Call your senators: might be a vote on health care this week!

If you want to read up on the Senate bill a bit more, here are some good stories about how it slashes Medicaid and will cause premiums to rise for many people to give a tax cut to the wealthy.

Please call today. You don’t have to get in to policy much, just say something like

Hi, my name is <your name>, and I’m a constituent of Senator <senator’s name>. I’m urging <him/her> to vote against any health care bill that would cause tens of millions of Americans to lose their insurance, like the one proposed in the Senate.

If your senator opposed the bill (here’s a handy whip count – note that Senator Cruz is currently opposed!), be sure to say something like “I urge the Senator to stand against the bill even if minor changes are made”, because this is exactly what happened with the House bill – they made some small changes and that gave cover for representatives to vote for it.

Senator Cornyn’s numbers are: (512)469-6034 (Austin office) and (202)224-2934 (DC office)
Senator Cruz’s numbers are: (512)916-5834 (Austin office) and (202)224-5922 (DC office)

Texans: call Senators Cornyn and Cruz to save healthcare!

A few weeks ago, the House passed the AHCA (aka TrumpCare, aka the American Health Care Act), which is terrible for reasons I’ve gone into before. (why it’s bad, why essential health benefits are good) The CBO scored the bill and estimated that 23 million people will lose their health care if the bill passes, and people with preexisting conditions may have to pay higher premiums (like, way higher). It is bad!

The Senate is now working on a health care bill – they say they’re going to “start from scratch”, so who knows what they’ll come up with. Also:

Senators Cornyn and Cruz are both involved in this effort (per item 2 here) – let them know what you think!

I had a hard time thinking about what to say since it’s not as straightforward as “vote/don’t vote for this bill”, but the suggested text from that item is good:

“Hello, my name is [NAME] from [TOWN]. I know the Senator is on the working group of the new healthcare bill. The House’s plan is a disaster. The ACA isn’t perfect, but it has expanded access to coverage to millions of Americans. Does the Senator pledge that the new bill will allow those millions to keep their insurance, and will contain no loopholes for insurers to charge more for pre-existing conditions?”

Senator Cornyn’s numbers are: (512)469-6034 (Austin office) and (202)224-2934 (DC office)
Senator Cruz’s numbers are: (512)916-5834 (Austin office) and (202)224-5922 (DC office)

The Senate is in recess this week so call today!

Why health care isn’t like cupholders (or, why essential health benefits make sense)

Apparently the Republican effort to drastically weaken the Affordable Care Act isn’t dead after all, maybe. So I thought it would be a good idea to take a look at one of the issues that came up last time – getting rid of essential health benefits.

Essential health benefits are a list of 10 things that every health care plan is required to cover. (this was a new requirement under the Affordable Care Act) They include things like:

  • hospitalization and emergency care
  • maternity/newborn care
  • prescription drugs

and more. The libertarian/small-government conservative view of this is presumably something like:

Why should the government mandate what you can offer in a health plan? Let the free-market figure it out – if people don’t like what’s in a plan, they won’t buy it and the company will change it to improve sales.

or something along those lines. (I’m trying to make a good-faith representation here – if an actual libertarian wants to correct me, feel free!)

Here’s what I don’t think that makes sense.

Let’s say the government wanted to pass a law (because everybody loves cupholders!) that requires every new car sold to have at least two cupholders. This seems unnecessary for the following reasons:

  1. People know whether they want cupholders in their car
  2. It is exceedingly obvious how many cupholders a car has
  3. There are many car companies, so if a car company refuses to make a car with cupholders other car companies will step in to make cars with cupholders, because they will make more money doing so

Now, back to health care.

  1. The problem with health care insurance is that it’s not a good. If you never have to use your insurance, you’re happy! But you don’t know what kind of health problems you’re going to have over the next year, so expecting people to predict what health care problems they’re going to have and buy the appropriate insurance is pretty unreasonable.
  2. There were many stories before the ACA about people who bought insurance and then were surprised when it didn’t cover something catastrophic. Now, you could certainly argue that it’s the person’s fault for not reading details about their coverage closely enough.

    Here’s another way to think about it. In some poorer countries the water they get is contaminated with various microbes, and aid groups distribute chlorination tablets to make the water drinkable. People in those countries have to remember to use the tablets every time, or they’ll probably get sick. This is a mental burden on them even if they never forget to treat their water. In the US we can afford to provide clean water to everyone, and everyone benefits from it. (I think this example is from Why Nations Fail but I’m not sure)

    Having insurance that doesn’t cover what you think it covers can literally send people into bankruptcy. Yes, this makes premiums more expensive, but that’s why the ACA includes subsidies to help lower-income people afford insurance.

  3. There aren’t a ton of insurance companies, but more problematic is the idea of a “death spiral”. Let’s say company Gold provides a generous insurance plan that covers all sorts of treatments, etc. with a higher premium, and company Bronze provides a very bare-bones insurance plan with a lower premium. If I think I’m a healthy person with a Gold plan, this will make me want to switch to a Bronze plan since the premiums are cheaper. That means that the average person on the Gold plan is now less healthy, which means company Gold will have to raise their premiums to compensate. That will in turn drive more healthy people to leave the Gold plan, and the spiral has begun.

Hopefully this gives you an idea why essential health benefits are a good idea!

Obamacare survives! Some mostly jubilant thoughts

Yay! Here’s one of many articles covering it.

– While part of the problem was the House Freedom Caucus thought the bill didn’t do enough, there were also a chunk of moderates that wouldn’t support it. I saw a number of quotes from people saying they were getting thousands of calls against it and single-digit number of calls for it. Calling your representative can work! See:

– The bill itself was very unpopular (this poll had it at 17% approve 56% disapprove, and that was before they got rid of the essential health services!), which I guess isn’t surprising for something that would have made 24 million people lose health insurance in the next 10 years. This is a good example of how passing Obamacare moved the Overton window – just repealing it wasn’t acceptable to even most Republicans since so many people would have lost insurance.

– Margins matter. The estimates of how many votes the Republicans were short is in the neighborhood of 15 or so when it was closest to passing. If the Republicans had 30 more seats in the House it easily could have passed. (although who knows what would have happened in the Senate…but again, the Republicans have a very slim majority there)

– We’re going to lose a lot. It was great (and important!) to win this battle, but the Republicans still control the House, Senate, and Presidency, so I wouldn’t be surprised if they pass some terrible tax bill or whatnot. So don’t lose hope when this happens, and don’t give up!

why you should oppose the Republican health care bill (aka the ACA “repeal and replace”)

If you want to read the bill itself, you can do so at the clever URL ReadTheBill.gop. I tried to get through it and gave up – it’s 120 pages and not the easiest thing to read. But I do appreciate having the bill easily available!

If you want to read articles by people smarter than me, here’s a pretty good summary, and here’s an article wondering why the bill exists because both conservative and moderate Republicans are unhappy about it for different reasons. And here’s a roundup of how people are responding to it.

Here are some weird/bad things about it:

If you don’t have insurance through your employer, poorer people will get less of a subsidy/tax credit, and richer people will get more – see here for a chart with some samples. The original bill would give a tax credit to everyone (without employer health insurance) based solely on age, so Mark Zuckerberg and I would get the same amount. Now they added some phasing out based on income, so Zuckerberg won’t get anything. But it’s still less progressive than the ACA, and people are worried that more low-income people won’t be able to afford insurance at all.

We don’t know how much it will cost or how many people will lose coverage because the Republicans are voting on it out of committee tomorrow – the plan was released yesterday and they want to vote on it tomorrow! They’re not waiting for the Congressional Budget Office to “score” it, which is awfully suspicious. An expert suspects 15 to 20 million people would lose coverage under the bill.

The individual mandate is gone, but if you stop coverage and later want it your premiums will go up 30% which is just weird. One big problem you have to worry about in healthcare is that people will not buy insurance until they get sick, then they’ll buy it to cover procedures, etc. This can lead to the feared “death spiral” where more healthy people drop their insurance, which makes premiums go up, which makes more healthy people drop their insurance, etc. Pre-ACA insurers dealt with this by either refusing to cover people with “preexisting conditions” or raising their premiums sky-high. The ACA attempted to solve this with the mandate, which says you have to have insurance or pay a penalty. But raising someone’s premium by 30% is probably not enough to dissuade people from doing this.

There’s a sweet tax break for insurance company executives that make more than $500K because it wouldn’t be a Republican bill without a tax break for the rich, I guess?

Six pages of the bill deal with keeping lottery winners off of Medicaid which really threw me for a loop when I started reading the bill! (more coverage here)

Here’s what you can do about the pseudo-#MuslimBan

On Friday, President Trump signed an executive order banning immigration from seven countries. This included US green card holders from those countries who happened to be out of the US at the time, which led to chaos at US airports before some of the executive order was stayed.

(it’s not technically a ban on Muslim immigration, but Rudy Giuliani has admitted that was the intent, and they crafted it to try to make it legal)

This is unprecedented. Here’s an admittedly conservative commentator about why this is both malevolent and incompetent. I spent a lot of yesterday in intermittent despair, but today I’m ready to do something about it. Here are some things you can do:

  • Call your representative and senators: Wait, come back! I know this sounds intimidating, but it really doesn’t have to be. There’s a very helpful step-by-step process for this at 5calls.org! Or read on for some common objections:
    • I don’t know who they are or how to reach them! – See usecalltoaction.com to look up your representative and his/her phone number. To find your senator, you can look them up by state at senate.gov.
    • I don’t know what to say! – Yeah, this was my big obstacle for a while. But you don’t have to be particularly eloquent and it doesn’t have to be long. Try this:

      Hi, my name is and I’m a constituent from . I’m calling to urge Senator/Representative to stand against President Trump’s cruel and unAmerican executive order on immigration. Thank you for your time.

      Feel free to add more at the end, but be polite since you’ll be talking to a staffer!

    • My representative/senator is a Republican, of course they’re going to support it, why should I bother? – Not so fast! Not many Republicans have said one way or the other where they stand on it. And you can read more in this guide written by former congressional staffers, but representatives do keep track of calls for and against issues. Trump’s popularity is already pretty low, so it’s not inevitable that Congresspeople are going to stand behind him!
    • My representative/senator is a Democrat, of course they’re going to oppose it, why should I bother? – Well, according to the same chart there are still some Democrats that haven’t made a statement about it. And if they have, thanking them for doing the right thing will encourage them to do so in the future. (see again the guide written by former congressional staffers)
  • Contact your representative and senators on social media – This is less helpful than a phone call, but still valuable. My representative Bill Flores actually responds to tweets, although that seems pretty rare. Again, this doesn’t have to be particularly eloquent; here’s mine:
  • Give to the ACLU – The American Civil Liberties Union filed a lawsuit against the executive order and won, which stopped some people from being deported. They’re making a real difference – help them!
  • Register to vote – Keith Ellison reminds us that elections are coming soon – if you’re not registered, here’s where you can get started.
  • Help a burned-down mosque in Victoria, TX – So this isn’t directly related, but early Saturday morning a mosque in Victoria, TX burned down. They’re still investigating the cause, but it certainly seems suspicious based on the timing. They have set up a GoFundMe to raise money for rebuilding – show them that Americans of all faiths stand with our Muslim brothers and sisters!
  • Tell others what’s going on – Taking these actions privately is good, but leading by example is better. It’s been such a chaotic week that your friends may have missed this. Let them know what’s going on, why it’s terrible and frightening, and what they can do!

And as always, don’t let yourself get overwhelmed. I must have checked Twitter a hundred times yesterday (as you can probably tell by all my retweets :-/) and by the end of the day I was feeling pretty despondent. Sadly, my usual distraction of reading a book on my Kindle didn’t help much because it’s about politics, so I found other things to do. Playing with a baby is recommended 🙂 as is seeing how many people are giving to help rebuild the mosque in Victoria!

why this whole crowd size thing is a big deal

Background: here is an example news story showing that Obama’s inauguration certainly appears bigger that started this whole kerfuffle, and the story about Press Secretary Sean Spicer lying about said crowd size among other things. (kudos to CNN for the title “White House press secretary attacks media for accurately reporting inauguration crowds”)

First of all, in terms of ranking presidents, “crowd size at inauguration” is really really unimportant. It’s probably biased towards Democrats since DC itself is very Democratic and so is Maryland (and northern Virginia, at least), and you have to be able to take a day off from work, and the weather, etc, etc, etc. It is also not a huge surprise that Trump cares a lot about it, though.

The way I see it this is both good and (mostly) bad:
– The bad news, obviously, is that we have apparently have an administration/press secretary that is willing to lie to the American people right out of the gate. So that’s not great.
– The good news is that, instead of being devious about this, 1 day into the administration we know we can’t trust them. If they had been truthful for a while and then starting lying about intelligence when we were about to go to war, they would have some credibility. Now we can know not to trust them, and hopefully the media will not be cowed into unskeptically reporting lies.

Also kudos to the Dallas Stars Jumbotron operator! (thanks Adam!)