Thursday, February 19, 2015

HCA's King v. Burwell brief notes dramatic success of ACA for women

Last week, I wrote about the amicus brief in the King v. Burwell case that was filed by Hospital Corporation of America, the nation's largest private-sector provider of medical care. The brief concludes that the arguments of the plaintiffs, who are attempting to strip federal exchange Obamacare subsidies from some 7 million people, defies logic. So far, so good.

A detail of the brief, however, elaborates on a specific policy success of the Affordable Care Act's federal exchange: demonstrable improvements in access to health care for women. As the original brief explains, one of the main goals of passing health care reform was to improve access to care for women. To support the claim that denying subsidies on the federal exchange would defeat the entire purpose of the law, HCA compiled data for its facilities operating in states served by federal exchanges, and noted just how much women with federal exchange insurance are benefiting compared to their uninsured counterparts. The data HCA presents is remarkable: for instance, 77 percent of the oncology care given to patients with federal exchange insurance goes to women. 65 percent of HCA's patients insured on the federal exchange are women, vs. 53 percent of insured patients--suggesting that uninsured women are forgoing care at a higher rate than male counterparts. And women with federal exchange insurance are three times more likely to get recommended breast ultrasounds than uninsured patients. So why does this matter? As Emily Crockett at RH Reality Check says:
The brief draws special attention to the health benefits for women insured through the exchanges because Congress also paid special attention to women’s health issues in the Affordable Care Act—like covering women’s health services as “essential benefits,” or banning the practice of charging women more for health insurance. The Supreme Court case determining the fate of Obamacare hinges on what Congress intended when it wrote the law. If Congress intended to benefit women’s health, HCA argues, it can’t possibly have wanted millions of women to go without the essential care they can only afford thanks to the federal exchange subsidies.
When arguing about whose interpretation of a law is correct, context and Congressional intent matters. The statistics HCA brings to the table prove just how successful Obamacare has been at achieving the intent of improving health care for women. CATO's Michael Cannon, by contrast, would apparently prefer to see poor women die slowly from cancer than allow them to afford insurance.

Wednesday, February 18, 2015

California Senate Field Poll: no, Condi Rice doesn't "lead" anything

Many of my California political friends are exercising a fair bit of consternation about the latest Field Poll on the race to claim the California Senate seat currently held by Barbara Boxer. The poll suggests that more people would consider supporting the Republican former Secretary of State, Condoleezza Rice, than would consider supporting the leading Democrats: Attorney General Kamala Harris and former Los Angeles Mayor Antonio Villaraigosa. So does this mean that Rice is all of a sudden a frontrunner and Dems should start quaking in their boots about a seat they might have at first thought was safely theirs? Absolutely not.

To begin with, Rice isn't even a potential candidate at this point. She has declared repeatedly that she has no interest in running. The Sacramento Bee reported that she was informed of the poll results and it did not change her mind one bit about the idea of running. But even beyond that, the way the poll question is worded is they key issue. Instead of saying "if the election were held today, which candidate would you vote for?" and reading a list of names, it simply asks whether or not people would be inclined or not to vote for a particular candidate. Let's take Kamala Harris, the Democrat with the highest inclination ratings at 46%. She has 74% of Dems inclined to vote for her, with 13% not inclined at 13% with no opinion. Her numbers among Republicans are essentially reversed. Rice does as well among Republicans as Harris does among Democrats, but gains a much higher inclination among Democrats than Harris does among Republicans, scoring an inclination of 30.5%. But does that mean that if Rice were a candidate, she could be remotely capable of getting 30% of the Democratic electorate to vote for her in a head-to-head with Harris? Absolutely not. Statistically speaking, it's very likely that most of the Dems who were inclined toward Rice also reported being inclined toward Harris in the poll. When given a choice between a Democrat and a Republican they would be inclined toward, it's very doubtful that all, or even most of that 30.% percent of Dems would choose Rice over Harris. The same could of course be said of the small number of Republicans who are inclined toward Harris, but Rice stands to lose far more ground with Dems than Harris does with GOP voters in this poll.

Furthermore, Rice has a veneer of moderation, which makes her palatable for middle-of-the-road voters and some Democrats. But if she ever did decide to become a candidate, Democrats would undoubtedly spend millions to hang the Bush administration around her neck like an albatross. So first: Rice isn't running. Second, even if she were running, she wouldn't be as much of a threat as the poll implies. And third, even if she were such a threat, she would find herself losing her moderate sheen in short order.

At ease, Californians.

More on California's 25th Senate District: letter from a transgender resident

A transgender resident of Glendale, CA published a letter to the editor in the Glendale News-Press that echoes my thoughts about Zareh Sinanyan. Sinanyan, you may recall, is the current mayor of Glendale, and his city council colleagues somehow saw fit to appoint him as mayor despite his long online trail of horrific racism, sexism and homophobia. Here's the letter in full:
I live in Glendale and I am transgender, but I don’t need to be transgender to not like that my city council has on it Zareh Sinanyan, a guy who was called out for online comments he’d made before his election to the council that were deeply misogynistic, racist and homophobic. Of course, then the council thought his was such a swell image for Glendale that they made him mayor. Now I see Anthony Portantino, who is in the running for state Senate, has included Sinanyan in his video of endorsements.

I’m not a political beast by nature, but I wonder about this town I live in that thinks this stuff is OK. Ethan Czahor just got canned (“resigned”) for his awful tweets while Jeb Bush’s tech officer, but I think if he’d only come to Glendale he might have a future.

Grey James

I think it's pretty obvious that Portantino has made a political calculation. He would rather proudly claim support from an avowed racist than risk causing any sort of rift in possible support from the Armenian political community. When it comes time for the Democratic Party to make its endorsement, I hope the delegates of the 25th District remember this decision.

Tuesday, February 17, 2015

What will Republicans do for King v. Burwell victims? They have absolutely no idea.

Late last week, House Budget Committee Chair Paul Ryan (R-WI) was asked what Congress would do if the Supreme Court decides to take away subsidies from the approximately 7 million participants the federal Obamacare exchange by ruling with the plaintiffs in King v. Burwell. The answer? They have no freakin' clue:
Republicans are developing a “contingency plan” to address the states whose residents would lose subsidies while lawmakers work on a full replacement for the Affordable Care Act, Ryan, a Wisconsin Republican, told reporters Friday in Washington.
“What’s the bridge out of Obamacare for people in the states that just lost it?” Ryan said during a Bloomberg Television interview Friday. “What we want to do is give the states freedom to let their people go into a patient-centered health care system, which will look like what we would ultimately like to replace Obamacare with.”
In other words: they're not going to issue the technical fix that would allow the law to work the way everyone acknowledges it was intended to work, because the goal has always been to destroy the law. What will they do? They have absolutely no idea, but whatever it is, it will end up being whatever it is that they'll end up drafting to replace Obamacare. Of course, the last "Obamacare replacement" that Republicans came up with wasn't so much a replacement as it was a much crappier version that offered fewer subsidies and eliminated many of the law's basic consumer protections.

Every day, Republicans make it harder and harder for both the Roberts Court and for the general public to take them seriously.

My latest on King v. Burwell

Available at Daily Kos. I have so little respect for Michael Cannon.