It’s Time To End Gridlock and Provide Everyone Affordable Health Coverage

By Health Care for America Now (HCAN) Blog

Last week, Republicans who control the Wisconsin legislature killed the latest attempt to expand Medicaid in the state. In blocking Medicaid, the state gave up $1.6 billion in federal funding and denied coverage to 90,900 Wisconsinites.  

Wisconsin is not the only state where Republicans are denying uninsured people health coverage.The Missouri’s governor and legislature have refused to implement the 2020 ballot measure to expand Medicaid that was approved by more than 53% of Missouri voters and supposed to take effect on July 1st.Earlier this year, Republicans leading the Kansas legislature defeated efforts by Governor Laura Kelly to expand Medicaid in that state.

In addition to Missouri and Oklahoma, where voters have approved ballot measures that have yet to be implemented, twelve states continue to block efforts to expand Medicaid coverage to the residents of their states that are eligible under federal law.  In South Dakota, where health advocates have already gathered over 10,000 signatures to put Medicaid expansion on the ballot after years of gridlock, state lawmakers led by Republican Governor Kristi Noem have gone so far as to try and change the Constitution to prevent 42,000 South Dakotans from getting health coverage. 

Medicaid expansion has reduced the number of uninsured by millions

Before the Affordable Care Act went into effect, 44 million people in the United States were uninsured. The ACA brought the number of uninsured people to historical lows, by making coverage more affordable for people buying policies in the ACA marketplaces and by increasing funding and expanding eligibility for Medicaid coverage in states.  In the law’s first decade, 20 million people gained health care coverage, most through Medicaid which provided insurance for more than 12 million more people thanks to the ACA. 

Millions more are eligible for Medicaid coverage, but Republicans are blocking access

But the ACA has yet to be fully implemented in every state. So far, thirty-eight states and the District of Columbia have expanded Medicaid coverage. In the remaining twelve states, state legislatures controlled by Republicans are blocking coverage for four million nonelderly adults without insurance who  would be able to get Medicaid if they lived in a different state. 

Medicaid access improves health outcomes and increases economic security. Since the ACA was enacted,Medicaid has saved at least 19,000 lives. If all states had expanded Medicaid, the number of lives saved just among older adults in 2017 would have rivaled the number of lives seatbelts saved.  Medicaid enables people to get regular preventive care, to get treatment for chronic health conditions like diabetes and high blood pressure and Medicaid is the leading payer of mental health and addiction treatment services. 

There are also significant financial benefits from Medicaid expansion. Fewer low-income adults in Medicaid expansion states struggle with medical debt and low-income renters in those states are less likely to face eviction. Medicaid expansion is associated with less debt, better credit, and increased savings.  People who gain coverage from ACA expansion have reported that it’s easier for them to find and keep jobs.

It’s time to close the coverage gap once and for all. 

President Biden’s American Rescue Plan increased incentives for states to expand Medicaid and provide enhanced services. .States would collectively receive almost $10 billion MORE than it would cost to expand Medicaid over the first two years alone–but even that has not been enough to overcome partisan politics. Republican lawmakers continue to put their political agenda ahead of healthcare for millions. 

President Biden and the 117th Congress must take stepped up action to ensure that everyone who is eligible for coverage, no matter where they live, how much money they have or which political party they voted for, can get access to affordable health coverage they need to recover from COVID, get basic services and take care of their families. 

Georgia Senators Warnock and Ossoff are urging the Administration to intervene with a federal fix to the coverage gap in the upcoming Build Back Better plan saying in a letter, “The federal government, which already funded coverage for these individuals through the Affordable Care Act, has a responsibility to step in and help these citizens who have been left behind by their state leadership.”

As the nation recovers from the worst public health crisis in generations and seeks to address gaps exposed by the crisis, there has never been a better time to ensure that the future of healthcare fully addresses the needs of every American and equips us all for a healthier and more secure future. 

The Looming Supreme Court Decision on Abortion

By Health Care for America Now (HCAN) Blog

On Monday, the Supreme Court announced that, next term, it would hear a challenge to a 2018 Mississippi abortion law, which conservative legal scholars have said provides an opportunity to overturn Roe v. Wade, the landmark decision that ensures civil rights for pregnant people. The Mississippi law mirrors a Louisiana statute that the Supreme Court ruled unconstitutional in a 5-4 decision just a few years ago. But the Supreme Court has changed. 

Justice Ruth Bader Ginsburg passed away and was succeeed by Justice Amy Coney Barrett, who President Trump appointed to court largely because of her anti-abortion ideology. Barrett’s confirmation as a Supreme Court Justice skewed the balance of the Supreme Court, creating a 6-3 conservative majority that could very well endanger Roe v. Wade despite decades of past precedence that protects legal abortion for everyone. 

Access to safe, affordable abortion is a health and economic issue that affections millions of people. One in four women in America today have had an abortion by age 45. Nearly wo-thirds of the women who have abortions have already had at least one birth and 75% are low-income or poor. Research shows that forcing people to delay abortion, denying them abortion and forcing them to expand their families before they are ready has negative long-term consequences for the pregnant person and for their families. 

How could abortion access change if Roe v. Wade is overturned or restricted?

If Roe v. Wade were overturned, abortion would likely become illegal in at least 22 states right away making it a crime. The closest abortion provider to more than 40% of women in the United States would close. The average distance individuals seeking abortions would have to travel could increase by more than 200 miles creating a huge burden for low income women who are seeking this service and effectively denying abortion access to anyone who doesn’t have the money, time and opportunity to exercise this option. 

Even if the court decides not to overturn Roe v. Wade directly, however, the restrictions they might allow could dramatically restrict access to abortion. When Texas instituted onerous restrictions in 2013, the number of legal abortions fell by more than half in 20% of Texas counties. The restrictions were particularly damaging to abortion access for Hispanics and low-income patients in the state. 

While Roe v. Wade is primarily known as the case that established abortion rights as implicit in the 14th Amendment’s privacy protections, but it also protects the civil rights of pregnant people more broadly by clarifying that fetuses do not have separate rights under the law that supercede those of the pregnant person. Abortion opponents have long sought to overturn the law and create legal fetal personhood, which could have tremendous consequences and result in criminal punishment for pregnant people and not just for abortion. Any behavior that is deemed a danger to the fetus could become a crime–from miscarriage to addiction to even failure to wear a seatbelt.  Without Roe v. Wade, courts could also restrict a pregnant person’s right to “due process of law, informed consent, bodily integrity, liberty and life.” 

Do Americans Support Turning Abortion Into a Crime?

Americans have a complicated view of abortion, but they overwhelmingly oppose overturning Roe v. Wade. At the same time, a significant number also support increased restrictions on abortion and some even support more extreme views. Over half of Republicans support prosecuting doctors or providers who provide abortions.  Nearly half of Republicans also support legal punishment for people who have abortions even thought incarcerating women for abortion takes them away from their other children and breaks up families. 

As we wait for the SCOTUS decision, it’s important to consider what women will lose if Roe v. Wade is overturned and how people will be able to exercise fundamental decision-making power over whether or when to start a family because of these changes. Abortion is basic healthcare. Like other healthcare services, taking it away from people can only have negative consequences for themselves and their families. 

The ARP includes robust opportunities to expand Medicaid in states that need it most – like North Carolina. Giving millions to states to expand Medicaid with enhanced funding to weather the ongoing covid impact.

By Naomi Randolph, Action NC Blog

The pandemic has hit North Carolina hard, including people I love. I have watched friends, family and neighbors struggle and I know I’m not the only one. More than 11,000 North Carolinians have died from COVID and that doesn’t take into account those of us experiencing the effects of the economic crisis the mishandling of the pandemic has caused.

The impact in the Black community in North Carolina has been especially devastating. We are more likely to work in frontline jobs that don’t allow us to work from home, which has put us more at risk. We have contracted COVID-19 at a higher rate and our loved ones have died at a higher rate. We have also been more likely to lose our jobs, our small businesses, and to remain among the long-term unemployed.

The pandemic has only exacerbated the racial inequality that has long plagued our state. Black North Carolinians are much more likely to be uninsured and would disproportionately benefit from expanding Medicaid, if and when the state legislature finally agrees to do so. Maternal mortality among Black moms in North Carolina is also devastatingly high. All of these factors will have a generational impact on our lives.

North Carolina’s overall rate of maternal mortality is slightly lower than the national average, at 27.6 per 100,000 births. But, the rate is much higher for Black women in North Carolina – 56.8 deaths per 100,000 births. Black women are three to four times more likely to die from pregnancy-related complications, according to the CDC (Centers for Disease Control).

Black women are also twice as likely to lose an infant to premature death. Infant mortality for black babies, defined as when a child dies before reaching her first birthday, is about two-and-a-half to three times the rate for white women. For every woman who dies, the National Institutes of Health say 70% more experience “near misses” that lead to significant short-or long-term consequences to a woman’s health.”

President Biden’s American Rescue Plan (ARP) directly addresses many of our challenges. The law will make healthcare more affordable for millions of people. It creates significant incentives for states to expand Medicaid to cover uninsured people. More than 404,000 North Carolinians could finally get coverage, including many who have been most impacted by COVID. ARP also provides North Carolina the option to extend coverage for new mothers for a full year from the current 60 day limit. More time to recover and regular care after birth give mothers and their babies a better chance for a healthy future.

All of these policies are steps in the right direction when it comes to guaranteeing more people healthcare coverage and addressing racial disparities that result in higher maternal and infant mortality for Black people. But President Biden and Congress can do a lot more.

They can make permanent the features of the ARP that make healthcare more affordable and accessible in the next package as well as make major new investments in childcare, family leave, jobs and other key economic stimulus policies that also factor into racial equity and health. To make it possible, President Biden must keep his promise to finally make the rich and corporations pay their fair share of taxes so that we can make these long-term investments to build back better for everyone, no matter what they look like or where they live.


It’s the 11th Anniversary of the Affordable Care Act, But We’re Not Done Yet

By Health Care for America Now (HCAN) Blog

As the United States edges toward 30 million reported cases of COVID-19 this week, the Affordable Care Act (ACA) celebrates its 11th year. On March 23rd, 2010, President Barack Obama signed the landmark legislation into law as the most sweeping reform in healthcare since the 1965 enactment of Medicare and Medicaid. The Affordable Care Act brought the number of uninsured people to historic lows by extending insurance to over 20 million more people, created new rules that for the first time protected over 135 million Americans with pre-existing conditions from being overcharged or denied coverage and improved the quality of coverage by implementing no cost preventive services and requiring coverage of essential health benefits like mental health services and maternity care in every policy. 

The importance of the ACA has become even more apparent during the pandemic and the economic crash that it caused. In recessions before the ACA was enacted eleven years ago, workers that lost their jobs and employer-provided health insurance had limited options. In 2020, millions of people that would have otherwise been forced to be uninsured signed up for coverage via the ACA marketplace or Medicaid, options that didn’t exist or were much more limited before the Affordable Care Act. 

But we’re not done yet. There’s much more to do to guarantee that everyone in America, no matter where they live, what they look like, what their health conditions are or how much money they have will get equitable access to quality affordable health care. In his campaign for President, Biden outlined some of his goals for strengthening and improving the ACA including increasing affordability and access. In his American Rescue Plan (ARP) relief bill that passed in early March, Biden is already putting the plan into action. 

The ARP makes healthcare on the ACA marketplace more affordable for people of all incomes, extends coverage to the unemployed at no cost and includes big incentives to expand Medicaid in the dozen states where the law hasn’t been implemented. The ARP also provides states more funding and flexibility to use Medicaid for extended postpartum coverage for new moms, for COVID testing, vaccines and treatment for the uninsured and for expansion of home and community-based health care. 

The ARP enjoys high public support across both parties, but every Republican in the House and Senate voted against passing it despite the critical healthcare, direct payments to families, small business aid and direct payments to families in the bill. Many of these same Republicans also voted to repeal the ACA over the past four years.  At the same time, they supported Trump’s tax law, which gave $1.9 trillion in tax breaks mainly to the wealthy and corporations, while cutting ACA and Medicaid. 

Helping the rich get richer cannot be a legislative priority if our country is to recover from COVID and build back a better economy in which everyone has the opportunity and freedom to prosper and take care of their families. During the first 10 months of COVID, the 660 billionaires in the United States increased their wealth by $1.1 trillion dollars. That’s nearly a 40% increase in less than a year, while most people have been struggling to afford health care, prescriptions, childcare, rent and food. 

To make the improvements to healthcare affordability in the ARP permanent and ensure more people have health care coverage they can count on, President Biden and Congress must require wealthy households and corporations to finally pay their fair share of taxes so we can invest in quality, affordable health care for everyone. President Biden can deliver on his promise to “build back better” by putting #healthcareoverwealthcare in the coming stimulus package, building on the ACA, Medicare and Medicaid and holding drug and insurance corporations accountable for their price-gouging. That will give us even more to celebrate next year.

Rural families are in need of a rescue too

By Mayor Daniel Corona Blog

By Mayor Daniel Corona
West Wendover, NV

For the better part of a year, since the pandemic began, it’s been the responsibility of state and local leaders to take action on protecting their constituents. Whether it’s issuing public health directives in accordance with CDC recommendations or establishing programs and task forces to address economic security for families and businesses alike, it’s been our priority to make sure Nevadans are safe and healthy. In West Wendover, for example, we immediately paused shutoffs for nonpayment of City-run utility bills, and worked to ensure that our local food pantry and senior center had enough funds to keep those who are the most vulnerable in our community fed. But these initiatives don’t come without a cost. Congress must pass President Joe Biden’s American Rescue Plan to ease the financial strain of COVID-19 on states and local municipalities and on the pocketbooks of Nevada families.

As we steadily and safely reopen our state’s businesses and public amenities with the need to protect public health, we must also remember that it’s our workers on the frontline who are in the most need of additional help. These don’t just include health care providers and medical staff, but educators, janitors, and all matter of public servants as well. These folks have gone 10 months since the CARES Act Relief Fund passed in Congress, which included resources to aid frontline workers. Now that those resources are drying up, these workers risk losing their jobs and their livelihoods without further aid. In West Wendover, the entity that oversees parks & recreation is almost entirely funded through room tax revenue. This pandemic has pushed them to their limits and without assistance to help recuperate their losses in revenues, many programs that the youth in our community rely upon will potentially have to be cut or scaled back. 

Further, our state, counties, cities, and school districts are in dire straits as well. The chaotic nature of the previous administration’s initial response to COVID-19 left state and local officials with the daunting task of coordinating finite resources as best we could as the crisis unfolded in real time. This has led to damaging cuts to public services and public sector workers, leading to a backlog of public projects unfinished, furloughs and layoffs, and local municipalities being less helpful to the people they serve. West Wendover, thankfully, fared well without any layoffs or furloughs, but other jurisdictions around the state may have had a much different experience. We have had to delay a planned recreation center since it is funded primarily by room tax revenues which have taken a major hit. est Wendover thankfully fared well but that you can’t speak for other municipalities in the state. 

Under our new leadership at the federal level, it must be an immediate priority for Congress to pass the President’s COVID-19 relief package. The Economic Policy Institute (EPI) and others have argued persuasively that insufficient support for state and local services after the 2007 Great Recession slowed the recovery to full employment. We cannot repeat this same mistake. 

The American Rescue Plan would help rural communities like West Wendover support its frontline workers, its small businesses, and our public services to help us all get through this crisis and recover together. Even further, it will help us have the resources needed to distribute the COVID-19 vaccine and get our city back on track. As a community that relies heavily on tourism, it is imperative that the resources for widespread vaccination become available without delay so that we can fully open and get our community members back to work safely! I hope you will join me in urging Congress to immediately pass the American Rescue Plan for the well-being of our home here in West Wendover, and for Nevadans across the state.