• Obamacare's Nine Lives

    Mar 5, 2015Richard Kirsch

    If Obamacare survives yesterday’s Supreme Court challenge, it will really be the cat with nine lives.

    The death of what became the Affordable Care Act has been predicted regularly ever since President Obama’s election in 2008. Right after Obama’s election, I got a wave of calls from reporters, each highly skeptical that the President-elect would really try to get health care passed. When you consider the relentless attacks and near-death experiences ever since, the reporters’ skepticism was understandable.

    If Obamacare survives yesterday’s Supreme Court challenge, it will really be the cat with nine lives.

    The death of what became the Affordable Care Act has been predicted regularly ever since President Obama’s election in 2008. Right after Obama’s election, I got a wave of calls from reporters, each highly skeptical that the President-elect would really try to get health care passed. When you consider the relentless attacks and near-death experiences ever since, the reporters’ skepticism was understandable.

    So when I found myself with a fresh wave of anxiety before the Supreme Court heard oral arguments yesterday on the latest assault on the law, I decided to list all the times that the survival of what became the Affordable Care Act was up in the air. And when I then counted them, it turned out that they number eight. So if Obamacare survives this last, desperate challenge at the Supreme Court, it really will have nine lives. Here they are, in chronological order:

    1. The Great Recession: After Obama’s election a chorus of pundits predicted that the new President would have to give up his promise of health care reform because of the economic crisis. Instead, the President worked to get the economic stimulus passed, while paving the ground for health reform moving. Just a few weeks after the stimulus became law, the President went on a national tour to push for action on health care. 

    2. Tea Party August: The tea party movement came to national attention, with loud, vitriolic attacks on health care at congressional town meetings held by Democrats in August 2009. Republicans gleefully predicted they had killed the bill. But by the second half of August supporters of health reform had rallied at dozens of town hall meetings, usually turning out more activists than the tea partiers. The press didn’t give the same attention to meetings that were not marked by raucous demonstrations. But Democratic members of Congress were sent back to Congress knowing they had support in their home districts to move ahead.

    3. Scott Brown’s Election: The surprise election of Republican Scott Brown to the U.S. Senate in January 2010, on a platform opposing health care, looked like it might kill the bill. But having voted to pass the legislation in both houses, Democrats were not going to turn back. President Obama rallied the public by finally attacking the practices of health insurance companies and even without a filibuster proof majority in the Senate, the Patient Protection and Affordable Care Act became law.

    4. The Supreme Court Challenge: Immediately after the ACA’s passage, opponents launched a legal attack, which – shocking most legal scholars – was taken seriously by the courts. And by the time the Supreme Court heard the challenge, the odds were that the Court would gut the key provision of the law that enabled insurance to be affordable to individuals. But Chief Justice Roberts saved the day  – and much of the Court’s credibility.

    5. The 2012 Election: If the Senate had gone Republican in 2012 – as was widely predicted – and Mitt Romney been elected, Obamacare would have been repealed. Instead, the ACA emerged with a new electoral mandate.

    6. Government Shutdown and Congressional Repeals: I hesitated to put the 50 or so Republican votes to repeal the law, culminating in the government shutdown in the fall of 2013, on the list, only because of President Obama’s veto pen. But even if the ACA always had the presidential veto as armor, the barrage of repeal missiles has got to be counted. Texas Senator Ted Cruz led the government shut down before health insurance enrollment opened up because, as he said, “no major entitlement has ever been implemented and then unwound.”

    7. Healthcare.gov: And then, with the disastrous launch of the website to enroll people in health care, Ted Cruz appeared to have gotten his wish fulfilled. The ACA might not be legally dead, but much of it was functionally comatose. Then the administration resuscitated the website, and millions were enrolled and started benefitting from the coverage. It looked like, As Cruz feared, the ACA was here to stay.

    8. Supreme Court Redux: That is until the Supreme Court agreed to hear a desperate, last minute challenge to ACA’s for millions of newly enrolled people in the King v. Burwell case. Could this be like one of those movies where the soldier survives the war, only to be killed by a bullet on his way home, fired by an enemy that hadn’t heard the war was over?

    The news reports of the oral arguments yesterday were encouraging, particularly Justice Kennedy’s raising of a constitutional issue with the plaintiff’s case. And there are a host of other legal reasons to believe that the lawsuit is groundless. But then it did get this far. The opponents have been relentless. They haven’t gotten the message that the war is lost.

    In June, we’ll find out if the ACA is the cat with nine lives. Easy to laugh at, if not for the fact that the actual lives of millions of people who rely on the law for life-saving health care are at stake. 

    Richard Kirsch is a Senior Fellow at the Roosevelt Institute, a Senior Adviser to USAction, and the author of Fighting for Our Health. He was National Campaign Manager of Health Care for America Now during the legislative battle to pass reform.

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  • America's Tax Code Is Broken, But the Rubio-Lee Plan Won't Fix It

    Mar 4, 2015Eric Harris Bernstein

    "We believe that America’s best days are still ahead. But we also recognize that restoring the shared prosperity that comes from a strong economy requires reforming the most antiquated and dysfunctional government policies, beginning with the federal tax system."

    -Senators Marco Rubio and Mike Lee 

    Finally, something we can all agree on. 

    "We believe that America’s best days are still ahead. But we also recognize that restoring the shared prosperity that comes from a strong economy requires reforming the most antiquated and dysfunctional government policies, beginning with the federal tax system."

    -Senators Marco Rubio and Mike Lee 

    Finally, something we can all agree on. 

    In their joint op-ed in this morning's Wall Street Journal, the two Republican senators proposed a new tax plan and argued that our current federal tax structure is broken, its problems "rooted in the same fundamental unfairness and inequity of a government that picks winners and losers."

    Again, we here at the Roosevelt Institute welcome this realization. For too long, our tax code has helped the few at the expense of the many. Unfortunately, an analysis of their proposed solutions shows that the senators have come out on the wrong side of this argument. 

    First, they propose lowering the top corporate tax rate to 25 percent. This would be a step worth discussing if not for the fact that, with offshore tax havens and a wealth of other tax benefits, America's largest corporations currently pay an effective rate of just 12.6 percent. In the words of Roosevelt Institute Chief Economist Joseph Stiglitz, it would seem that the problem is not double taxation, but no taxation.

    The senators then argue that, in order to incentivize investment, they would make all capital expenditures 100 percent tax-deductible, suggesting that taxes have squeezed corporations out of the investment business. But if this is the case, then how do we explain the $2 trillion currently being held abroad by America's largest corporations? And what about the enormous sums that companies like Apple and Home Depot are spending on buybacks to enrich investors? 

    In fact, new research from Roosevelt Institute Fellow J.W. Mason shows us that the link between corporate cash flow and productive investment has been all but severed since the shareholder revolution of the 1980s. Shareholders now pocket an increasingly large portion of corporate earnings and borrowing that would have once gone to capital investments, job creation, or raising workers’ pay. Given these facts, as well as the current level of historically high profts, it is clear that corporate investment is not suffering from lack of funding, and that more spending on corporate welfare is the wrong way to go.

    Lee and Rubio suggest that corporate taxes drive American industries abroad. This is absolutely true: Corporations want to benefit from American security, infrastructure, and human capital, but they don't want to pay their share to maintain those invaluable assets, so they shelter themselves in tax havens like Ireland. The problem, from our point of view, is not, as Rubio and Lee suggest, that the tax code taxes corporations (indeed, that is what a tax code exists to do); the problem is that it allows wealthy corporations to avoid those taxes. 

    We need policies that will ensure corporations contribute like the rest of us, not ones that will commit more public money to private enterprise. 

    The senators state that their plan is guided by the principles of fairness, freedom, and growth. This raises the question: In whose mind is it fair to spend hundreds of billions of dollars on wealthy corporations, while Americans drive on pothole-pocked roads and send their children to overcrowded schools to learn from underpaid teachers?

    For the individual income tax, Rubio and Lee propose reducing the number of brackets to two -- one at 15 percent and one at 35 percent. Even though they have been greatly reduced since the 1980s, lowering rates for middle-income earners is worth discussing. The far more significant part of this proposal, however, is the 11 percent tax break for top income earners, which would further reduce the amount of public funds available for things like roads and schools, and which would further tip our economic balance toward the wealthy.

    The senators would likely argue that this tax break will stimulate productive spending, but trickle-down economics did not work under Reagan and will not work now.

    Toward the end of their op-ed, the authors posit a series of pro-family tax reforms, like tax credits for children and tax breaks for couples filing jointly. These policies are rooted in a belief that families with married parents are more economically stable and productive than single-parent families. Again, this may be a point worth debating, but these miniscule incentives are scarcely more than lip service to the American middle class, which this plan largely forsakes in favor of more tax cuts for large corporations and the wealthy. 

    More generally, Rubio and Lee frame their entire plan as a benefit to average Americans, but do this while glossing over policies that will only continue our current trend of supporting the wealthy at the expense of the country as a whole. The Stiglitz tax reform plan, on the other hand, offers a blueprint for a tax code that would bolster the middle class while driving growth and opportunity. 

    Now that we’ve all agreed on the problem, we should look to solutions that economists tell us actually work.

    Eric Harris Bernstein is a Program Associate at the Roosevelt Institute.

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  • Reduce Police Brutality Through Community-Building

    Mar 2, 2015Andrew Lindsay

    Efforts that connect police to the community in which they serve help to reduce encounters that lead to extrajudicial killings by police.

    Efforts that connect police to the community in which they serve help to reduce encounters that lead to extrajudicial killings by police.

    In Darren Wilson’s grand jury testimony, he describes Michael Brown, an unarmed teen, as a “demon.” After he fired the first shot, Wilson says he heard a “grunting, like aggravated sound” coming from the teenager. He explains, “You could tell he was looking through you. There was nothing he was seeing.” After firing 12 rounds, Wilson eventually shot Brown in the head, killing him.

    In a 911 report, a caller related that someone, possibly a child was pointing “a pistol” at random people in a Recreation Center. The caller clarified that the gun was “probably fake.” According to the responding officers, they approached 12-year-old Tamir Rice, ordering him to hold up his hands. Tamir reached to his waistband and grasped a bb gun. In a matter of seconds, one of the officers fired two shots, fatally hitting Rice once in the torso. Footage was released of the officers tackling the bereaved 14-year-old sister of Rice after they shot her 12-year-old brother. Rice’s mother said that a friend had given him the toy gun to play with minutes before the police arrived.

    In these descriptions we see fewer teenagers and more vicious animals. Many extrajudicial killings of Black people share similar dehumanizing stories. Policy makers and community members need to shift this pervasive negative narrative. Micro-place community policing is one solution.

    In vulnerable communities, high rates of gang violence and high rates of police bias come hand in hand. Between 1991 and 2013, there were on average approximately 400 police killings reported to the FBI from local police. Out of all these incidents reported annually, an average of 96 per year involved a white police officer killing a black person. In contrast, there were no fatal police shootings in Great Britain in 2013. In Canada, cases of ‘justifiable homicide’ hover around a dozen annually. These figures reveal a disturbing propensity for US police officers to use deadly force and a high potential for racial bias in shoot/don’t shoot scenarios.

    Project Longevity in Connecticut, Operation Ceasefire in Boston, and lesser-known initiatives in Chicago and Cincinnati are organize to reduce the homicide victimization and gang violence among young people in these areas, with the help of local law enforcement and community partners. However, these programs also have unseen potential to increase police-community relationships and humanize black lives in the eyes of law enforcement. Community members not only patrol with police but also are considered equal partners.

    Project Longevity is a community-oriented policing strategy to reduce gang violence in three of Connecticut’s major cities: New Haven, Bridgeport, and Hartford. It is modeled after successful efforts implemented by the Chicago Police Department (CPD) and Operation Ceasefire: Boston Gun Project. Connecticut has seen dramatic declines in police and civilian violence after the initial implementation of this program.

    Project Longevity directs federal and state spending to the most vulnerable communities in these cities with the purpose of steering at-risk youth and repeat offenders away from violence. A broad array of social services (housing, educational opportunities, addiction and mental/health care) are offered to those who want to end the cycle of community violence and gang activity – with the option of “receiv[ing] the full attention of the law” the next time any crime occurs.

    Longevity combines social services, law enforcement, and community involvement to target crime and positively influence dynamics between residents and the police. Key to this strategy is a quarterly “call-in,” an intervention that combines local, state, and federal level law enforcement; community members; service providers; parents; and members of the clergy.

    According to Tiana Hercules, “They speak to these young men and in some cases young women at the call-in and explain to them the consequences of further gun violence in the city of Hartford. Essentially, the message is put the guns down or the next body that drops in the city or person to get shot is going to receive the full focus of law attention. And not only yourself, but also those who you run with.” Violent crime in Connecticut’s three big cities after Project Longevity has decreased nearly 15 percent and crime in the state has decreased 10 percent, twice the national average. Longevity is credited with half of this overall cut in statewide violent crime.

    The problem of police brutality in the United States is one of police accountability, but not in the conventional understanding of the term. The typical hypothesis is that once law enforcement is vigorously policed they will be held to a higher standard, decreasing the likelihood of police excess. This is the motivation behind the Obama administration’s $75 million push for mounted body cameras nationwide. Perhaps if Darren Wilson were monitored, he would not have so easily killed Mike Brown, or so the story goes. However, history teaches us that this conventional way of policing the police may be misplaced. In the trial of LAPD officers who beat Rodney King in 1991, videotape evidence was argued away because it did not present the full picture. This year, apparently indisputable video was refuted in the recent police killings of Eric Garner and John Crawford.

    Instead of external accountability, police officers need to develop a greater sense personal accountability to the vulnerable in communities where they serve. This need for personal accountability stems from a racial and spatial separation that keeps communities and police isolated. This gap reinforces the biases that keep youth like Mike Brown and Tamir Rice dehumanized by the very people tasked with their protection. Programs that put law enforcement and communities in greater contact should be encouraged.  There is no better policing mechanism than one’s conscience. Working closely with residents provides information that can prevent dangerous encounters with police, simply by police intimately knowing community members and their families. More importantly, these programs humanize members of vulnerable communities to law enforcement. Darren Wilson was wrong. There are no demons, just police officers isolated from communities.

    Andrew Lindsay, a 2015 Truman Scholarship Finalist in Massachusetts, is a junior at Amherst College, where he is an active member of the Roosevelt Institute | Campus Network and studies Law, Jurisprudence & Social Thought.

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  • Make the Stop Overdose Stat Act a Priority for 2015

    Feb 26, 2015Emily Cerciello

    It’s time for Congress to take an evidence-based and public health focused approach to the epidemic of opioid overdoses.

    It’s time for Congress to take an evidence-based and public health focused approach to the epidemic of opioid overdoses.

    Opioid overdose is an epidemic in the United States. Drug overdose death rates have more than tripled since 1990, with the vast majority of these deaths attributable to an increase in the prescription and sale of opioid medications. The death rate from heroin overdose doubled between 2010 and 2012, and young people are now more likely to die from drug overdose than from motor vehicle crashes.

    These statistics may be surprising, but their causes are familiar – commonly abused prescription opioid medications include names such as Vicodin, OxyContin, Percocet, or codeine, as well as the illicit drug heroin, which creates similar pain-relieving effects. Prescription drugs are often considered a “gateway” to heroin use as heroin addiction often begins as a cheaper alternative to prescription painkillers.

    In March 2014, Rep. Donna Edwards (D-MD) introduced the Stop Overdose Stat (SOS) Act to create a federal plan for preventing fatal drug overdoses and prioritizing community- and state-based efforts for the development of best practices. The SOS Act would provide federal support for overdose prevention programs, which can include training bystanders, law enforcement, and first responders in recognizing signs of overdose, seeking medical assistance, or administering naloxone. Naloxone is a life-saving medication that reverses the effects of heroin or opioid prescription overdose. As of December 2014, twenty-six states and the District of Columbia have removed legal barriers to provider prescription and layperson administration of naloxone. Additionally, 20 states and the District of Columbia have established Good Samaritan protection, which grants immunity from arrest for calling 911 to seek medical assistance in the event of overdose.

    The SOS Act, cosponsored by 39 legislators, approaches opioid prevention and treatment through a public health and health equity lens. While no socioeconomic or demographic group is immune to the abuse of prescription drugs or heroin (the most dramatic increases have occurred among white, middle-aged women in rural areas), urban areas with large African American populations are still where the majority of overdoses are happening. The SOS Act would create a grant program administered by the Centers for Disease Control and Prevention that gives priority to community organizations working to prevent overdose in high-risk populations.

    The SOS Act would also create a mechanism for detailed reporting of overdose data for the development of best practices for preventing overdose deaths. It would require the Secretary of Health and Human Services to develop a national plan to be submitted to Congress within 180 days of enactment that incudes a public health campaign, recommendations for expanding overdose prevention programming, and recommendations for legislative action.

    The bill was closed out of the 113th Congress, but should be reconsidered in the current session as the issue builds momentum in both Democratic- and Republican-led states. The re-introduction of the SOS Act is an opportunity for Congress to take immediate action in responding to a significant public health issue with a bipartisan solution. States are implementing evidence-based laws to address the worsening overdose epidemic. It is time for the federal government to follow suit.

    Emily Cerciello is the Roosevelt Institute | Campus Network Senior Fellow for Health Care, and a senior at the University of North Carolina at Chapel Hill.

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