Former Housing and Urban Development Secretary Ben Carson warned Democrats against stoking racial divisions on “The Ingraham Angle” Monday.
“As a neurosurgeon, when I open that head and operate on a brain, which makes you who you are, I can’t tell whether you are Black, White, Yellow or Brown,” Carson told host Laura Ingraham. “It’s absurd.
“We need to move away and start to think about something that is important in this country,” he added. “Just using this to divide people and to provide power for a political class is absolutely absurd and unnecessary.”
He also reacted to Washington Post writer and MSNBC host Jonathan Capehart, who recently said there is “no way to be Black in America” without “liv[ing] under siege.”
Carson responded that Capehart is rejecting the advice of Dr. Martin Luther King Jr:
“[He] dreamed of … a nation where people were judged by the content of their character and not the color of their skin. Every day it seems like there is something else to inflame the racial situation,” he said.
“I am not saying there is not a racial problem, but I will say it has gotten so much better if my lifetime. The difference is night and day. We need to keep working on it. There was racism yesterday and today and tomorrow, but it doesn’t have to be a central focus of everything we do.”
Carson added there is no reason to change educational standards to control for racial differences, which Ingraham had described as “adjusting for educational outcomes instead of holding the bar high for everyone regardless of skin color.”
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“A person with a normal IQ is good at math,” he responded. “People say, ‘I am not good at math.’ Not true. It’s a matter of how you are taught. That’s where we need to be investing resources. The way school systems work now, it’s millage [property] taxes, so if you live in a poor area there is not a lot of money for your school.
“That just perpetuates the inferiority of education and the inferiority of outcome.”
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The media mostly treated President Biden’s announcement of his 36-member commission on the Supreme Court last week as a deft deflection of court packing. Well, not so fast. The Chairman of the House Judiciary Committee and other Democrats introduced a bill this week to expand the Supreme Court to 13 Justices from nine.
Message: The Democratic left is serious about this, and the Biden commission better not dismiss it. Oh, and pay attention, Justices. Congress will remake the Court if you issue rulings that offend progressives.
Republicans are rightly calling this out for the political intimidation it is. But here’s another message for the GOP and the commission to consider: If Democrats do turn the Court into another legislature by packing it, the GOP has the power to limit or strip its jurisdiction.
If that sounds radical, consider what Democrats are proposing. Merely because GOP appointees now hold a 6-3 majority on the High Court, progressives want to blow it up on a partisan Congressional vote. Adding Justices in this way would undermine the Court’s legitimacy with the American public, with perhaps lasting harm, as Justice Stephen Breyer warned in a timely speech last week.
Many Republicans respond by saying they’ll return the disfavor when they next have power and add more Justices. But this concedes the progressive view that the Court is merely another policy-making body. It would turn the Court into a de facto House of Lords, albeit with power, which would put an end to its traditional judicial role of applying the law to cases and controversies.
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THE EXCUSES were plentiful as Germany’s centre-right Christian Democrats (CDU) slumped to two of their worst-ever state-election defeats on March 14th. The party was up against popular incumbents in Green-led Baden-Württemberg and in Rhineland-Palatinate, run by the Social Democrats (SPD). The CDU’s state chapters had chosen weak candidates. And anyway Armin Laschet (pictured), the party’s leader, had said before the votes that state elections have their own character. National politics is another matter entirely.
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All true. Yet there is no disguising the malaise that has descended on Germany’s ruling party. Bad enough on their own, the election results contributed to a broader sense that the CDU has lost its way. Six months ahead of a general election after which Angela Merkel, the chancellor, will step down, the party that has run Germany for over 15 years is suddenly confronting the prospect that it could leave government at the same time that she does.
Long bereft of ideas, for most of the Merkel era the CDU has relied on two other qualities for its electoral appeal. One is competence. The four governments led by Mrs Merkel brought Germany through a series of crises barely scarred. Unemployment and debt remained low, and the country’s export-led growth model looked robust. The state largely passed tricky tests such as a huge influx of migrants in 2015-16. The bland managerialism of the CDU, and Mrs Merkel in particular, gave voters permission to switch off from politics.
The government’s steady handling of the pandemic’s first phase reinforced that idea. Mrs Merkel’s ratings, and those of her party, soared, even as its SPD coalition partner flatlined (see chart 1). Yet the situation is becoming rockier as Germany enters its third covid-19 wave. Vaccination was slow even before the controversial decision on March 15th to suspend the AstraZeneca jab. A plan to ease the lockdown settled in early March, even as recorded cases were rising, is in disarray; having just reopened, parts of Germany are now shutting down yet again. The despair of customer-facing businesses has been compounded by bureaucratic hold-ups in distributing aid.
On top of that a series of scandals has centred on MPs from the CDU and the Christian Social Union (CSU), its Bavarian sister party, who lined their pockets through mask-procurement deals. It has left a nasty stench, has punctured party morale, and may have further to run. Fully 88% of voters are dissatisfied with the vaccine roll-out. The number who say the CDU/CSU is best placed to manage Germany’s problems has plummeted. In a matter of weeks the party’s “covid bonus” in the polls has almost evaporated.
The Merkel era’s other great appeal to voters was its aura of inevitability. The CDU/CSU has led German coalition governments for 51 of the republic’s 71 post-war years, retaining support even as political fragmentation ate away at the SPD, its traditional rival. Germany had long seemed on course for a CDU/CSU-led coalition with the Greens after September’s election. But as the people have drifted away from what CDU stalwarts call “the last people’s party”, the notion of a government without the conservatives has gained traction. A “traffic-light” coalition of the SPD, Greens and the liberal Free Democrats (FDP)—of the sort likely to stay in office in Rhineland-Palatinate—is the talk of the day, though it remains unlikely at federal level. But once the party stops looking invincible, more voters will be tempted by alternatives.
Not much of this is directly the fault of Mr Laschet, who has been in charge of the CDU for scarcely two months. His immediate priority was to unite the wings of a party bitterly divided between his centrism and the more robust conservatism of Friedrich Merz, whom he narrowly defeated for the leadership in January. But so far Mr Laschet has signally failed to provide the leadership so many in his party crave. He was slow to respond to the corruption scandals. He brushed off complaints that he was missing in action after the state elections with a tin-eared argument that it was the job of the CDU secretary-general to respond. And though his brand of amiable moderation chimes with the public mood, he has shown no interest in offering a vision for post-Merkel Germany. “The only explanation I can see is that he doesn’t have any ideas,” says one despairing CDU MP. Even supporters profess exasperation.
At some point in the seven weeks between Easter and Pentecost (these are Christian Democrats, after all) Mr Laschet and Markus Söder, the CSU leader and Bavaria’s premier, will decide which of them is to lead the two parties into the election. Mr Söder is a savvy politician who has built a national reputation while insisting his ambitions do not run beyond his state’s borders. Yet although just 16% of CDU voters back Mr Laschet for the candidacy, even frustrated CDU MPs think their leader will probably get the nod. Some quietly wonder why Mr Söder would want to swap a comfortable perch in Munich for the stress of leading a demoralised party into an uncertain election.
Indeed, the last campaign of the Merkel era promises to be its liveliest. The Greens, almost certain to enter government in one coalition or another, are fizzing with ideas. The FDP, enjoying a modest recovery, has finally found a distinctive voice in the pandemic. Even the long moribund SPD has rediscovered a taste for power, animated by the prospect of booting the conservatives into opposition. Traditional voter blocs have broken down. “Even if we write the best manifesto in the world, it won’t be easy for us,” says Katja Leikert, a CDU MP.
Yet for all its woes, the CDU/CSU is still odds-on to lead Germany’s next government. Optimists tell a story of a summer campaign in which a reunified ruling party exploits a public mood buoyed by a belatedly successful vaccination campaign and a rebounding economy. Mr Laschet remains the favourite to succeed Mrs Merkel at the helm of the EU’s largest country. But his chances would be that much better if he could explain why he deserves the job. ■
This article appeared in the Europe section of the print edition under the headline “The sleepwalker”
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House Democrats are moving forward with their plan to add the District of Columbia as the 51st state of the union and this time they have supportive leaders in the Senate and the White House on their side.
D.C. Delegate Eleanor Holmes Norton, who has been leading the statehood charge in Congress, predicted earlier this year “there’s never been a time when statehood for the District was more likely.”
The first step will take place Monday, when the House Committee on Oversight and Reform will hold a hearing on Norton’s 51st state legislation, aptly titled H.R. 51, the Washington, D.C. Admission Act.
D.C. Mayor Muriel Bowser, who has pushed to have a statehood bill on President Biden’s desk within his first 100 days in office, will be among the witnesses testifying. Biden is supportive of D.C. becoming the 51st state.
DEM SENATOR INTRODUCES DC STATEHOOD BILL — BUT EFFORT FACES UPHILL BATTLE
Bowser has framed statehood as a civil rights issue where taxpaying U.S. citizens have been disenfranchised for the last 200 years and denied democracy.
Muriel Bowser, mayor of Washington, D.C., speaks during a news conference ahead of a District of Columbia statehood bill vote on Capitol Hill on Thursday, June 25, 2020. (Stefani Reynolds/Bloomberg via Getty Images)
With Democrats in control of the House, the Senate and the White House, Bowser said in January that the momentum toward statehood is “a promising sign that our country is finally ready to right this historic wrong.”
D.C. statehood already passed the House last June but it died in the GOP-led Senate. House leadership is committed to bringing up statehood for a vote again this year and 214 Democrats have co-sponsored the legislation — or just about all of the Democratic caucus which sits at 220 members currently.
With the Senate now in Democratic hands, Sen. Tom Carper, D-Del., is leading the effort there for statehood. So far, his statehood legislation has 40 of the 50 Democratic senators signed on as co-sponsors. However, without changing the legislative filibuster, Carper would need the support of at least 10 Republicans to meet the 60-vote threshold to advance — an uphill climb in a divided Senate.
D.C. has a population of more than 700,000 residents ‒ greater than Wyoming and Vermont ‒ but the residents don’t have voting members in Congress or full control over local affairs. However, the District of Columbia pays more in federal taxes than 21 states and more per capita than any state, according to the 2019 IRS data book.
HOUSE PASSES DC STATEHOOD BILL: HERE’S HOW IT WOULD WORK
Under the plan, the 51st state would be called “Washington, Douglass Commonwealth,” named for Frederick Douglass.
D.C. would have full control over local affairs and full representation in Congress, which would amount to two senators and one representative in the House based on the current population.
The area around the White House, Capitol, Supreme Court and National Mall would be carved out into a federal district controlled by Congress and named the “Capital.”
Republicans have been firmly against D.C. statehood, calling it a Democratic power grab designed to tip the balance in the Senate in favor of Democrats by adding two senators from a liberal stronghold.
During the hearing Monday, Republican House members will have one witness, Zack Smith of the Heritage Foundation.
Del. Eleanor Holmes Norton speaks on Capitol Hill on July 23, 2020 in Washington, D.C. (Tasos Katopodis/Getty Images)
GOP members intend to say H.R. 51 is unconstitutional and raise concerns about Democrats’ failure to consider the practical and financial implications of D.C. statehood, D.C.’s “radical” policies and the progressives’ political motives behind D.C. statehood, according to a Republican Oversight Committee aide.
“D.C. statehood is all about Speaker Pelosi and liberal Democrats consolidating their power to enact radical policies nationwide like the Green New Deal, packing the Supreme Court, and eliminating the filibuster,” said Rep. James Comer, R-Ky., the top Republican on the oversight committee.
Comer said H.R. 51 “is a dangerous political power grab that will ensure more government intrusion into Americans’ daily lives.”
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The push for statehood comes after House Democrats passed H.R. 1, a massive restructuring of election and campaign finance laws that Republicans also panned as a power grab. That legislation now sits in the Senate, where it also requires 60 votes to advance.
H.R. 1 would set federal guidelines for elections such as automatic voter registration; restoring voting rights to felons after they have completed their sentences; and expanding early voting access and absentee voting. The legislation also allows voting without an identification card if a voter signs a written statement attesting to their identity, under the penalty of perjury.
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Two of New York state governor Andrew Cuomo’s fellow Democrats have called on him to quit over allegations he sexually harassed several women.
His accusers, including some of his female aides, have said he behaved in a sexually suggestive manner and made similar such remarks.
One woman said the 63-year-old had asked her if she would ever have sex with an older man, while another said he had once kissed her without her consent.
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Andrew Cuomo said earlier this month that his actions ‘made people feel uncomfortable’ but it was ‘unintentional’ and he feels ‘awful’
The state’s two senators, Chuck Schumer and Kirsten Gillibrand, both Democrats, have joined those urging him to step down “due to the multiple, credible sexual harassment and misconduct allegations”.
“Governor Cuomo has lost the confidence of his governing partners and the people of New York. Governor Cuomo should resign,” they said in a statement issued on Friday evening.
The remarks from Mr Schumer, the Senate Majority Leader and Ms Gillibrand, a senator since 2009, will damage Mr Cuomo’s chances of riding out the storm.
They echo those of another well-known Democrat, progressive New York congresswoman, Alexandria Ocasio-Cortez.
She said “we believe these women”, and expressed concern about the safety and well-being of the governor’s staff in a joint statement published with New York congressman Jamaal Bowman.
More than half of the state’s 27 elected representatives have called for the governor to quit.
Reporter Jessica Bakeman became the seventh woman to accuse Mr Cuomo on Friday, saying he had often put his hands on her.
While taking a picture with her at a 2014 holiday party, she said he remarked, “I’m sorry. Am I making you uncomfortable? I thought we were going steady,” in a piece she wrote for New York.
Speaking before the latest accusation was made, Mr Cuomo repeated his denial of the allegations and said it was “reckless and dangerous” for politicians to ask him to resign before they have all the facts.
“Women have a right to come forward and be heard, and I encourage that fully. But I also want to be clear: there is still a question of the truth. I did not do what has been alleged, period,” he said.
On Thursday, New York’s state legislature announced it would open an impeachment investigation into the allegations, running parallel to an investigation led by the New York State Attorney General.
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Analysis by WorldTribune Staff, March 4, 2021 House Democrats on Wednesday passed H.R. 1, their election reform legislation which they call the “For the People Act”. The legislation passed in a mostly party-line vote of 220-210. Only Democrats voted in favor. All Republicans and Mississippi Democrat Rep. Bennie Thompson were opposed. The bill would void […]
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WASHINGTON, DC – OCTOBER 06: Senate Minority Leader Mitch McConnell (R-Ky.) spoke to reporters on October 06, 2018 in Washington, D.C. (Photo by Chip Somodevilla/Getty Images)
OAN Newsroom UPDATED 6:15 PM PT – Tuesday, March 2, 2021
Senate Minority Leader Mitch McConnell (R-Ky.) is calling for fellow Republicans to block Joe Biden’s nearly $2 trillion coronavirus relief package. On Tuesday, McConnell continued his attacks on Democrats for attempting to push the bill through Congress without Republican contribution.
Less than 9% of Democrats’ spending plan would go to directly fight COVID-19. Less than 1% to vaccinations.
This isn’t a recipe to safely reopen America. It’s what Democrats promised almost a year ago: Taking advantage of the crisis to check off unrelated liberal policies.
He accused Democrats of taking advantage of the budget reconciliation process and trying to sidestep the Senate filibuster. McConnell also said they are trying to push proposals that are unrelated to the coronavirus pandemic.
“So, we’ll be fighting this in every way that we can. It is my hope that, in the end, Senate Republicans will unanimously oppose it just like House Republicans did,” McConnell stated. “I think it’s noteworthy to know we’re in the House. The only thing bipartisan about the proposal was the opposition to it.”
Senators are gearing up to vote on the package, which is expected to hit the Senate floor as early as this week.
MORE NEWS: Bipartisan Group Of Lawmakers Introduce Bill To Make Puerto Rico A State
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With millions around the country calling for a $15 minimum wage, small business owners fear their businesses will be crippled while minimum wage workers have hope for better days ahead.
Is any increase better than no increase?
That may be the question some Senate Democrats are asking themselves as they try to pass a $15-an-hour minimum wage hike inside the $1.9 trillion COVID-19 relief package that seems to be almost impossible.
Democrats have made it clear that they want to increase the federal minimum wage to that number, but last week were dealt an almost fatal blow when the Senate’s parliamentarian ruled that the hike should not be included in the measure.
There also seems to be no serious hope that the Senate will eliminate the filibuster. Politico reported Monday that the party “could be at risk of getting nothing unless it engages with Republicans.”
Democrats have a 10-vote edge in the House and are tied in the Senate 50-50. Democratic Sens. Joe Manchin of West Virginia and Kyrsten Sinema of Arizona have voiced opposition to the minimum wage hike in the relief bill, and other moderates have expressed concerns, too.
In order for the Senate to pass the bill—with the wage hike included— it would need every Democrat and win over 10 Republicans to hit the 60-vote threshold. The number is impossible with the minimum wage addition the way it is currently written. But some Republicans seem willing to negotiate.
Sens. Tom Cotton and Mitt Romney wrote on FoxNews.com on Monday that it is time for an increase to the minimum wage.
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But they wrote, “Many Democrats are hung up on an unserious scheme to raise the minimum wage to $15 an hour. Their plan doesn’t have the votes to pass, and even if it did, a $15 minimum wage would destroy 1.4 million jobs, according to the nonpartisan Congressional Budget Office (CBO).”
REP. KEVIN McCARTHY: DEMS’ $1.9 TRILLION COVID BILL IS NOT RESCUE OR RELIEF PLAN, IT’S A PELOSI PAYOFF
Their bill, which is called, the Higher Wages for American Workers Act, “would raise the federal minimum wage to $10 an hour over time and make sure all the gains go to legal workers, not illegal immigrants.”
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Sen. Susan Collins, R-Maine, who is considered a moderate, told Politico that she does not understand the “all-or-nothing approach.”
“Going from $7.25 to 10 dollars an hour … is a substantial and long-overdue increase. So why would the progressives to whom [Sen.] Chuck [Schumer] is clearly listening be opposed to that? It sounds like Chuck wants an issue, not a solution.”
The Associated Press contributed to this report
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MANY IMMIGRATION activists would have cheered President Joe Biden had he merely spent his first month in office signing nine executive actions that reverse some of Donald Trump’s most hostile orders on migration. Mr Biden has told officials they may no longer take children from the arms of asylum-seeking parents. A task-force has been told to find the still-missing parents of 600 such detained children. Rules on deportation are to be milder than before. Refugee resettlement is to expand anew. And those seeking sanctuary at the southern border will be treated more humanely: a few vulnerable ones may again plead from inside America, rather than wait in unsafe camps in Mexico.
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To the surprise of even some close observers of immigration policy, however, Mr Biden has signalled he wants to go further, quickly. Last month he proposed a comprehensive immigration bill: last week the US Citizenship Act was sent to Congress. If enacted (which is unlikely) it would amount to the biggest shake-up of the migration system in decades . It sets out how an estimated 11m undocumented migrants could win settled, legal status. It would put more resources into immigration courts, encourage inflows of skilled workers and try to tackle instability in Central America in the hope of reducing outflows from there.
Piecemeal legislation will also be revived. Campaigners say the Senate could take up two bills that were passed by the House in 2019 (they could easily be moved again in the House, perhaps in March). One is the American Dream and Promise Act, a version of a long-standing legislative effort to allow Dreamers—who were children when they migrated, without papers—to stay. The Migration Policy Institute, in Washington, estimates that this could affect up to 2.9m people. Another bill, to modernise farming, would give better protection to agricultural labourers, over 1m of whom are undocumented migrants. Both bills won at least some Republican support; polls suggest they are popular.
Another legislative push could come as part of a new covid-19 relief package. Proponents say that bill should offer help, including legal rights, for unauthorised immigrants who toil as “essential” workers in health care, food production, factories and shops. Such labourers have been especially exposed during the epidemic and could perhaps number 5.6m.
This boldness is surprising and politically risky. Mr Trump’s appeal, at least during his rise to power in 2016, rested heavily on voters anxious about high levels of migration. The ex-president is already attacking his successor for being lax on the border, a theme he is likely to bring up in a big speech to conservatives on February 28th. Nor do decades of failed attempts to overhaul immigration, most recently in 2013, bode well for new efforts. Nobody talks seriously, for example, of the Citizenship Act actually getting the 60 votes in the Senate.
Why then push for broad reform? Mr Biden calculates—prodded by Esther Olavarria, his deputy director for immigration at the White House Domestic Policy Council—that he has no better option. He lacks time to take a cautious approach, since the 2022 mid-term elections will probably reduce his slender congressional advantage. And given the “upside-down world of the pandemic”, says Ali Noorani of the National Immigration Forum, an advocacy group, voters might like a bold push to help migrants quickly. Party management probably favours a doomed effort at comprehensive reform over no effort at all.
The requirement for 60 votes in the Senate remains a high hurdle, which is why some campaigners wonder whether immigration could be reframed as a policy with a fiscal impact. That might permit passing a migration bill through “reconciliation”, though the Senate parliamentarian (a kind of reconciliation referee) might disagree. Would voters approve of such a wheeze? Polls last year showed few people actually liked Mr Trump’s fierce hostility to migrants. College-educated Republicans in the suburbs, especially, recoiled from it. And roughly half of voters, according to YouGov, a pollster, say they are open to immigration resuming after the pandemic. Yet as the border becomes more porous again, the old politics of immigration will likely return. ■
See also: We are tracking the Biden administration’s progress in its first 100 days
This article appeared in the United States section of the print edition under the headline “Go big or go home”
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Every week, Shellie Fry carefully plans out each meal she, her 81-year-old father, and her 30-year-old son will eat. She buys the least amount of food she thinks they can manage because money has been tight since her father lost his job cleaning charter buses in March, after the pandemic hit. Without health insurance, she pays out of pocket for the medications she needs for her bipolar disorder, heartburn and blood pressure, and by the time the family pays its other bills, as well as her father’s Medicare contribution and medications, there is little money left. “I’ve had a few times where I just didn’t know how we’re gonna pay for groceries,” she says. Still, she knows she can’t skip her medications, thinking, “Who’s going to take care of these people when I’m gone?”
Because Florida did not expand its Medicaid program in 2014 when the Affordable Care Act (ACA) first allowed states the option, Floridian adults without children are not eligible regardless of how little they make. While Fry’s son is autistic and can’t be left alone for more than a few hours, Fry says, his age means that she does not qualify for public health coverage. When she looked into buying coverage through the ACA marketplace, she didn’t make enough to qualify for any assistance there either, and the plans were far too expensive.
Fry’s story, while unique in the details, is familiar to millions of low-income Americans who remain uninsured, caught in a coverage gap that leaves no affordable option for health insurance—even during a pandemic when access to health care is more important than ever. Now Democrats are trying to use their proposed $1.9 trillion COVID-19 relief package to address the problem by expanding Medicaid access and increasing ACA subsidies nationwide.
This week, the House Energy and Commerce Committee presented a provision, which it advanced on Friday, that would offer states that have not yet expanded Medicaid significant financial incentives to do so. The House Ways and Means Committee also approved legislation this week that would boost ACA subsidies, resulting in cheaper insurance plans to many middle class people and those who have lost jobs during the pandemic. The Biden Administration will also reopen enrollment on the ACA marketplaces starting Feb. 15. If they pass the House and Senate, these combined efforts could help a significant number of Americans access more affordable health coverage.
But they also only go so far. While the ACA subsidies and the special enrollment period and can be implemented by the federal government, conservative states must choose to accept federal funding and expand Medicaid for the lowest-income Americans to get this help. Republicans control the governments in most states that have not expanded Medicaid, and even the three states with Democratic governors have to contend with Republican-led legislatures.
This political reality is at odds with both President Joe Biden’s ambitious plans for expanding health care coverage and with some Democrats’ high hopes of meaningful reform. On the campaign trail, Biden proposed creating a “public option” health insurance plan that would automatically enroll people in the Medicaid coverage gap. Now that he’s in office, saddled with a razor-thin Democratic majority and many urgent priorities, a host of procedural and political hurdles make those big plans difficult to deliver.
The most obvious hurdle is that Democrats need 60 votes in the Senate to pass most legislation. That means they must either secure support from ten Republican lawmakers, or use a wonky process called budget reconciliation, which allows lawmakers to pass budget-related legislation with just a simple majority. Health policy experts say creating a new public option plan through reconciliation would be difficult because it would likely involve measures beyond the process’s budget-related scope, and many lawmakers are worried about bogging down the COVID-19 relief package with more controversial health reform debates. The House’s current approach—offering states financial incentives to expand Medicaid—is an attempt to avoid these procedural and political pitfalls.
Still, Democratic efforts to expand Medicaid have also become highly politicized in recent years. When the ACA first passed in 2010, Congress designed it so that Medicaid would provide health insurance to people in or near poverty, and the federal government would cover most of that cost. But Republican states sued in 2012, arguing the federal government could not force them to expand their Medicaid programs, and the Supreme Court agreed. Since then, most states have moved to expand Medicaid and accept the federal funding, but 12 have not.
Because the ACA was written with the expectation that very low-income people would receive coverage through Medicaid, it did not make that population eligible for subsidies on the ACA marketplace. The result is that those whose incomes are below the federal poverty level—about $12,880 for an individual and $26,500 for a family of four—and who live in states that did not expand Medicaid are caught in a trap: they qualify for neither Medicaid nor subsidies to buy health insurance on the ACA marketplace. This has left about 2.2 million people in poverty and uninsured, according to estimates from the Kaiser Family Foundation (KFF).
“These are the most vulnerable among us. And it’s absolutely critical to be thinking about how to get their needs addressed,” says Joan Alker, executive director of the Center for Children and Families at Georgetown University.
Congressional Democrats hope to address this problem by giving the conservative states that have not expanded Medicaid more money if they agree to do so. Under the existing system, the federal government shares Medicaid costs with states and covers 90% of the costs for each state’s expansion group. The proposal put forth by the Energy and Commerce Committee makes that more generous: it proposes that for any state that newly expands Medicaid, the federal government would increase what it pays for all non-expansion Medicaid enrollees by 5 percentage points for two years. That’s in addition to still covering 90% of the costs for expansion and on top of a 6.2 percentage point bump in federal Medicaid matching funds that Congress allocated last spring in response to COVID-19. The new money would be available to the 12 states that have not expanded Medicaid, and to Missouri and Oklahoma, which voted to expand Medicaid last year and are expected to implement the programs this summer.
That’s a pretty enormous financial incentive, experts say. Because the traditional Medicaid population, which includes many seniors and people with disabilities, is where states spend the bulk of their Medicaid budgets, that extra 5% in federal funds would more than cover the states’ cost of expanding Medicaid, according to a new analysis from the Center on Budget and Policy Priorities. “It’s to the point where I think what you see in the provision is saying, we need to just do whatever we can so we can get these people covered,” says Judy Solomon, a senior fellow for health care at CBPP and a co-author of the analysis.
The new federal money on offer also comes at a time when many states face intense budget crunches as a result of the coronavirus pandemic. “States are seeing really difficult budget choices. So if you say to them, Listen, you can expand Medicaid, and it will reduce state costs, that could be pretty attractive,” says Matthew Fiedler, a health economist at the Brookings Institution. “At the same time, these states have been willing to turn down huge amounts of federal money for seven years now.”
The political winds are also shifting. While many Republican-led state legislatures and governors have been reluctant to expand Medicaid, public polling indicates that voters of both parties largely support the idea. The red states that have voted to expand Medicaid in recent years have largely done so as a result of ballot measures. But there are only three states left—Florida, Mississippi and South Dakota—where ballot measures are constitutionally allowed. In the rest, elected officials will have to be persuaded. In North Carolina and Kansas, the state’s Democratic governors have been pushing efforts to expand Medicaid, and Democrats and health care advocates in other states have waged years-long campaigns without much progress.
But health care activists hope the pandemic and the extra money could move the needle. A survey conducted by the Commonwealth Fund in October, just before the 2020 election, found that three quarters of likely voters in swing states that had not expanded Medicaid—Florida, Georgia, North Carolina, Texas, and Wisconsin—supported the idea. In Texas, some Republican state legislators have said they are open to considering expansion, and in Alabama, a new poll coming out later this month shows that 64% of likely Republican voters favor expanding Medicaid in their state when told about arguments for and against the idea, according to Cover Alabama, a coalition of groups advocating for Medicaid expansion.
“Governor Ivey has said for many years that the question is not about whether to expand Medicaid. It’s about how do we pay for it,” says Jane Adams, director of Cover Alabama. Her state would get an estimated $940 million in new federal funding if the House Democrats’ provision becomes law, according to CBPP. “It’s just too good of a deal to not take,” Adams says.
If all the remaining states took Congress up on this offer and expanded Medicaid, KFF estimates that at least 4 million uninsured people could gain coverage: the 2.2 million caught in the coverage gap and another 1.8 million who are currently eligible for ACA marketplace subsidies but would get more comprehensive and cheaper plans under Medicaid. This is particularly important during the pandemic. About 60% of this group are people of color, and at least 640,000 are essential workers, all of whom are at greater risk of getting sick from the coronavirus. It’s not just helpful during the pandemic. Research has shown that expanding Medicaid is linked to a range of better health outcomes, increased access to primary care and preventive health services, and lower out-of-pocket spending.
Take Fry, for example. In Florida, she has found primary care through the St. Petersburg Free Clinic, an organization that serves uninsured Floridians, but if she has an issue the health center can’t handle, she typically waits it out and hopes she can avoid going to the hospital, she says. This is not only dangerous for her health, but it also costs states money. By contrast, many states have found that expanding Medicaid actually saves them money by reducing spending on uncompensated care from people without insurance, as well as by getting federal support for programs such as mental health care.
In addition to offering states these expansion incentives, the Energy and Commerce Committee’s portion of the relief bill also includes other Medicaid-related provisions that would take aim at drug costs, cover COVID-19 vaccines and treatment through Medicaid and the Children’s Health Insurance Program and allow states for five years to grant Medicaid coverage to women for 12 months after they give birth, among other areas. The package also provides funding to bolster the nation’s public health system, allocating $14 billion for vaccines and $46 billion for testing, contact tracing and mitigation, for example.
The Medicaid provisions are popular among Democrats and are expected to make their way through the House and then the Senate reconciliation process without issue. But ultimately, the current plan means people like Fry will need to wait to see whether her state takes the federal government up on its offer.
“It could be huge for people in those states,” Solomon says. “But here’s where we have to just hope that states see the the benefit of these added dollars along with the overall lasting benefit that expansion would have.”
Thank you for dropping by My Local Pages and seeing this news update on the latest Healthy Living news items titled “Democrats’ Push to Expand Medicaid Depends on Red States Taking the Bait”. This article was presented by MyLocalPages as part of our national news services.