law that says those who don’t qualify for Medicaid will be able to get insurance through new marketplaces called exchanges. Those who can’t afford the premiums will be eligible for subsidies.

States are expected to set up the exchanges, but many states have been slow to get started. As with the Medicaid expansion, some may pass. If a state won’t set up an exchange for its residents, the federal government will step in. But there’s yet another catch.

The law says that the uninsured can get subsidies for premiums on state-run exchanges. It doesn’t say subsidies will be available for premiums on federally run exchanges.

That glitch too can be worked out – if there’s a will.

For now, millions of working Americans who lack insurance are still pawns on the great political chess board. And that’s a shame. We can and should do better.

© 2012 Marsha Mercer. All rights reserved.


Thursday, July 12, 2012

Ike and the monumental headache -- July 12, 2012 column


On Veterans Day 1954, President Dwight D. “Ike” Eisenhower and his family -- brothers, wife, son and grandchildren -- gathered in Abilene, Kan., for the dedication of the Eisenhower boyhood home and museum.

Ike emphasized that the museum would focus on promoting good citizenship. Nothing else, he stressed, “could ever have induced the Eisenhower brothers to attach their name to something which inescapably would have certain elements, let us say, of self-glorification, except that this project was presented as something for the future good of America.“

Speaking with “humble pride” for the six generations of his family buried nearby and for generations yet to come, he said, “I am privileged to dedicate this shrine to the future citizens of a great and glorious America.”

His remarks are relevant because they provide a sense of how the Supreme Commander of Allied Forces in Europe in World War II and the two-term president, from 1953 to 1961, would want to be remembered. And that’s a matter of great 21st century debate.

Time and again over the years, Eisenhower chose to downplay his own personal triumphs, which were many, and to celebrate instead the shared effort of the nation and its future good. He had no use for “talking Generals” or for the cult of personality that most politicians cultivate. 

Ike’s granddaughter Susan Eisenhower, who was 2 years old that November day in Abilene, now leads the family fight against the proposed design of the Eisenhower Memorial in Washington.

In 1999, three decades after Eisenhower’s death, Congress authorized construction of a permanent national monument equal in caliber to the Washington, Jefferson, Lincoln and FDR presidential memorials. Like those, though, the execution of the Eisenhower memorial has been fraught with disputes and delays.

Competing visions of how to commemorate Ike have pit world-class architect Frank Gehry against the Eisenhower family and an array of traditionalists. The Interior secretary has told the Eisenhower Memorial Commission to keep working on the design, and a House appropriations subcommittee last month pulled the plug on nearly $60 million in funding for construction of the memorial starting in fiscal 2013.

The memorial is to be located on four acres adjacent to the Education Department and other federal office buildings at the foot of Capitol Hill, off the National Mall. To partly shield the view of office buildings and create a square, Gehry envisions stainless steel mesh screens eight stories high.

The Toronto-born Gehry, 83, a star architect with a portfolio of internationally acclaimed structures, is known for his use of unconventional materials. He wrapped his own California home in corrugated metal and chain-link fences, infuriating the neighbors but winning a big architectural award.

His Eisenhower design, which beat out other contenders in a national competition, is Gehry’s first memorial and will be his first project in Washington.

Susan Eisenhower, testifying before a congressional panel in March, denounced the screens – Gehry calls them tapestries – for evoking memories of the Iron Curtain or chain-link fences around concentration camps. And she predicted practical difficulties.

“It is easy to imagine that 80-foot metal mesh curtains would require constant maintenance. Any high wind would assure that everything from leaves to trash could easily get caught in the metal gaps. It is hard to imagine that the National Park Service would be equipped to handle the constant cleaning, especially at the higher reaches,” she said. She and other critics also objected to the depiction of Eisenhower as only a barefoot boy in Kansas, dreaming of his future.

When it comes to choosing how we remember America and Americans past, conflict is more the rule than the exception.

The Washington Monument -- plagued by political battles, lack of money and the Civil War -- was under construction, off and on, for 36 years. Critics worried that the Jefferson Memorial’s Parthenon design would compete with the Lincoln Memorial. The FDR Memorial was built after nearly half a century of debate.

Gehry produced a design revision in May that keeps the young Ike and the screens but adds sculptures of Eisenhower later in life, along with limestone blocks with quotations.

Better but not enough change, the family and other critics said. They want a simpler, scaled back, less expensive memorial that reflects the values Eisenhower held dear.

They’re right. Drop the gigantic, ultra-modern screens and let the memorial honor Ike and the future good of America.

©2012 Marsha Mercer. All rights reserved.


Thursday, July 5, 2012

Derecho isn't cool but what about Obama and Romney -- July 5, 2012 column

At last, Democrats, Republicans and independents agree on something.

Most people, regardless of their political leanings, believe the presidential election is annoying and it will be exhausting, the Pew Research Center reported this week.

Pew confirmed what the rest of us already suspected. Presidential campaigns are important but they last too long.

My guess is people are more interested in the split between Tom Cruise and Katie Holmes than in the differences between Mitt Romney and, well, Mitt Romney.

Maybe it’s time to give the raging debate between Romney and himself a rest, even if it is rare to see a presidential candidate devote so much energy to refuting his own success. Romneycare, the health care plan Governor Romney brought to Massachusetts and the model for Obamacare, is working.

Summer has brought a new word to the national vocabulary and has given a makeover to another.

Many Americans on the East Coast learned last week that derecho means a catastrophic windstorm that will carry you straight back to the 19th century – and not in a good way.

The official definition says a weather event can be classified as a derecho, pronounced “deh-REY-cho,” if the wind damage swath extends more than 240 miles and includes gusts of at least 58 mph.

A “super derecho” swept across the Midwest and mid-Atlantic, bringing a line of severe thunderstorms and strong winds that felled thousands of trees, toppled countless power lines and plunged about 4.3 million electric customers into a hot and dark pre-plug Hades for days on end.

The term derecho was new to many in the mid-Atlantic but it’s been around for more than a century. In 1888, a professor at the University of Iowa, Gustavus Hinrichs, used it to describe severe thunderstorms that hit Iowa in July 1877. In case you’re wondering, derecho means direct or straight ahead in Spanish. Hinrichs taught modern languages before he taught the physical sciences. Those were the days.

That’s cool, you might say. But what would you mean? Cool, it turns out, isn’t what it once was. And that could have implications this election year.

“James Dean is no longer the epitome of cool,” says a University of Rochester Medical Center psychologist with the unlikely name of Ilan Dar-Nimrod.

To think of cool today, forget Miles Davis, he says. Forget being distant, tough, rebellious, and in-control emotionally.

Dar-Nimrod says he was the coolest kid on his block at 13 when he bought his first pair of sunglasses because the shades gave him distance and kept his emotions secret.

He led a study over several years and found the perception of cool has changed. The results, just published in the Journal of Individual Differences, found that among young people, it’s cool to be friendly and nice.

“The main thing is: Do I like this person? Is this person nice to people, attractive, confident and successful? That’s cool today, at least among young mainstream individuals,” he says.

Defining what’s cool today may seem frivolous, but consider this: If Dar-Nimrod is onto something, the new concept of cool could predict how the presidential candidates connect -- or don’t -- with younger, campaign-weary voters, especially independents.

Dar-Nimrod didn’t extrapolate to the current presidential race, and he conducted his research on young people in Vancouver, British Columbia, so it’s not clear how the findings square with young people here.

But we know that President Barack Obama is famously cool in the old sense: detached, non-emotional and remote. Romney, the golden retriever of candidates, is ever friendly, always trying to please, so much so that he flip-flops to win voters.

And then there’s the passion quotient. These days, Dar-Nimrod says, being passionate is considered cool. Obama has been criticized for losing the passion he showed in 2004 in his speech at the Democratic National Convention.

Ann Romney came out passionately for her husband this week, criticizing the Obama campaign. Is that the kind of intensity voters want in a first lady?

So who’s cooler – Obama or Romney? It’s up to the voters. We may not know until Nov. 6.

(Marsha Mercer writes from Washington. You may contact her at )

© 2012 Marsha Mercer. All rights reserved.