Tag Archives: Affordable Care Act

Use Post Offices to Turn Obamacare Enrollment Into a Smashing Success

7 Nov 2013 By in Ideas Tags: , , , 2 Comments

Remember that vast chain of derided properties that the US postal service owns?  Have you recently driven or walked past a post office?  I bet that you have.

With some 32,000 post offices in virtually every inhabited corner of the country, the postal service offers a nexus for interacting with the public that few other federal entities can rival.  For this reason, in the past US post offices have sometimes been made to serve double duty.  Until recently, the IRS used the post offices to make printed tax forms available to taxpayers.  The Selective Service has used the post office for decades for draft registration.  Post offices house passport services on behalf of the State Department.  Historically, the post office has been the communications hub connecting the government at Washington with the people at large.  The local, face-to-face character of the post office makes it ideal for placing an initiative within reach of the people.

Now, the Department of Health and Human Services could use the post offices to facilitate Americans’ enrollment in ACA-compliant health-insurance policies listed on the federal insurance exchange.  Even if the HealthCare.gov website were fixed overnight, most citizens could still use help figuring out how to apply—how to negotiate the website—their eligibility for subsidies—that sort of thing.  Given all the concern about the under-utilization of post offices as federal property, pressing them into service at this juncture would be a crowd-pleaser—one justified on grounds of efficiency, too.  Teams of HHS and IRS personnel (or even volunteers from Americorps) could be enlisted to staff these physical exchanges, where citizens could learn about the policies and sign up for them, with the aid of old-fashioned paper forms, if need be.  The New York Times recently reported on the success of one such face-to-face state-level system in Kentucky.

I sincerely hope that the Administration will think more creatively about how to bring Obamacare’s promises to the public without more delay.  Given the vast resources of the government, there is no single right way, but many ingenious strategies that will advance the nation toward attaining health-care coverage for all.

© 2013 Susan Barsy

The GOP obstructionists

3 Oct 2013 By in Affordable Care Act, Republican extremism Tags: , , , , , , , , , 4 Comments

Who are the obstructionists intent on defunding Obamacare and delaying its implementation?

I appended to Monday’s post on Republican Fire-Eaters this list, compiled by fellow blogger Eric Prileson, giving the names and phone numbers of the 228 Republicans and 2 Democrats who passed a House spending bill to this effect on September 20.

The determination of the House to “hold up” the government until the Affordable Care Act is modified to its liking solidified when House Speaker Boehner and other G.O.P. moderates decided, once again, to cave in to the far-right members of their party.  The 80 radical Republicans leading the charge have been nicknamed the “suicide caucus”–an apt coinage highlighting their resemblance to a terrorist group.

As Thomas L Friedman and others have noted, this group is a minority with some striking geographical and sociological peculiarities.  I encourage you to read Ryan Lizza’s geographical analysis of the suicide caucus, recently published on the New Yorker website.  Accompanying it is a dandy map, based on data from The Cook Political Report, showing the “upcountry” character of the caucus’s constituency. Click on the map to go to its source.

congressdistricts_final-01.png

Lizza:

The geography of the suicide caucus shows . . . [that] half of these districts are concentrated in the South, and a quarter of them are in the Midwest, while there’s a smattering of thirteen in the rural West and four in rural Pennsylvania (outside the population centers of Philadelphia and Pittsburgh) . . . . there are no members from New England, the megalopolis corridor from Washington to Boston, or [from] along the Pacific coastline.

These eighty members represent just eighteen per cent of the House and just a third of the two hundred and thirty-three House Republicans. They were elected with fourteen and a half million of the hundred and eighteen million votes cast in House elections last November, or twelve per cent of the total.

The districts represented are also whiter than the nation as a whole.

The South, where many of the obstructionists live, is home to some of the nation’s unhealthiest populations.  Most Southern states, under Republican control, have decided against implementing the ACA-funded expansion of Medicare that might have benefited their neediest citizens.  This interactive map, published in today’s New York Times, shows the millions of people who will be affected by their choice.

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Minorities, if sufficiently intransigent, can cause great harm if the majority fails to neutralize or contain them, leading to a frightful dynamic that President Lincoln, long ago, most eloquently described.

Republican Fire-Eaters

30 Sep 2013 By in Republican extremism Tags: , , , , , , , , 3 Comments

Political cartoon from Puck, showing various political types, including the "fire-eater" (Courtesy Library of Congress)

In politics, as in the circus world, a fire-eater is a performer who will swallow fire to attract a crowd and earn a living.  This aptly describes the tawdry crowd of grand-standing Republicans threatening to shut down the federal government today.

Their behavior resembles nothing so strongly as that of radical pro-slavery men, who, before the Civil War, threatened angrily to secede from the Union whenever the federal government wasn’t going their way.  Antebellum fire-eaters pretended to be great patriots and high-minded constitutionalists while actually serving the retrograde interests of a minority.

So it is with today’s right-wing Republicans, whose aversion to President Obama and health-care reform is so intense as to drive them along a reckless and self-defeating course.  Ted Cruz is, if anything, more self-serving and sophomoric than leading pro-slavery apologists–men such as William Lowndes Yancey of Alabama or Robert Barnwell Rhett of South Carolina–whose parochial defense of slave-holding and states’ rights marred careers as distinguished as any in their day.  In the end, these men could not love the United States more than they loved holding slaves, leading them to sacrifice true patriotism to an ignoble cause.

By now it has dawned on many Americans that those in Congress intent on derailing Obamacare at all costs are more like demagogues than patriots.  In their stubborn attempt to thwart the inclinations of a national majority, stand in the way of progress, and sabotage the federal government, Cruz and his ilk recall the secessionists whose noblest vision was to arouse local populations to follow them.  Intent on justifying their contempt of the federal government with high-toned ideas, the first fire-eaters used every conceivable means they could to oppose the federal government and the will of the majority, ultimately succeeding in persuading their fellow-citizens to withdraw from the Union and take up arms.

So it is with the current Republican spoilers, laboring unceasingly to deprive Americans of access to the new ACA-mandated health-insurance plans.  Don’t they realize that most Americans are tired of extremism, tired of factions intent only on undoing?  Republican fire-eaters would be better off quitting the circus and getting down to the sober, un-sensational business of governing.

Image: A 1900 political cartoon from Puck showing various American political types, including the fire-eater at right, courtesy of the Library of Congress.

Want to tell the fire-eaters what you think of their actions?
FOR A HANDY LIST OF THEIR TELEPHONE NUMBERS, COMPILED BY FELLOW BLOGGER ERIC PRILESON,
CLICK HERE

The Next Political Football: Medicaid

6 Jul 2012 By in Affordable Care Act Tags: , , , , , , , , , 2 Comments

Last week’s Supreme Court ruling on the Affordable Care Act has placed a spotlight on the expansion of Medicaid benefits that the legislation envisioned.  Reactions to the Court’s ruling, which gave states the right to opt out of the expansion, again illustrate the state-level differences in our political culture.  Already a number of states, notably Florida, have declared their states will not be going along, while others (including California, New York, and Illinois) have embraced the measure.

THIS INTERACTIVE MAP on the PBS News Hour website allows you to see where each state stands with respect to the plan and the number of eligible recipients who will be affected in each.

Readers may also be interested in the maps below, showing the US House and Senate votes that led to the passage of the health reform bill.  Click on the maps to see larger maps and full legends.

http://upload.wikimedia.org/wikipedia/commons/thumb/5/54/111th_Congress_roll_call_165.svg/256px-111th_Congress_roll_call_165.svg.png

US House vote on March 21, 2010,
by congressional district, showing yeas and nays by party.

http://upload.wikimedia.org/wikipedia/commons/thumb/9/92/111th_Congress_1st_session_Senate_roll_call_396.svg/256px-111th_Congress_1st_session_Senate_roll_call_396.svg.png

US Senate vote on December 24, 2009, by state.

Maps courtesy of Kurykh on Wikimedia Commons.


RELATED:
Susan Barsy, Progress Isn’t Popular, Our Polity.
Susan Barsy, A Decision We’ll All Feel, Our Polity.
Susan Barsy, The Map of Federal Benefits, Our Polity.
Susan Barsy, Help Understanding the Budget, Our Polity.

Progress Isn’t Popular

29 Jun 2012 By in Affordable Care Act Tags: , , , , , , 3 Comments

YESTERDAY WAS a great day for majorities.  A majority of the Supreme Court upheld the majority of the Affordable Care Act, a complex but very necessary piece of legislation that majorities in Congress had passed more than two years back.

Besides the great satisfaction that comes from watching the various branches of our government working in the intricate ways our forefathers envisioned, yesterday’s events furnish an opportunity to reflect on the great courage required of leaders in our contentious democracy.  I hope every congressman and senator who voted for the passage of the ACA will feel more comfortable taking credit for this landmark legislation.

I’m sure the Affordable Care Act is imperfect and that down the line it will need to be tweaked.  But the complex provisions of the law are complex for the very reason that they represent an accommodation: an accommodation of many powerful private interests, institutions and professions, as well as a dizzying range of individual, programmatic, and social needs.  The health-care reform act will affect us all, and it will shift around the burdens of health care in our society; but it marks a path toward a healthier society, so far the only one a majority of our legislators has managed to agree to.

A minority of Americans will continue to rail against our national institutions, and will try to convince the rest of us to hate a measure likely to confer broad benefits on us, both individually and as a society.  May their cries fall on deaf ears, and may they remember that the very foundation of our system is a respect for majority rule.

RELATED:
Susan Barsy, A Decision We’ll All Feel, Our Polity.
David Brooks, Modesty and Audacity, New York Times.

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