August 03, 2020

Another one to watch

I've kind of been obsessed with health care policy for pretty much my whole career with the American Friends Service Committee, which began in 1989.

The first big fight I ever had, the Pittston coal strike (1989-90), was largely about health benefits for coal miners and their families, especially for retirees. Health care was a major issue in other good labor struggles from the Ravenswood Aluminum lockout (1990-92) to the recent WV work stoppages by teachers and school service workers.

In terms of public policy, lots of fights in the era of welfare reform (1996-early 2000s) had to do with health care. These included enacting the Children's Health Insurance Program at the federal level, followed by several pushes here to get the state to implement and expand the program. That culminated in 2011, when then Governor Tomblin expanded eligibility to 300 percent of the federal poverty level.

There were also efforts in that period to make sure people got "transitional Medicaid" when they left public assistance, along with supportive services related to minimal dental and vision care.

Then came the epic struggle to enact the Affordable Care Act. Misnamed Obamacare, it's really more like the Senate version of a reform bill. The House version was better, but with the death of Senator Edward Kennedy in August 2009, the senate version was the only game in town. It passed in March 2010.

I remember all hell breaking loose at town meetings in WV and around the country in 2009. At one in Huntington, a conspiracy theorist argued that reform meant something like a military takeover by the World Health Organization. You know, black helicopters and microchips in the butt. Apparently, they haven't made it out my holler yet.

At another event in southern WV, a  Catholic priest got heckled by someone during the opening prayer, with a shout of "How much are you getting paid?"

Efforts to repeal it began as soon as efforts to defeat it in Congress failed. In 2012, the US Supreme Court weighed, affirming the constitutionality of the law but making a key piece of it, Medicaid expansion, a state option.

People here worked hard to persuade Tomblin in 2013 to make the expansion, which he did with characteristic caution, seeking an actuarial opinion that fortunately underestimated the benefits of the expansion to WV. The effects were and are huge.

While quite a few states jumped on right away, others, particularly in the south and west, held out. A series of state by state fights ensued. I think each time a state decides to expand it, the harder it will be to undo the whole thing.

(I'm going  to skip over the epic fights since the 2016 election to block Trump, WV attorney general Patrick Morrisey and others of that ilk to take it all away from millions of Americans, not to mention the next US Supreme Court ruling, which is expected to come early next year. I get tired just thinking about it.)

The last time a state expanded Medicaid was in Oklahoma in June, where voters narrowly approved the expansion despite a flood of dark money..

Which brings us to tomorrow, when voters will take up the measure in Missouri. The following alert went out from Joshua Saleem, director of AFSC's St. Louis program to Friends and contacts in that state:
On August 4, Missouri voters will have the chance to make history and save lives by voting “Yes!” on Amendment 2, which would expand Medicaid to cover around 200,000 currently uninsured state residents. The expansion would particularly benefit adults in working families earning up to 138% of the federal poverty level.
This step makes sense in “ordinary” times by extending health care, opening the path to recovery from addiction, easing the path to reentry for formerly incarcerated people, supporting hospitals and health care providers, creating jobs and generating economic activity—but these aren’t ordinary times. In these times of a global pandemic that has yet to slow down, a yes vote is absolutely imperative.
Medicaid expansion is a provision of the 2010 Affordable Care Act. It was intended by Congress to apply across the nation, but a U.S. Supreme Court decision made it a state option.  As of now, 38 states, including the District of Columbia, have expanded Medicaid. Missouri should join their ranks.
The vote could be close. In Oklahoma, voters approved the expansion in June—but by a bare margin of one percent. Millions of dollars in dark money will be spent to defeat the measure.
This is why we’re asking you do three things: vote yes, share this email with friends, and do all you can to get out the vote.
Since its founding over 100 years ago, the American Friends Service Committee, following the Quaker belief in the value of all persons, has worked to promote economic rights as human rights. It has supported access to health care internationally as well as at the national and state level in the United States.
It doesn’t often happen that ordinary people have the opportunity to make such a huge difference with such simple steps, but this is one of those times. Please help us make the most of it.
It will be the latest round in a series of struggles that probably began in the USA in 1912 when former president and presidential candidate Theodore Roosevelt first proposed something like universal health care as the candidate of the Progressive Republican Party.

I plan on staying up as long as it takes for the vote to be counted.


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