Tag: Affordable Care Act

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Opinion The Last Word

The Growing Case for Medicare for All

In her debate with Donald Trump, Vice President Kamala Harris declared, “Access to healthcare should be a right, not a privilege for those who can afford it.” Her stance is laudable, and the reforms she advocated that evening make political sense in a tight presidential race, i.e. widening access to care through the Affordable Care Act (ACA) and extending negotiated drug prices (e.g., insulin capped at $35 per month) to all Americans, not only Medicare recipients. 

But such reforms only go so far in realizing the fundamental value of healthcare as a right belonging to all Americans. The reforms won’t address the inequities and structural problems plaguing our fragmented healthcare system (or “semi-system,” as political scientist Jacob S. Hacker has described it).

This past year, the U.S. experienced a national medical emergency affecting millions of Americans. Known as the “Great Unwinding,” this underreported emergency entailed the disenrollment from Medicaid of 23 million Americans, many of them children. Medicaid, the joint federal-state program providing healthcare coverage to poor Americans, had put millions of people on continuous coverage as a result of 2020 legislation passed at the outset of the pandemic. Prior to the pandemic, Medicaid recipients had to undergo regular checks on their income-related eligibility for the program, checks that often interrupted care with red tape and bureaucratic glitches (patients moving, or not getting adequate notifications, as well as confusing instructions for individuals with disabilities). Continuous coverage meant that approximately 90 million people received necessary medical appointments and medications without interruption. 

But when the pandemic-era program expired last year, states began disenrolling patients (some states more aggressively than others) with results that were highly disruptive to patients’ ongoing care. One young Florida couple, whose 7-year-old daughter has cerebral palsy and epileptic seizures, was given a 10-day notice of their daughter’s disenrollment, a notification that meant disruptions to the visits with her daughter’s therapists, as well a threat to the continuous supply of her medications. Another couple was informed that their 12-year-old daughter had retained her Medicaid coverage, while their 6-year-old son was disenrolled.

Over the course of this past year, 56.4 million people (69 percent of the people who had been disenrolled) were eventually able to have their coverage renewed, while 25 million (31 percent) remain disenrolled, many for so-called “procedural” reasons (e.g., outdated contact information, inability to understand or complete renewal packets). Overall, 25.6 million Americans lack health insurance altogether. 

These figures are unacceptable in a nation as wealthy as the U.S. — a nation that spends more on healthcare per capita than any comparable nation in wealth and size. As Adam Gaffney, a critical care physician, has noted, any short- or long-term gaps in coverage can “precipitate potentially deadly ruptures of care.” Citing recent medical studies, Gaffney explains that, “most of the benefits of modern healthcare, after all, emerge not from emergency care provided in places like ERs or ICUs, as important as that is. Rather, health is protected through long-standing therapeutic relationships between patients and primary care physicians that allow medical problems to be recognized and chronic problems carefully managed.”

For these reasons (i.e., the fragmented nature of our healthcare system, the medically harmful discontinuities of care, the unacceptable number of uninsured individuals), our nation deserves a genuine Medicare for all: a single-payer healthcare system that’s publicly financed, and that provides individuals with comprehensive care and choice in selecting providers. And, as recommended by the advocacy group Physicians for a National Health Program, the delivery of care would remain “largely in private hands.”

The provision of coverage itself, however, must not be compromised by the introduction of for-profit insurance plans, like the Medicare Advantage (MA) plans that now enroll half of all Medicare recipients. Under such plans, a private insurer is paid a fixed monthly amount for each Medicare recipient who selects the option, and the plan handles the coverage for that individual. Introduced during the Reagan administration, the MA plans were intended to provide more efficient care, but they’ve ended up being more costly than traditional Medicare, have posed problems to patients and rural health facilities because of frequent denials of care, and have been investigated for fraudulent overbilling.

In its Project 2025 blueprint for governance, the Heritage Foundation has called for privatized MA plans to be the “default option” for Medicare, and they will likely be Donald Trump’s preferred option were he to be elected president this November. He would also be likely to follow the Project’s recommendations on stripping certain key consumer protections from the ACA.

If Kamala Harris is elected president, she will have before her an array of policy options that go far beyond the reforms she mentioned in her debate with Trump. These are options that can provide all Americans, no matter what their employment or socioeconomic status, with comprehensive and continuous healthcare.

For example, there is proposed Medicare for All legislation now before the Senate and House (Sanders, Jayapal, Dingell), with 15 cosponsors in the Senate and support from half the Democratic caucus in Congress. In addition, the 2024 Democratic Party platform includes a plank calling for a “public option” to supplement the marketplace plans in the ACA. Such an option, which Harris advocated in her 2019 bid for president, would give Americans of any age the opportunity to enroll in Medicare-style, publicly funded coverage.

In recent weeks, Harris has said that although her policy positions may have changed, her values haven’t. If she is elected president, she should seize the opportunity to align her values — healthcare as a right, not a commodity — with policies that offer the best chance of realizing those values fully. 

Andrew Moss, syndicated by PeaceVoice, writes on labor, nonviolence, and culture from Los Angeles. He is an emeritus professor (nonviolence studies, English) from California State University.

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Opinion The Last Word

Healthcare at a Crossroads

Kamala Harris plans to expand access to healthcare. (Photo: Hush Naidoo Jade Photography | Unsplash)

As the November election approaches, the nation again nears a crossroads on healthcare, with candidates diverging on a basic question of equity: Who is to bear the risks and costs of care? For Donald Trump, his congressional allies, and conservative policy analysts, the answer is clear: cut government spending and shift the risks and costs back onto individuals, employers, and states. For Kamala Harris, the priorities move in a strikingly different direction: expand access to healthcare, strengthening the federal government’s role in guaranteeing healthcare for all Americans, no matter what their socioeconomic status may be.

The differences show up most pointedly in the candidates’ positions on the Affordable Care Act (ACA) and Medicaid. Fourteen years after Congress passed the ACA, providing subsidies that enabled millions of Americans to obtain health insurance, the percentage of uninsured Americans has declined to a historic low of less than eight percent. Vice President Harris has advocated for, and defended, the ACA, and is expected to support the extension of enhanced subsidies, introduced during the pandemic, beyond their expiration date of 2025. These subsidies have made it possible for many people to obtain marketplace coverage.

Donald Trump tried and failed to repeal the ACA in 2017, and since then he has vowed he “would make it much better than it is right now,” though without providing specifics. One likely course of action, however, would be to target the ACA’s protection of individuals against insurance denial because of preexisting health conditions. As president, Trump authorized the expansion of short-term insurance plans as an alternative to the more comprehensive ACA marketplace plans. These short-term plans allowed insurers to bar people from coverage because of preexisting conditions, and to set rates based on their medical histories.

More recently, the Republican Study Committee, a group comprising four-fifths of Republican congressional members and their leadership, released a budget proposal calling — among many other things — for an end to the federal government’s regulation regarding preexisting conditions, and allowing states to decide whether or not to keep the rule.

Medicaid also represents a major difference between the candidates. A joint federal-state program established in 1965 along with Medicare, Medicaid now provides health insurance for almost 75 million low-income Americans. When Congress passed the Affordable Care Act in 2014, it included a provision to expand Medicaid coverage to all Americans earning up to 138 percent of the Federal Poverty Level. Forty-one states, including the District of Columbia, adopted the expanded coverage, along with federal matching grants to go with it, and 10 states (primarily Republican-controlled states) rejected it, keeping insurance out of reach for many low-income residents. 

As president, Donald Trump approved waivers allowing states to set work requirements in order for people to receive Medicaid, and waiver programs have proved costly and ineffective. The Biden-Harris administration withdrew those waivers, claiming that work requirements do nothing to advance the purpose of Medicaid, which has been to expand access to healthcare.

What should voters make of these differences? One way to begin answering the question is to listen to people closest to the issues. An internist working at a San Francisco public hospital writes of treating an indigent man who requested hospice care rather than undergoing an amputation for a bone infection in his arm, an infection that didn’t respond to antibiotics. The man explained that with an amputated arm, he’d be much more vulnerable to assault on the streets, and thus he opted for hospice — unless he was able to get housing — a goal far out of reach in a city with a critical shortage of available housing.

The man eventually died of sepsis (the physician refers to the cause as “end-stage poverty”), and the internist explains, “ … that illness in our patients isn’t just a biological phenomenon. It’s the manifestation of social inequality in people’s bodies.”

The U.S. spends more money per capita on healthcare than any comparable nation in wealth and size, and yet life expectancy in the nation is lower than that of any peer nation. There are many reasons for this, one certainly having to do with the U.S. being the only advanced nation without universal healthcare for its citizens. Poverty and racism factor significantly as well, with persistent indicators like major racial gaps in maternal and infant mortality. A recent California study found that babies born to the poorest Black mothers have almost twice the mortality rate of the poorest white mothers, and even babies born to the wealthiest Black mothers have a higher mortality rate than the poorest white mothers.

The U.S. has been slowly moving in the direction of other advanced nations, gradually increasing the federal role in guaranteeing healthcare for all. This November’s election will be a referendum of sorts, indicating a continuation of the present direction or a significant reversal of policy. At stake is a choice between leaving individuals more or less to their own devices in a highly unequal society, or recognizing that healthcare — and the eradication of inequity — is a collective responsibility. 

Andrew Moss, syndicated by PeaceVoice, writes on labor, nonviolence, and culture from Los Angeles. He is an emeritus professor (nonviolence studies, English) from the California State University.

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News News Blog News Feature

Medicaid Expansion Could Decrease State Spending

Photo by CDC on Unsplash

A study from the Robert Wood Johnson Foundation (RWJF) shows that Tennessee could see a decrease in state spending if Medicaid coverage is expanded.

According to the study, most non-expansion states “would increase state spending under expanding,” however this is not the case for Tennessee. 

“Tennessee’s spending will decrease slightly by 0.1 percent because the state has one of the highest parent eligibility thresholds among non-expansion states at 82 percent of FPL (federal poverty level).”

The study also estimated that more than 300,000 people would enroll in Medicaid and CHIP (Children’s Health Insurance Program) and that the expansion could lead to a decrease in the rate of uninsured people by 27 percent.

“Some would be newly eligible enrolled while others would come from the healthcare marketplace and others would transition from more expensive employer-sponsored insurance to Medicaid,” said the study.

The philanthropic health organization conducted research on the 10 states that have opted to not expand Medicaid programs. Among the 10 states are Tennessee, Mississippi, and Alabama. According to the foundation, the states have not expanded their eligibility under the Affordable Care Act.

“Under the Affordable Care Act, states have the option to expand Medicaid eligibility to non-elderly people with incomes up to 138 percent of the federal poverty level,” reads the executive summary of the study. “Governors, legislators and other stakeholders in many of the non-expansion states are actively debating Medicaid expansion.”

In 2012, the Supreme Court of the United States ruled that while Americans are required to have affordable health insurance coverage, the decision to expand coverage lies within the state. Tennessee has opted to not expand.

According to the Tennessee Justice Center, which advocates for improved health care and economic policies for families, there are “$1.4 billion of federal tax dollars per year in Washington” allocated for the state to use.

“Thanks to the American Rescue Plan’s incentive, our state could also receive an additional $900 million over two years ($1.2 million per day) over and above the cost of expanding coverage,” said the organization.

While the study does not include a state-by-state analysis, it did say that expansion would also reduce uncompensated care in Tennessee. The study cited information from the Tennessee Hospital Association saying that state hospitals “provided $1.1 billion worth of uncompensated care in 2021 for the underinsured and uninsured.”

This has also led to a number of rural hospital closures in the state.“Tennessee has experienced 16 hospital closures, with 13 of those being rural, since 2010 — the second highest rate in the United States. Of the 95 counties that make up the state, 82 percent are rural,” said the Tennessee Hospital Association.

Former Tennessee Governor Bill Haslam pushed for Medicaid expansion starting in 2013, however the state Senate blocked Haslam’s proposals. 

There are lawmakers such as Representative Caleb Hemmer (D-Nashville), who have openly advocated for Medicaid expansion. Following the release of the study, Hemmer took to his X (formerly Twitter) account to not only share highlights of the report, but to express his support of expansion.

“It’s passed (past) time we did it in Tennessee,” said Hemmer. “ A dirty little secret is Tennessee expanded Medicaid because of the COVID waivers recently and @TennCare did a great job managing the same populations that we would through traditional Medicaid Expansion. Now, the working poor who would benefit are starting to get disenrolled.”

Hemmer’s tweet references the Medicaid continuous coverage rule, which ended in March of 2023. Under this rule, states could disenroll people from Medicaid. The state had previously been prohibited from doing so due to a nationwide pause on this policy as a result of the COVID-19 pandemic.

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Politics Politics Feature

Healthcare “Road Show” Off to a Good Start

CREDIT: Jackson Baker

There has been no shortage of skeptics about the bona fides of the health-care task force recently appointed by state House Speaker Beth Harwell (R-Nashville) to look into the matter of an alternative to Governor Bill Haslam‘s “Insure Tennessee” proposal for federally funded Medicaid expansion, which was dead on arrival upon its presentation to the General Assembly in last year’s sessions of the General Assembly.

Criticism came from both left and right. Early on, state Democratic Party chair Mary Mancini seemed to dismiss it out of hand in a press release titled “A Task Force Called Meh,” in which she said, “It doesn’t have any actual policy or concrete meeting dates. It doesn’t have the will to actually, you know, do anything. … Once again we are a witness to the failure of the Republican majority to lead.”

Nor was everybody in the state Republican Party exactly blissful about the task force’s creation. At a meeting of the National Federation of Independent Business in Memphis last week, two key GOP state Senators were less than enthusiastic. “It remains to be seen how serious this is as a task force,” said Brian Kelsey (R-Germantown), the state Senate’s Judiciary chair. “I find it curious that the House now has this road show,” said state Senator majority leader Mark Norris (R-Collierville), referring to a series of public hearings the task force has begun statewide.

(Both GOP Senators, it should be noted, were vehement opponents of “Insure Tennessee.”)

To be sure, the task force has evolved since Harwell put it together in early April. Back then, it consisted of four House members, all Republicans: Cameron Sexton of Crossville, the task force chairman, who chairs the House Health Committee; Steve McManus of Memphis, chair of Insurance and Banking Committee; Roger Kane of Knoxville; and Matthew Hill of Jonesborough.

Since then, the Speaker, acquiescing to pressure to diversify the group, has added state Rep. Karen Camper (D-Memphis) and one member from the state Senate, Richard Briggs (R-Knoxville), a physician. Crucially, perhaps, both Camper and Briggs were supporters of “Insure Tennessee.”

The reconstituted task force began holding its public hearings in Nashville last week and intends to hold several more before preparing legislative recommendations, which chairman Sexton says he hopes to have ready by June.

On Monday afternoon, three members of the task force — Sexton, Camper, and McManus — were on hand at the University of Memphis University Center, where they were joined by panelists and audience members representing a diverse group of respondents, including hospital spokespersons, representatives of ad hoc health providers, and prospective patients.

In the spirited discussion that ensued for two hours, there was some evidence that, the critics of left and right notwithstanding, the task force might indeed be up to something serious. A key moment came at the very close of things, when McManus, who in 2015 had adopted an adverse position on “Insure Tennessee” and chaired a brief hearing of his committee to an inconclusive end, responded to some passionately expressed testimony by uninsured and under-insured attendees, mostly low-income people who had invested some hope in the prospects for Medicaid expansion through “Insure Tennessee.”

“We’re going to have something for you,” McManus said, in an emotional statement of his own. Asked later if he thought his group would give serious reconsideration to some version of the governor’s plan. “Absolutely, we will,” he said, adding, “Let’s face it. Back then the matter was a political football.” Meaning that its coupling with the Affordable Care Act, better known among Republicans as “Obamacare,” had doomed the proposal to partisan treatment by the General Assembly’s GOP super-majority.

Typical of a potential sea change among Republicans was a lament by panelist Ron Kirkland, a Jackson physician who ran for Congress in the 8th District GOP primary in 2010, that more than $1 billion annually in Affordable Care Act (ACA) funding had been lost to the state by its failure to endorse “Insure Tennessee.” As Kirkland put it, “We’d have been jumping up and down if that much money was available to the [West Tennessee industrial] mega-site!”

And numerous of the medical-community representatives noted that Medicare funding allotments for Tennessee had been scaled down under the ACA with the idea of fleshing them out again with the Medicaid-expansion component of the Act. Subsequently, the Supreme Court’s ruling that the latter component was not mandatory upon individual states had allowed Tennessee and various other states to opt out of Medicaid expansion, with the unintended consequence of reducing overall medical funding.

Overall, the discussion on Monday seemed pointed more toward solutions of this and other dilemmas than to recapitulating various rhetorical talking points. Perhaps this is one road show that might lead to something real and tangible on the main stage of Tennessee government.

• “Give a mouse a cookie…”: Given the factional divisions on the Shelby County Commission, such as they are, it is a rare thing indeed that Heidi Shafer, the East Memphis Republican who so often speaks for what is arguably the Commission’s dominant coalition, should quote with approval Steve Basar, a fellow Republican but one who often sides with another, predominantly Democratic group.

But so Shafer did on Monday, in the course of her current effort to retard — or at least subject to serious vetting — a proposal to assist the office of District Attorney General Amy Weirich with backup to help process the future use of body cameras by local law enforcement, primarily the Memphis Police Department.

A condensed version of the Basar remark cited by Shafer would go something like this: “Give a mouse a cookie, and he’ll ask for a glass of milk. Then he’ll want another cookie.” And this de facto little aphorism was employed by Shafer as a warning against what she called “mission creep” in the matter of funding Weirich’s office.

The fuller argument, as she and other skeptics have developed it in two of the Commission’s mid-week committee sessions and two of the body’s regular public meetings, boils down even further to a fairly simple formulation: “Why us?” — the idea being (a) that the impetus for use of body cams came from the MPD and city government, and (b) the District Attorney General’s office is a creature of state government, not county government.

Ergo, why should county government have to foot the bill?

That argument has found enough buyers so far to have stymied the initial proposal for a fuller funding of the D.A.’s office in the amount of $143,378. By the time of Monday’s meeting, the issue of direct new funding was off the table — replaced by an offer from the administration of Shelby County Mayor Mark Luttrell to shift residual money in the county’s fund balance to provide “temporary support staff for body camera rollout.”

That support would total out, as finally agreed to by the Commission on Monday, to about $25,000 from the fund balance. And that amount, as Shafer reminded an acquiescent administration CAO Harvey Kennedy, would have to be shared with the Public Defender’s office, which, according to state law, is entitled to funding equivalent to 75 percent of any sums appropriated to a District Attorney General’s office.

Enough stop-gap money will be shifted to endow three temporary employees for the D.A.’s office, along with two for the Public Defender’s office, for a period of roughly a month to assist with body-cam rollout.

To stick with the aforementioned Basar analogy, that compromise solution is less a cookie than a crumb, and it’s a clear signal that, with stiff funding increases sought by the Sheriff’s Department, and even stiffer ones sought by Shelby Couty Schools, the D.A.’s office will face difficulty during forthcoming budget negotiations in getting much more for the body-cam matter.

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Memphis To Get Obamacare Help Center

The first Health Help Agency, a help center for people with questions about the Affordable Care Act (ACA), in Tennessee will open in Memphis on November 2nd at the corner of Madison and Cleveland in Midtown.

The Health Help Agency will provide free face-to-face help with ACA issues for both English- and Spanish-speaking residents. The agency’s 10 employees will be on-hand answer questions ranging from which plans are the most affordable to how to find healthcare providers to questions about deductibles and co-pays. The agency also has a website — obamacareservices.com — where residents can ask questions.

“Our approach is different because our community is unique and has unique educational challenges. Not everyone in our community has a computer and the internet. We feel everyone needs a place where they can ask questions about their health reform options and get help,” said Health Help Agency Operations Director Kelly Kish.

The agency is also working with local nonprofits to promote education around the ACA. Open enrollment for the ACA begins on Sunday, November 1st. The Health Help Agency will be located at 1339 Madison.

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Politics Politics Beat Blog

Democrats, Others Urge New Special Session on Insure Tennessee

CREDIT: JB

JB

L to r, participants at Thursday’s press conference were Harris, Miller, Parkinson, Coffield, Kyle, Stewart, Coffield, and Roberson.

With what turned out to a providential act of timing — within an hour or two of Thursday’s latest Supreme Court decision upholding the Affordable Care Act — a group composed of state Democrats and local advocates of Governor Bill Haslam’s proposal for Medicaid expansion under the Act made a pitch in Raleigh for a new special legislative session to reconsider that proposal, Insure Tennessee.

The primary spokesperson for the group was state Democratic chair Mary Mancini of Nashville, and for obvious reasons her focus was on Democratic support for Insure Tennessee and partisan Republican attempts to obstruct it in a February special session of the legislature this year, as well as during the regular session itself.

Expressing pleasure at the brand-new Supreme Court decision, Mancini said, “passing Insure Tennessee becomes even more important now.” She noted that the aborted plan would have provided affordable health-care coverage for 280,000 currently uninsured persons statewide and “68, 000 right here in Shelby County.”

Pointing out that Haslam, a Republican himself, had been unable to garner support for his plan from the members of his party, Mancini said she and her fellow Democrats had persistently called on the Governor “and the Republican leadership” to support another special session, “and they have refused.” She accused Republicans of “focusing on politics rather than providing what the majority of Tennesseans want.”

Alluding to revelations (not always welcomed by the legislators in question) that a significant number of Republican General Assembly members who acted to stonewall Insure Tennessee were beneficiaries of blue-ribbon health insurance plans provided by the state, Mancini asked, “And why are they more concerned with hiding access to their own affordable health-care plans they get than they are with helping other Tennesseans get the same access?”

Other members of the predominantly Democratic Party group of presenters made such other points as that as many as 220 Tennesseans might have died during the last year for lack of an affordable health-care plan and that other matters of importance included jobs and the survival of hospitals, many of which have been over-burdened with emergency-room care for indigent patients.

State Representative Larry Miller, sponsor of the House resolution for Insure Tennessee (one which, like the Senate version, was blocked before it could get to the floor), promised to “name names” of local legislators deserving special blame for obstructing Insure Tennessee, and he did so, mentioning state Senator Brian Kelsey and state Representative Steve McManus.

State Senator Sara Kyle was equally blunt. “Stop being selfish!” she said, as a message to those Republicans who had bottled up the Insure Tennessee resolution in committee. “It’s a moral issue,” she added.

State Senator Lee Harris, the Senate’s Democratic leader, who had made a well-received appearance the evening before at a meeting of the Germantown Democrats, where he had addressed similar themes, made an effort to move the issue beyond pure partisanship.

Pointing out that polls show a clear majority of Tennesseans favoring Insure Tennessee, regardless of their party, Harris said the appeal for a new special session should by rights be directed to “a very narrow audience” of resisters, “a very small group of leaders on the other side of the aisle and extremists who have dominated the debate.”

Harris absolved “rank and file Republicans,” reminding his hearers that the plan’s author, Governor Haslam, was also a Republican, and he added a hat-tip for John Roberts, the GOP-appointed Chief Justice who had voted with the majority on Thursday to uphold the ACA against a lawsuit, King v. Burwell, that challenged it on largely technical grounds.

Another effort to bridge the gap between Democrats and Republicans was made by Ed Roberson, the current director of Christ Community Health Centers, a onetime Democrat who has been a financial officer in several prominent Republican campaigns over the past couple of decades.

Identifying himself as a Republican, Roberson professed solidarity with the others on Insure Tennessee and called it “unacceptable” that Tennessee should rank 44th in the nation in health-care and that Memphis should have been called the “unhealthiest” city in the country in one nationwide survey.

Roberson’s participation provided at least a measure of ecumenism to Thursday’s press conference, as did his presence side-by-side with Ashley Coffield, local director of Planned Parenthood — an organization that has often been at odds with Roberson’s over their different attitudes toward legal abortion but which in many instances provides overlapping medical care.

Participants at the press conference were Mancini, Harris, Miller, Kyle Coffield, Robinson, state Rep Mike Stewart of Nashville, and state Rep. Antonio Parkinson, whose local Raleigh office provided the venue.

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News The Fly-By

University of Memphis Grad Assistants Demand Health Coverage

CREDIT: Bianca Phillips

When Le’Trice Donaldson was a graduate assistant (GA) at the University of Memphis, she was diagnosed with breast cancer. But because the university doesn’t offer health coverage to GAs, and her income from the university was only $900 a month, Donaldson wasn’t sure how she would afford medical care.

“The first thing that came to my mind after my diagnosis was, ‘How am I going to pay for this?'” Donaldson said.

Luckily, Donaldson qualified for a TennCare loophole that only applies to breast cancer patients. But not every GA is so fortunate when he or she gets sick. Around 25 percent of

Bianca Phillips

United Campus Workers demand Medicaid expansion during Bill Haslam’s recent visit to Memphis.

U of M GAs have no health insurance.

Additionally, those whose stipends fall below $11,490 per year don’t qualify for Medicaid or for subsidies through the Affordable Care Act (ACA). Had Governor Bill Haslam chosen to expand Medicaid after the ACA was passed, those GAs would have access to health coverage subsidies through the ACA Marketplace.

Now, United Campus Workers has begun putting pressure on the university to provide health insurance to GAs and the state to expand Medicaid.

GAs are employees of the university. While they attend classes toward their own graduate degree, they’re also teaching classes for undergrads or working in research labs.

Since they’re working at the university, their tuition is waived, and they receive a stipend, but the amount of that stipend differs by department. Some make less than $11,000 a year and others top out at $18,000.

They’re not allowed to hold additional outside jobs because, according to Interim Dean of the U of M Graduate School Jasbir Dhaliwal, “they are full-time students, and we want them to focus on their studies.”

Josh Dohmen, a GA in the philosophy department, helped compile a report on how other schools handle insurance for GAs. Of the U of M’s academic peers (schools that are comparable to the U of M based on academic accomplishment), 75 percent offer full health coverage to GAs. Of the U of M’s funding peers (schools with similar financial resources), 50 percent provide full coverage. The University of Tennessee system provides health coverage as part of their GAs’ stipends.

Dohmen’s report, which was compiled last academic year, also surveyed U of M students about their personal health insurance situations — 25.1 percent of the

U of M’s GAs were uninsured; 37.2 percent were on a parent or spouse’s plan; 22.1 percent were on a U of M student plan (but as of this academic year, that student plan no longer exists); and 15.6 percent had coverage under the ACA.

“We brought that report in to the administration of the Graduate School, and we were told that we shouldn’t be asking the university for funding, but that we should be putting pressure on the state to fund the university better,” Dohmen said. “I think it’s the case, if they wanted to, they could give health insurance to their GAs. But if that is legitimately not the case and I’m wrong, they need to be the ones putting pressure on the state. They have lobbyists in Nashville.”

Dhaliwal said, “In a perfect world, we certainly would like to provide health insurance.” But he said funding for GAs is limited.

“If we were to start offering health insurance, the number of GAs we could have would be less,” Dhaliwal said. “We feel there’s a shortage in the community for advanced degrees, and we’re trying to provide as much education as possible to as many people as possible.”

Dohmen said United Campus Workers will continue to pressure the university and the state. Just last week, outside the Shelby County Health Department while Haslam was in Memphis getting a flu shot, they held a protest to demand the state expand Medicaid.

“I plan to take my report [on how other schools handle health coverage] to the administration of the University of Memphis,” Dohmen said. “And I am in talks with University of Tennessee-Knoxville to draft a statewide letter saying [health coverage] is what we need. We need to raise awareness to folks making financial decisions for the state.”

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News The Fly-By

Fly on the Wall 1327

It’s a Sign

If you have a sign with changeable letters, chances are good that someone will change the letters. This message was conveyed at Otherlands coffee bar.

Neverending Mongo

Once a year Prince Mongo spends an hour in the studio with WHBQ’s MemphiSports Live sports talk radio. During this visit, Mongo tasted Whole Foods’ new Prince Mango sorbet for the first time. This is his response: “Oh my gosh. This is unbelieveable. (smack) I’m certainly going to go over and get a gallon of it. (slurp) I promise them to be expecting me. (smack) Oh, this is wonderful. (slurp) Oh my heavens, this is good. I can’t stop eating it. May I lick the cup?”

Things Named Memphis

The lede-of-the-week award goes to New Orleans’ Times-Picayune for this one sentence tour of the Dirty South: “In what sounds like a Southern crime travelogue, police said a pimp known as ‘Memphis,’ on the run from the law in Mississippi, has been arrested in New Orleans.”

Opposite Day

Hats off to the Memphis Business Journal for the headline “ACA beginning to hurt hospitals in states like Tennessee,” topping a story about how states that have chosen not to expand Medicaid eligibility are “expected to face financial challenges.” In other words, it’s a lack of the ACA in Tennessee that’s causing the problems.

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News News Blog

Sebelius Lauded in Memphis Visit

Kathleen Sebelius

  • Kathleen Sebelius

Health and Human Services Secretary Kathleen Sebelius was far away from tense Congressional chambers filled with pointed criticisms Friday as her Memphis visit felt at times more like a pep rally.

The secretary’s event at the Benjamin L. Hooks Central Library was a push to get residents enrolled in a health insurance plan in the one-month-old Health Insurance Marketplace.

The new, government-run health insurance “store” is a product of the Affordable Care Act. The marketplace has been a source of intense scrutiny this week by Republicans who have pointed to the failures of healthcare.gov, the marketplace’s online home, as a systemic failure of the health care law overall.

Sebelius took full responsibility and apologized to the country for the site’s failures in testimony Thursday before the House Energy and Commerce Committee, whose members grilled her in sometimes-heated exchanges. The failures also account for a growing number of GOP leaders calling for Sebelius’ resignation.

But nearly 1,000 miles away from the halls of Congress, Sebelius was welcomed in Memphis to raucous applause, standing ovations, and local leaders calling her “our general” for health issues and a “warrior” for health care advocacy.

Sebelius first met with local stakeholders — politicians such as Memphis Mayor A C Wharton and Congressman Steve Cohen, public health officials, pastors, and CEOs – in the library’s Memphis Room. She then addressed a standing-room-only crowd of locals who had come to either hear the secretary speak or to get help signing up for health insurance.

She apologized again Friday for the “frustrating” process for those trying and failing to get health care at healthcare.gov. She also gave a tongue-in-cheek apology for the 2008 University of Kansas win over the University of Memphis in the NCAA championship, which happened when Sebelius was governor of Kansas.

Officials constantly reminded the crowd and the media that the marketplace is one month into a six-month open enrollment period, which ends March 31st. Wharton noted that critics lambasted the launch of the Social Security program, which is now considered essential to many.

Cohen said Republicans are using the Affordable Care Act to undermine and politically damage President Barack Obama and that nearly 88,000 Memphians will be eligible for coverage through the marketplace.

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Opinion The Last Word

The Rant

CREDIT: Senator Ted Cruz

Hi, kids. Uncle Randy checking in once again. Happy fall to all. Fall always reminds me of fresh starts and new beginnings.

This rapid weather change, however, makes me believe that we are going to pay for that reasonably mild summer we experienced in Memphis.

Which reminds me, I hope everyone gets their flu shot this year. That is, if you don’t believe that the vaccine is a secret government conspiracy to make you sick enough to wish you had health insurance. In that case, you’re in luck. Obamacare is due to kick in on October 1st, and, as I predicted in these pages, we are already seeing the insurance companies running competing advertisements for affordable policies. That’s different. For someone like me, who went without health insurance for a decade because of the dreaded “preexisting condition,” the Affordable Care Act is a long-awaited remedy. For a person who receives all their information from Fox News and right-wing websites, it’s the worst thing to hit America since the influenza pandemic of 1918.

With only days before the law takes effect, the Republicans are scrambling around like cockroaches, attempting anything and everything to derail or delay Obamacare. The Tea Party-dominated House Republicans passed a bill to allot money to run the government, without funding Obamacare, technically a violation of the law. If the Tea Party began telling the American people to stop paying their income taxes or to ignore the speed limit, wouldn’t they be aiding and abetting the commission of a crime? The Koch brothers have been running television ads that show a creepy looking Uncle Sam with a wicked smile preparing to perform a gynecological exam on an unsuspecting young woman. The grotesquery is supposed to convince younger people to opt out of Obamacare. This is where you younger folks come in. I understand that the Affordable Care Act is unpopular and that the right-wing hysteria has had its effect, but all the bill does is deliver 30 million new customers to the health insurance industry. The problem isn’t Obamacare, it’s the health insurance scam that the medical/pharmaceutical complex forced upon us in the first place. Now that we’re all in this together, the first step out of this trap is to at least make health insurance more affordable and available to everyone.

Obamacare allows a young person to remain on their parents’ insurance until age 26. I know you’re feeling great now, but when you start getting close to 30, things begin to happen. You may be fit enough to play on a park commission basketball team, until you’re diving for a loose ball and get your teeth knocked out, which actually happened to a friend of mine. Another friend was a teammate in a softball league until he tore out his knee sliding into home.

You’ll be happy you have health care on these occasions, not to mention when you get illnesses that require a doctor’s care. Young people’s participation is necessary to make the law effective, despite the Koch brothers’ efforts to convince them otherwise. Obamacare is the settled law of the land, yet the House bill to defund the act allows the “loyal opposition” to kick their 42nd attempt at killing the law over to the Senate, where it stands no chance of passing but every chance of becoming the partisan, political spectacle of the fall season.

All eyes will be on the man Sarah Palin refers to as “Tea Party Ted” — Texas senator Ted Cruz. The first-term senator, whose presidential ambitions are embarrassing, has vowed to do “everything necessary and anything possible to defund Obamacare,” including a promise to filibuster any spending bill that does not defund the health care law. Majority leader Harry Reid responded, “Any bill that defunds Obamacare is dead. Dead.”

Cruz is living proof that a degree from Harvard ain’t what it used to be. He may possess a rich intellect, but he displays poor judgment. That leftist rag, The Wall Street Journal, called Cruz’s idea of using the continuing resolution to defund Obamacare “crazy.” John McCain said it was a “bad idea.” Before “Tea Party Ted” was to appear on Fox News Sunday, host Chris Wallace said he was “stunned” to receive opposition research on the senator “from other Republicans.” Cruz, the neo-Joe McCarthy, has labeled Social Security a “Ponzi scheme” and said that “sharia law is an enormous problem in this country.” Oh yeah, he voted against the Violence Against Women Act too.

Even fellow conservatives despise him. Right-wing representative Peter King of New York said, “He should stay in the Senate, keep quiet. If he can deliver on this, fine. If he can’t, he should keep quiet from now on, and we shouldn’t listen to him.” Harry Reid will merely strip any language about defunding Obamacare from the spending bill and send it back to the House. Then it’s up to “Crying John” Boehner to find the votes to pass the Senate bill and prevent a government shutdown or stand with the Tea Party and go down with the ship.

If you recall, the last government shutdown was a disaster that led to the fellating of President Clinton. The deadline is September 30th, and if you think this is exciting, just wait until next month’s self-inflicted crisis over the damned debt ceiling, when the Tea Party lunatics attempt to delay the implementation of Obamacare for another year. I’m not a lawyer, but I watch a lot of television. Isn’t this legal grounds for obstruction of justice?

Randy Haspel writes the “Born-Again Hippies” blog, where a version of this column first appeared.