Insurance Pays for Health Care. Who’s Providing It?

Mar 28, 2014Rachel Goldfarb

Public funds for family planning services are essential to ensuring people have somewhere to access health care, not just the insurance to pay for it.

Public funds for family planning services are essential to ensuring people have somewhere to access health care, not just the insurance to pay for it.

As if somehow the case still needs to be made that family planning deserves federal funding (and apparently the case does need to be made), last week a panel of researchers, advocates, and family planning providers spoke at a Congressional briefing on the topic “The Publicly Funded Family Planning Network: An Essential Partner in the New Health Care Environment.” Among the panelists was Roosevelt Institute Fellow Andrea Flynn. She and the others explained how Title X, the only federally funded family planning program, fits into the health care landscape now so dramatically changed by the Affordable Care Act. On the heels of Flynn’s white paper on this topic, last Thursday’s panel marked the next step in Roosevelt’s approach to research and policy discussions – namely, to get ideas up and out to those, like the Congressional staffers who attended the briefing, that can convert them into action.

Some background: when Title X was signed into law in 1970, it was intended to ensure that more Americans had access to family planning services, including birth control, because of rising concerns about population growth and poverty. Title X funds patient services, staff salaries, infrastructure, and supplies at clinics across the country. The law had strong bipartisan support – Democrats worked alongside Congressman George H. W. Bush and President Richard Nixon to pass it. And it is pretty effective: according to Flynn, the program today provides care to 4.7 million individuals annually. From 1980 to 2000, Title X-funded clinics provided women with 54.4 million breast exams and 57.3 million Pap tests and prevented an estimated 20 million unintended pregnancies. It’s also cost effective: Flynn notes that in 2008 alone, services provided at Title X-supported clinics accounted for $3.4 billion in savings.

Opponents of federal family planning clinics argue that with full implementation of the Affordable Care Act, the need for funding will drop off. No, said Clare Coleman, President and CEO of the National Family Planning and Reproductive Health Association. Insurance, she pointed out, isn’t the same as access to care. Patients still need providers. Amanda Dennis of Ibis Reproductive Health, based in Cambridge, highlighted an Ibis study conducted after health care reform went into effect in Massachusetts, that found many women took their new insurance straight to Title X-funded clinics for family planning services. Patient numbers actually increased at these clinics and so did the number of insured patients. Women like the care they get at Title X clinics; having insurance doesn’t mean they want to switch providers.

The panel confirmed Flynn’s major conclusions on Title X: the Affordable Care Act doesn’t guarantee every American will be insured at all times, so there remains a need for publicly funded care providers. More federal funding for the Title X family planning network will be essential to ensure women can access reproductive health care. And Coleman drove home another invaluable point as we work on health care access: the Affordable Care Act creates a massive shift in the way many Americans actually go about getting their health care. As a child growing up with insurance, I had an annual physical that was scheduled months in advance, and my mom picked up our prescriptions at the pharmacy. Americans who grow up uninsured have a different experience. They go to public clinics, where they can expect long waits, and when they leave, they go with prescribed medication in hand, obtained at the on-site dispensary.

In other words, signing up for health insurance on healthcare.gov won’t on its own teach anyone how to use insurance. That will take a generational shift. Besides which, you don’t get health care from your insurance – you get health care from your doctor, and cover the costs with insurance. That’s why Title X clinics must remain an option. Public funding for family planning does increase access to providers. Advocates: keep driving this point home to legislators!

Rachel Goldfarb is the Communications Associate at the Roosevelt Institute.

 

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Venezuela: The Crisis We Fuel With Our Apathy

Feb 28, 2014Leslie Bull

When the mainstream media ignores crises abroad, the crisis doesn’t stop or disappear, and that lack of attention can shift a situation from bad to worse.

When the mainstream media ignores crises abroad, the crisis doesn’t stop or disappear, and that lack of attention can shift a situation from bad to worse.

Given the recent revolutionary events in Ukraine, it is understandable that much of American media attention on foreign politics is concentrated on that country, and that country alone. But it is important to remember that our myopic focus on just one world event at a time comes with a price: sometimes the other crises in the world that go ignored are actually made even worse because of it. We sometimes forget the power that just paying attention to a crisis can have – without it, those perpetrating the crimes can rest assured that the international community’s eye is elsewhere, and can behave with impunity. In the case of the current unrest in Venezuela, the price of that apathy might just be my friend’s life.

That friend is Carlos Vecchio, National Political Coordinator of the Venezuelan opposition party Voluntad Popular (VP). I met Carlos when he came to Yale University just a few months ago to start his term as a Yale World Fellow. While he was here, he spoke passionately about his tireless efforts to promote democracy in Venezuela; his enthusiasm and depth of knowledge were infectious. As a recent college grad, I was by far the youngest and least experienced of the staff on the program and he always made time for me and treated me with respect and kindness. He reached across campus to students, faculty and other Fellows – many of whom have rallied around him in this time of crisis – with his pure love of his country and genuine respect for democratic ideals. And now, just two months after returning to Venezuela, he is facing a warrant for his arrest.

Venezuela is in the midst of game-changing anti-government protests by students and opposition party supporters (many led by Voluntad Popular members), calling for improved security, an end to shortages of basic goods, and better freedom of speech. The Venezuelan government has responded with a violent crackdown on protestors, raids on VP’s political offices, and persecution of VP leaders, including Carlos. Following the detention of top VP leader Leopoldo López, who was taken into custody on February 18, Carlos now serves as the de facto leader of the VP party, making him a likely government target. Carlos’ safety is in serious jeopardy, and he is currently in hiding with limited access to communication. Unlike López, he is not an internationally recognized figure, so media outlets outside of Venezuela have yet to report on his situation. Amnesty International has released an alert specifically naming Carlos as a government target, but his relative anonymity will allow government forces the space and ability to do whatever they please without fear of international repercussion. 

This is the real, human result of what may seem like harmless apathy on our part. Leaders who want to stifle political opposition and media freedom through extreme or violent means are free to do so, and those working to effect positive democratic change are sacrificed because we can’t be bothered to pay attention. As Francisco Toro, of the blog Caracas Chronicles, put it best:

“Venezuela’s domestic media blackout is joined by a parallel international blackout, one born not of censorship but of disinterest and inertia. It’s hard to express the sense of helplessness you get looking through these pages and finding nothing. Venezuela burns; nobody cares.”

We cannot continue to choose our apathy over people like Carlos, who are putting their lives on the line for the sake of a functioning democracy. Senator Robert Menendez of New Jersey, Chairman of the Senate Foreign Relations Committee, has spoken out about Carlos’ persecution, and a few news outlets are picking up the story, but there is a long way to go if we are to ensure Carlos’ safety. Please share Carlos’ story far and wide, urge your representatives to speak out as well, and help us show the Venezuelan government that someone is paying attention.

Leslie Bull is a former Senior Fellow for Defense and Diplomacy with the Roosevelt Institute | Campus Network. She is currently a Woodbridge Fellow at the Office of International Affairs and the World Fellows Program at Yale University. All opinions expressed herein are her own, and not those of Yale University or its administration.

Photo via Flickr.

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We Need More Nuance from the CBO

Feb 20, 2014Jeff Madrick

The CBO's insistence on presenting just a single number makes its predictions misleading, and sometimes even useless.

I have long thought we need two Congressional Budget Offices, the current one and a real one. The problem with the current “bi-partisan” CBO is again apparent in the wake of its claims about the impact of the president’s proposed increase of the federal minimum wage to $10.10.

The CBO's insistence on presenting just a single number makes its predictions misleading, and sometimes even useless.

I have long thought we need two Congressional Budget Offices, the current one and a real one. The problem with the current “bi-partisan” CBO is again apparent in the wake of its claims about the impact of the president’s proposed increase of the federal minimum wage to $10.10.

But let’s take a step back. The CBO has long had little sensitivity to the impact of how it presents its invariably uncertain findings. To the contrary, it seems to respond to a demand from Congress and the general public for a concrete number, essential ambiguities aside. It has long presented one-number conclusions – the size of the budget deficit, the rate of economic growth, the impact on jobs of the minimum wage – as if people are educated enough in the uncertainties of economics that they won’t take the numbers too seriously. 

But, in fact, they do. The CBO economists disingenuously cover themselves by burying the extensive qualifications of the data and research, as well as alternative possibilities, in dense appendices and footnotes. In the process, they feed politicians and pundits with projections the poor naïfs think are written in stone – or are, most likely, perfect for use as political cover. Is this unwitting, or does the CBO enhance its influence with these easy-to-digest but misleading pronouncements?

But the CBO is worse than merely insensitive to its public relations impact. Their economists typically treat economic hypotheses as entirely true. A couple of centuries ago, John Stuart Mill pointed out that economics is hypothetical. CBO economists should go back and read this. They base forecasts on the imbedded idea that weak economies will automatically self-adjust within three or four years, for example. This is a neoclassical assumption, not a fact of life. They acknowledge that higher deficits can stimulate a weak economy but within a few years it will undercut growth. Evidence is highly ambiguous on this point. They have little compunction about making thirty-year forecasts, no less ten-year forecasts. No one knows what will happen in ten years. 

The bi-partisan label has become comical. The CBO does not necessarily lean Republican or Democrat, but it is not truly objective. Economics does not allow that.

A real CBO would present a range of projections and forecasts and make a priority of demonstrating how tentative most of its conclusions must be. The current CBO sometimes presents a secondary forecast if certain expected changes in the laws are actually made, but it should publish a range of likely outcomes with or without legal changes.

I guess I am merely stating the obvious, but the obvious has to be addressed at some point. The minimum wage debate is another clear example. Read the appendices and footnotes and you see the CBO took its job seriously; its economists read a lot of research. For those families below the poverty line, income would rise by $5 billion; for those from one to three times the poverty line, incomes would rise by $12 billion. These are mere estimates, let’s keep in mind. Nearly one million would be lifted out of poverty. Those who earn some seven times the poverty line or better would see their incomes reduced because business profits might come down due to higher wages and prices may go up for the products they buy, If true, these estimates suggest a pretty nice redistribution of the national income to lower-income families, not bad in a time of intense inequality.

But the headlines were created by the CBO’s claim that 500,000 jobs will be lost. Here’s the actual sentence: “Once fully implemented in the second half of 2016, the $10.10 option would reduce total employment by about 500,000 workers, or 0.3 percent, CBO projects.” The sentence that follows has the tepid disclaimer that there could be a wide range of job losses. But then why make the declarative sentence above? It’s the one, of course, that anti-minimum wage politicians focused on, as did much of the media. But the 500,000 number is not a forecast, it is simply a midpoint on this wide distribution from essentially zero jobs lost to one million. Oh, yes, the CBO eventually says that, but as a writer myself, I have to ask why the CBO doesn’t present the uncertainty immediately.

The CBO, as is now widely reported, did no original research. It looked at existing studies. A recent one in particular, which showed substantial losses, used a highly dubious methodology. The study showed the biggest future job losses were in manufacturing, which has relatively few minimum-wage jobs. By contrast, it showed few prospective losses in retail and similar industries, which have many such minimum wage jobs. This is highly implausible. Economic critics concluded the methodology was flawed. Why did the CBO pay attention to it?

It’s high time to rethink the purpose and practical capabilities of the CBO. It should be forthright about the ambiguities of economic science, it should avoid single-note forecasts, and it should make sure policymakers understand the risks and sensitivities of what they are doing. In sum, it should not produce simple answers to complex questions.

Does any of this really need saying? Judging by the minimum wage brouhahah, it does. Ideally, we need a “shadow” CBO to challenge its findings and explain their many assumptions on a regular basis. That would be costly, I fear. But some review of the purpose of the CBO and what they emphasize would be very useful. 

Jeff Madrick is a Roosevelt Institute Senior Fellow and Director of the Bernard L. Schwartz Rediscovering Government Initiative.

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Obama and the GOP Present Two Very Different Paths to Opportunity for All

Feb 3, 2014Richard Kirsch

Both the 2014 State of the Union and the Republican response emphasized the need for an opportunity society, but only the president called for collective action.

Both the 2014 State of the Union and the Republican response emphasized the need for an opportunity society, but only the president called for collective action.

Midway through listening to Rep. Cathy McMorris Rodgers’ Republican response to the State of the Union address last week, a colleague of mine e-mailed, “they got & used the economic narrative talking points to write this.” My friend was referring to the progressive economic narrative (PEN), developed to provide progressives with a powerful, clear story about the economy and the role of people, government, and business.

In fact, there are powerful similarities in the story of the American Dream that both Obama and Republicans express, particularly as Republicans increasingly see that they must speak to Americans who are being pushed out of the middle class and struggling to stay out of poverty. That convergence is not by itself bad. It is an opportunity to draw attention to the huge chasm that exists between the two narratives, a Republican story based solely on the individual and a Democratic one that sees the individual in relation to collective action.

Perhaps this is the line by McMorris Rodgers that triggered my colleague’s ire: “Last month, more Americans stopped looking for a job than found one. Too many people are falling further and further behind.” After all, one line from PEN is “Too many Americans can’t find a job and too many jobs pay wages that don’t support a family.”

It is not a surprise that Republicans have been embracing part of the progressive story – that the middle class is getting crushed – because that is how most Americans are feeling, and pollsters for both parties are emphasizing that politicians must speak to where people are now to have any credibility.

The similarities go beyond just relating to economic insecurity. Both Obama and McMorris Rodgers have the same vision of the American Dream, an opportunity society in which people are, as McMorris Rodgers said, “not defined by our limits, but by our potential.” Or, as the president put it, “our success should depend on… the strength of our work ethic and the scope of our dreams.”

The heroes in both stories are hardworking Americans. Obama: “the notion that if you work hard and take responsibility you get ahead.” McMorris Rodgers: “They taught me to work hard, help others, and always, always, dream for more.”

A job is how our hero achieves his or her dream. McMorris Rodgers says, “a job is so much more than a paycheck – it gives us purpose, dignity…” The president asks that “we do more to make sure our economy honors the dignity of work…”

The underlying value in both stories is opportunity. McMorris Rodgers anticipates that Obama will focus his speech on inequality and tries to cut him off at the rhetorical pass: “The president talks a lot about income inequality. But the real gap we face today is one of opportunity inequality.”

But Obama was not, in fact, giving a speech about inequality. He too was focused on opportunity, as Benjamin Landy bemoaned. “Instead of inequality, the President talked about ‘opportunity,’ a poll-tested alternative Obama deployed 14 times during the 65 minute speech. ‘Inequality’ was mentioned three times.”

Saying that “opportunity for all” is “what unites the people of this nation,” Obama declared, “Opportunity is who we are. And the defining project of our generation is to restore that promise.”

It is on the question of how we achieve the quest for opportunity for all that the president and McMorris Rodgers profoundly differ, where opposite visions of how we achieve the American Dream are projected. And remember that McMorris Rodgers’s speech is entirely a representation of Republican messaging

According to McMorris Rodgers, you get there by yourself, with the help of your family. Her talk, as those of you who had the patience to listen through it will remember, was all about herself and her family: the work and savings ethics taught by her parents in a rural small town in Eastern Washington, her raising of her son born with Down syndrome.

And that, in her political narrative, is how we address the challenge facing the country, “one manufacturing job, nursing degree, and small business at a time.” Her talk barely bothers with policy directives, but those few that appear are based on the individual.

The most robust policy paragraph in her talk is, “We have plans to improve our education and training systems so you have the choice to determine where your kids go to school...so college is affordable...and skills training is modernized.” When it comes to health care, “Republicans believe health care choices should be yours, not government. [emphasis added]”

As far as how to get Americans those jobs, Republicans have “plans that focus on jobs first, without more spending, government bailouts, and red tape.… We have solutions to help you take home more of your pay – through lower taxes, cheaper energy costs, and affordable health care.”

The villain is unmistakable in her story: “Government that decides for you.”

But while the president’s heroes are individual hard-working Americans, he makes it clear that we build the pathway to opportunity for all through collective action. The word “community” appears 13 times in Obama’s speech; not once in McMorris Rodgers. The president uses “us” referring to the nation, 17 times; McMorris Rodgers, four times.

The substance of Obama’s policy solutions are replete with concerted actions, and the entire premise that we do something together, through our government, is the exact opposite of the Republican story of getting the government out of the way.

The stories he tells unite the individual and the community. For example, a student who, “thanks to the support of great teachers and an innovative tutoring program, he led a march of his classmates – through a crowd of cheering parents and neighbors – from their high school to the post office, where they mailed off their college applications.”

Summing it all up – the heroes, the quest, the role of individual and the community, Obama says, “It’s the spirit of citizenship, the recognition that through hard work and responsibility, we can pursue our individual dreams, but still come together as one American family to make sure the next generation can pursue its dreams as well.”

The narratives in President Obama and McMorris Rodgers’ responses are more than just a minor part of the evening’s political theater. They speak to the fundamental ideological divide in the nation and frame the political choices before the country now and over the coming decade. In the starkest terms, it is a contrast between “you are on your own” and “we are all in this together.” We want to tell our story in those terms, for when we do, progressives absolutely win that debate.  

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.

 

Images via Thinkstock

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Daily Digest - February 3: Financial Reform Enters a New Era

Feb 2, 2014Rachel Goldfarb

Click here to receive the Daily Digest via email.

What's the Deal: What's Next for Financial Reform (YouTube)

Roosevelt Institute Fellow Mike Konczal talks about what the Dodd-Frank financial reform law accomplished, what still needs to be done to change the system, and why there are reasons for reformers to be optimistic about the future.

Click here to receive the Daily Digest via email.

What's the Deal: What's Next for Financial Reform (YouTube)

Roosevelt Institute Fellow Mike Konczal talks about what the Dodd-Frank financial reform law accomplished, what still needs to be done to change the system, and why there are reasons for reformers to be optimistic about the future.

  • Roosevelt Take: Read "An Unfinished Mission," the report from the Roosevelt Institute and Americans for Financial Reform that Mike discusses in this video, here.

New Fed Chief Janet Yellen Lets a Long Career of Breaking Barriers Speak for Itself (WaPo)

Ylan Q. Mui profiles Janet Yellen's career with a focus on gender, as Yellen has been a prominent face for women in economics over the years. She notes that Yellen has rarely spoken on gender issues, and has asked her staff to use the title "chair" rather than "chairwoman."

Oh, Sweet Mercy, Are We About To Have Another Debt Ceiling Fight? (HuffPo)

Jason Linkins examines why another debt ceiling fight seems likely, even though the GOP has already lost bargaining power by giving in on the last two. He sees the Republicans' insistence on turning everything into a fight against Obamacare as a losing strategy.

Domino’s Delivery Workers Settle Suit for $1.3 Million (NYT)

Steven Greenhouse reports on the settlement between 61 deliverymen and a Manhattan Domino's franchise. The workers filed the suit based on minimum wage and overtime violations after many were forced to list far fewer hours on time sheets than they actually worked.

Walmart’s Holiday Profits are Way Down. Food Stamp Cuts are a Big Part of the Reason. (Washington Monthly)

Kathleen Geier says the most interesting part of this story is the explicit tie Walmart has made between food stamp cuts and low sales. She sees this as part of the cycle of austerity politics, which fail to recognize how government cuts can slow the overall economy.

Jerry Brown's Austerity Kick Unpopular with Advocates for Poor (LA Times)

Anthony York writes that Californians disagree on how to use their multibillion-dollar budget surplus. In his State of the State address, Governor Brown pushed for a rainy-day fund, but others are discussing popular social safety net proposals like universal pre-K and paid sick leave.

The Problem with Retirement Savings: Making Enough Money to Save (The Guardian)

Suzanne McGee praises President Obama's MyRA plan as a "tiny positive step," but points out that it won't do anything to solve the real problem. As wages have flatlined, increased options for saving won't help workers who need every dollar for bills today.

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Daily Digest - January 31: Out of Economic Chaos Come Executive Orders

Jan 31, 2014Rachel Goldfarb

Click here to receive the Daily Digest via email.

The President and Inequality (All In with Chris Hayes)

Click here to receive the Daily Digest via email.

The President and Inequality (All In with Chris Hayes)

Roosevelt Institute Senior Fellow and Chief Economist Joseph Stiglitz discusses the place of inequality in this week's State of the Union address, and the deeper question of why we don't implement the economic policies that would absolutely make a difference.

A History of Executive Orders (All In with Chris Hayes)

Roosevelt Institute Fellow Dorian Warren talks about the similarities between President Obama's plans for executive orders, as announced in the State of the Union, and President Franklin D. Roosevelt's use of the executive order, which also pushed for progressive labor policy.

Obama’s Toughest Job (NYRB)

Roosevelt Institute Senior Fellow and Director of the Bernard L. Schwartz Rediscovering Government Initiative Jeff Madrick comments on the State of the Union, complimenting the president for making jobs a central focus despite the challenges of that issue.

The Post Office Should Just Become a Bank (TNR)

David Dayen argues that there's one policy the president could push through that would contribute to many of the goals he articulated in the State of the Union: postal banking, which would create jobs, help the poor, and could be accomplished through executive order.

Why Alt-Labor Groups Are Making Employers Mighty Nervous (TAP)

Lane Windham says that for all that anti-union groups want to tout low union membership numbers, labor isn't going anywhere. Alternative labor groups are growing and gaining power, as the growing discussion about raising the minimum wage makes clear.

GOTD: Inequality Is Not A Four Letter Word (Blog of the Century)

Benjamin Landy contrasts Tuesday's State of the Union with the president's December 4 speech at the Center for American Progress. His shift from "inequality" to "opportunity" is clearly a political one, since he still endorsed progressive policies, but why the centrist rhetoric?

New on Next New Deal

The Rise of 'Insourcing' Gives Internet Companies a New Way to Exploit Workers

Roosevelt Institute | Campus Network National Operations Strategist Lydia Bowers cautions that while Internet-based service companies like Uber and Taskrabbit may make life easy for their customers, they don't give their workers any real protections.

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The State of the Union Then and Now: Raising the Minimum Wage is Still a Good Idea

Jan 29, 2014David B. Woolner

Decades after FDR called for a national minimum wage, the debate continues -- and his arguments for it still ring true.

Decades after FDR called for a national minimum wage, the debate continues -- and his arguments for it still ring true.

We have not only seen minimum wage and maximum hour provisions prove their worth economically and socially under government auspices in 1933, 1934 and 1935, but the people of this country, by an overwhelming vote, are in favor of having the Congress—this Congress—put a floor below which industrial wages shall not fall, and a ceiling beyond which the hours of industrial labor shall not rise. – Franklin D. Roosevelt, State of the Union Address, January 3, 1938

In calling for an increase in the minimum wage in his State of the Union address, President Obama may have unwittingly echoed Franklin D. Roosevelt. For it was in the sixth year of FDR’s presidency, in the annual message to Congress that FDR delivered on January 3, 1938, that Roosevelt reiterated his increasingly vehement call for the passage of the Fair Labor Standards Act—the very law that would establish the national minimum wage.

In proposing the legislation, FDR used many of the same arguments that President Obama used to counter the conservative opposition that insisted—much as the conservative right does today—that the federal government has no business trying to increase the purchasing power of the average worker, and that the enactment of a national minimum wage law would hurt business and increase unemployment. Opposition in the largely non-union and racially segregated South—where there was a huge differential between the wages of white and black workers—was especially intense, and thanks to the actions of Southern Democrats in both the House and Senate, who had joined with conservative Republicans in the formation of an anti-New Deal coalition, passage of the Fair Labor Standards Act was not going to be easy.

To counter these arguments, FDR appealed, as he often did, to the moral sensibilities of the American people, insisting that government had “a final responsibility for the well-being of its citizenship” and this included enacting “legislation to end starvation wages and intolerable hours.” Furthermore, there were sound economic reasons to pass wage and hours legislation. In an earlier address on the subject, using language that is especially relevant to President Obama’s call for an increase in overseas exports, FDR observed that:

American industry has searched the outside world to find new markets—but it can create on its very doorstep the biggest and most permanent market it has ever seen… A few more dollars a week in wages, a better distribution of jobs with a shorter working day will almost overnight make millions of our lowest-paid workers actual buyers of billions of dollars of industrial and farm products. That increased volume of sales ought to lessen other cost of production so much that even a considerable increase in labor costs can be absorbed without imposing higher prices on the consumer. I am a firm believer in fully adequate pay for all labor. But right now I am most greatly concerned in increasing the pay of the lowest-paid labor—those who are our most numerous consuming group but who today do not make enough to maintain a decent standard of living or to buy the food, and the clothes and the other articles necessary to keep our factories and farms fully running.

Interestingly, a group of over 600 economists, including seven Nobel laureates, recently issued an open letter calling on President Obama and the congressional leadership in both parties to raise the minimum wage, arguing, as FDR did, that “the weight of evidence” shows that an increase in the minimum wage will “have little or no negative effect on the employment of minimum-wage workers, even during times of weakness in the labor market.”

It seems incredible that we should still be locked in the same debate about the moral and economic impact of an increase in the minimum wage more than three-quarters of a century later, at a time when even the McDonald’s Corporation had to admit after its own internal analysis that its minimum-wage workers could not survive on what they were receiving without the addition of a second job.

In 1938, Franklin Roosevelt argued that if we want to move “resolutely to extend the frontiers of social progress, we must… ever bear in mind that our objective is to improve and not to impair the standard of living of those who are now undernourished, poorly clad and ill-housed.” The Fair Labor Standards Act, which was signed into law on June 25, 1938, has helped improve the lives of millions of American workers—especially those at the bottom rung of the income scale—through its recognition of need to establish a minimum wage and through the provision that provides time and a half for overtime work. But in order for the law to be effective and have meaning, the minimum wage must keep up with the cost of living, and, as President Obama noted in last night’s address, the real wage of the average American worker has been in decline for decades when adjusted for inflation.

If Congress is serious about improving and not impairing the lives of the millions of working poor in this country, then it is high time to heed the president’s call to “give America a raise” and increase the minimum wage. To fail to do so would be yet another example of the callous indifference—most recently exemplified by the failure of Congress to extend long-term unemployment benefits—that those in positions of wealth and power have shown for the plight of the millions of Americans who struggle day by day to get by on wages that force even those working full-time to live a life of poverty. Indeed, the inability or unwillingness of this Congress to act on behalf of the most vulnerable in our society brings to mind the words of the late Pete Seeger, who died this week, when he sang, “which side are you boys, which side are you on?”

David B. Woolner is a Senior Fellow and Hyde Park Resident Historian for the Roosevelt Institute. 

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Roosevelt Reacts: What Worked and What Didn't in the 2014 State of the Union

Jan 29, 2014

Roosevelt Institute Fellows and Network members weigh in on what they liked about President Obama's fifth State of the Union and where it fell short.

Andrea Flynn, Roosevelt Institute Fellow:

Roosevelt Institute Fellows and Network members weigh in on what they liked about President Obama's fifth State of the Union and where it fell short.

Andrea Flynn, Roosevelt Institute Fellow:

Last night, President Obama again proved himself to be a champion of improving the economic security of American women. He addressed many policy initiatives – immigration reform, universal pre-K, paid sick and family leave, and strengthening the Earned Income Tax Credit – that, if advanced by Congress, would have a positive impact on women and their families. Most notable was his strong support for raising the minimum wage. Yesterday the president issued an executive order requiring federal contractors to pay their employees at least $10.10 an hour, and in his address he called on governors and state legislators around the country to follow his example. This is an issue that disproportionately affects women and their families. As of 2011, women represented 46.9 percent of the work force but more than 62 percent of minimum-wage workers. More than 2.5 million American women have incomes at or below the minimum wage. As President Obama noted, women still only get paid $.77 for every dollar earned by their male counterparts, with women of color being particularly impacted by wage discrepancies. Black women earn $.64 and Latina women $.55 for every dollar a white man earns. Conservatives are likely to criticize President Obama for using the power of his office to mandate such a sweeping change, but there is precedent for utilizing the power of executive orders to institute improvements in the workplace. In fact, more than 40 years ago, President Nixon issued an executive order prohibiting workplace discrimination based on sex, race, age and other characteristics. That order paved the way for an expansion of employment opportunities for women, just as President Obama’s order will begin to level the playing field for American women and their families.

Yasemin Ayarci, President, George Washington University chapter, Roosevelt Institute | Campus Network:

While I was pleased to hear the announcement of an increase in minimum wage for federally contracted workers through an executive order, President Obama must also put in place limitations on executive pay, which will hold them accountable for funneling taxpayer money into their own pockets. But after spending the majority of his time in office coddling banks and wealthy donors, Obama is not the person to look to for decreasing income inequality. To the president, economic reform means tweaking payroll taxes and making hollow calls to end tax cuts for the rich. When you observe the policy, he has made the Bush tax cuts permanent, lowered Wall Street's capital gains and dividends taxes to 20 percent, and lowered the estate tax to 40 percent, among other things. A rearrangement of the tax code that allows Americans to take back the wealth created by labor and accumulated by corporatists is key for a progressive job creation plan and for reducing income inequality levels. That sort of change will not come from the White House, and so progressives must shift their focus to the grassroots, bottom-up approach.

Erik Pekkala, member, Greater Boston Network, Roosevelt Institute | Pipeline:

President Obama set a bold vision for our nation in his 2014 State of the Union address last night. He started the speech by citing various policy accomplishments and measures of growth, signaling "after five years of grit and determined effort, the United States is better-positioned for the 21st century than any other nation on Earth."

The President addressed head-on the Washington gridlock that led to October’s debt ceiling brinksmanship, shuttered the federal government and deeply frustrated the American people. President Obama said he is "eager" to work with Congress to make his vision for the nation a reality, but made it clear that "...wherever and whenever I can take steps without legislation to expand opportunity for more American families, that’s what I’m going to do." While the Commander-in-Chief should use the powers of his office to serve the American people, there are limits to executive authority. If congressional infighting continues to block legislative progress, the Obama administration can only go so far through executive orders and federal agencies.

This State of the Union got a warmer reception from Republican members of Congress than in recent years, with GOP applause for Obama's statements on reforming the immigration system and corporate tax code. As the Republican Party continues its internal debate about its image and connecting with voters, perhaps it will be more open to collaboration and finding common ground with the President and Democrats in Congress. The President seemed renewed as he told the nation that he is ready to go to work. Let's hope he can use that same energy and leadership displayed in last night's speech to unite both parties in Congress to work together for the American people. Only then will the President's vision for our country be realized.

Rajiv Narayan, former Senior Fellow for Health Policy, Roosevelt Institute | Campus Network:

Like many, I was struck by the president's now-crystallized shift away from a deeply unpopular and inactive Congress. While I look forward to 2014 being the politico-zodiac Year of the Executive, I think the "do-nothing" and "lame-duck" characterizations of Congress miss what the legislative branch is doing. On no less than the day of the State of the Union address, the do-nothing Congress did something pretty deplorable -- a farm bill finally moved from conference to the House and Senate floors, and it aims to cut monthly SNAP benefits to 850,000 households by $90. For a presidency increasingly focused on closing the income gap and reducing income inequality, this is a lunge in the wrong direction. As the administration focuses on action at the state and executive levels, it's important to remember we cannot make a powerful legislative body completely irrelevant. President Obama and voters need to draw the line between an unproductive Congress and a counterproductive one. 

David Meni, Vice President, George Washington University chapter, Roosevelt Institute | Campus Network:

I found this State of the Union address to be a much different animal than addresses in past years. There was less rhetoric involving cooperation with Congress, and more emphasis on executive actions that can be taken with some immediacy and without gridlock. President Obama's relative sidelining of Congress has been talked up enough by the news, but I think the implications of the speech are interesting; we saw more policy discussion, from the long-overdue minimum wage increase for federal workers to expanding school broadband access. These are all immediate proposals that will not have to be watered down. That is refreshing.

On the other hand, I was dismayed by the amount that was glossed over. The president's discussion of college affordability was more of the same. The proposal for a comprehensive immigration bill, the much-applauded statement that women should have equal pay, and the brief sentences on gun control and military spending--all of these are critical issues that should be at the core of any State of the Union address, but what I heard was very little tangible policy. So while I am glad that the president is finally talking about addressing issues that are within his executive power, I have to admit that this State of the Union lacked ambition on many of America's most pressing issues.

Jill Nguyen, Co-Director, Hendrix College chapter, Roosevelt Institute | Campus Network:

2013 ended with President Obama’s disapproval rating at an all-time high of 56%, according to CNN. It was a tough year, especially with the technical challenges of healthcare.gov, a much anticipated immigration reform bill kept out of the House’s agenda, and gun control actions achieved only through Executive Orders. Despite my disappointment with failed promises of previous years, the State of the Union address last night brought me back to the hope-filled time that was 2008. By recycling some promises from previous years, the President has managed to satisfy my wish list.

Considering his declaration of 2014 as a year of action, I was glad to see the President return to immigration reform. As I see it, an ideal law should keep families together, evaluate the broken deportation machine, and offer job trainings and education access to immigrants’ families. I was also pleased to see the President recognize the work of the First Lady. It was even more important that he recognized that women are still not paid equally to their male colleagues. The women who were in the chamber, who included the bipartisan group of female senators who led the negotiations that ended the government shutdown, are constitutionally guaranteed equal pay. It's well past time for all women to be paid fairly.

Tarsi Dunlop, member, DC Network, Roosevelt Institute | Pipeline:

As someone who works in the nonprofit education sector, I tend to focus in on elements of the State of the Union that pertain to K-12 education, and to the status of young people in American more broadly. On a rhetorical note, I was thrilled to hear President Obama open the speech with an anecdote about a teacher helping a student. So often, it is the strength of this relationship and the effort and dedication of our teachers that reach those struggling students and help them succeed in the classroom. While education was not a primary focus of last night’s speech, the President did repeat a request from last year’s State of the Union for universal pre-K.

Many state governors are looking at universal pre-K as a possibility to help students start out on more equal footing. This seems to be the strongest acknowledgment we will get from our current government that growing up in poverty can have a negative influence on student learning and academic achievement. I’m familiar with the ‘no excuses’ refrain, and I agree, but the presence of poverty cannot be ignored. While pre-K is a start, kids who grow up in poverty are very unlikely to move out of it over the course of their childhood. We need to factor that into our efforts to support schools with high percentages of low-income students, whether it in wrap-around services, after-school programs or more targeted supports for student learning. Since the full implementation of universal pre-K will rest heavily on the states and cities, the President might also consider how his administration could support such efforts – other than competitive grant funding in the form of another race to the top program.  

Zach Komes, Policy Director, George Washington University chapter, Roosevelt Institute | Campus Network:

Globalization and technological change have dramatically transformed our urban economies from hubs for well-paying manufacturing jobs to neighborhoods suffering from extended structural unemployment. The president argued forcefully for a new year-long focus on boosting upward mobility and competitiveness in communities left behind by the economic growth of the past few decades. It's reassuring that the president has put emphasis on universal pre-kindergarten, education spending, job training, tax reform, and broadband access to help our struggling cities. However, specific and innovative urban community development policies were missing from much of the speech. In the end, though, many of the best solutions for our challenged metropolitan regions must come from far outside Washington in statehouses, city halls, college campuses, and our local communities. 

Magali Duque, Stanford University, Roosevelt Institute | Campus Network:

Last night's State of the Union address touched on many of the same issues the President has spoken on before, but he approached them in new ways. By using specific stories of ordinary citizens and aligning their struggles with policy arguments, the President is able to appeal to a broader audience – an audience focused on how their own issues fit into this democratic narrative. In that way, his speech was successful. My favorite moments were his appeal to women's equality, access to comprehensive health services including mental health, education innovations, socio-economic mobility, and fair policy. His hopes for women's equality in the economy appealed to not only women, but also to the American people as a whole because he framed "women's success" as "America's success."  In fact, this framework was reminiscent of John Stuart Mill's perspective on equality of the sexes in The Subjugation of Women, making an important point about the pervasiveness of gender inequality. Also, I appreciated how the President addressed educational, economic and immigration reform, because he simply laid out the facts for why they are so essential for our nation's progress. His calls to action such as "Congress, give these young people the chance they deserve" and "creating new jobs, not creating new crises," highlight the importance of a unified and unbiased approach towards policy because it "should be the power of our vote not size of our bank account that drives our policy. " The power of democracy should also be driving social progress rather than hindering it, and to do so, it should include more voices of our generation.

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State of the Union 2014: Obama Offers Action, Not Apologies

Jan 29, 2014Jeff Madrick

The president promised to do what he can without Congress, even if it isn't much.

From a political point of view, President Obama gave one of the best speeches of his presidency last night. In this, his fifth State of the Union Address, he avoided all apologies. No word about the slow progress on cutting unemployment, or the failure of the healthcare.gov rollout, or the inability to pass gun control, or the extreme excess of government intrusion on America privacy.

The president promised to do what he can without Congress, even if it isn't much.

From a political point of view, President Obama gave one of the best speeches of his presidency last night. In this, his fifth State of the Union Address, he avoided all apologies. No word about the slow progress on cutting unemployment, or the failure of the healthcare.gov rollout, or the inability to pass gun control, or the extreme excess of government intrusion on America privacy.

His tone was resolute and optimistic, and he struck many progressive chords. He made a nation that is down feel up. President Obama in particular made a strong case for a higher minimum wage. Commentators like David Brooks have pooh-poohed this because it wouldn’t raise that many families above the poverty line. This is the height of insensitivity. The poverty line is desperately low in America. But more than half the benefit would go to families that earn $40,000 or less, families in which one of its members will get a raise—usually an adult—if the minimum wage is raised. That’s a family, not an individual. And the higher minimum wage bumps up wages just above it.

Any idea that Americans are getting paid what they deserve, which is the assumption the Brookses of the world make, is a triumph of utopian insensitivity.

President Obama gave a shoutout to Senator Tom Harkin, who is leading the campaign for a $10.10 minimum wage in Congress. We are proud to say that Senator Harkin was our keynote speaker at the Bernard L. Schwartz Rediscovering Government Initiative's jobs emergency conference last year.  

But as I say, the president didn’t dwell in the realm of apology. He will raise pay for those on federal contracts. He talked about equal pay for women. He wants an immigration bill. He implied that inequality cannot be tolerated at this level in America. He would offer subsidies for business to bring jobs home.

All these struck optimistic notes. But he avoided the policies that really need doing. Sequestration has to be ended and government spending pumped up to get unemployment lower at a faster pace. But he did not talk about fiscal stimulus. He would live within the bounds of the austerity economics he helped bring about, even if he was not nearly as responsible for it as the Republicans.

He did not talk much about fixes to Obamacare but made clear it is helping millions already. This may sound like rhetoric, but it is critical. Too few realize how beneficial the new plan is—which has partly been Obama’s fault. He has avoided talking much about it. Last night he came out swinging, justifiably so. But it needs some fixes, and eventually a public option.

The headline is that Obama says he will do what he can with or without a recalcitrant Congress. The truth is he can’t do much. But for a president who has not taken the battle to the members on the Hill, this speech was a triumph and long in coming. He put Congress on the spot. He should keep using the bully pulpit, unafraid to do so, because he is right and they are mostly wrong. 

Jeff Madrick is a Senior Fellow at the Roosevelt Institute and Director of the Bernard L. Schwartz Rediscovering Government Initiative.

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Republican Alternative to Obamacare: Pay More, Get Less, Put the Insurance Companies Back in Charge

Jan 28, 2014Richard Kirsch

Now that Republicans have put out an alternative to the Affordable Care Act, Democrats should emphasize what a repeal would really mean for Americans' health.

Now that Republicans have put out an alternative to the Affordable Care Act, Democrats should emphasize what a repeal would really mean for Americans' health.

Boy, can Democrats have fun with the new Republican alternative to Obamacare. It puts the health insurance companies back in charge and raises costs for almost all Americans. In particular, it substantially raises costs and threatens to cut coverage for the half of all Americans who get health insurance at work. Seniors, the group that Republicans have scared witless about Obamacare, would lose the real benefits they receive under Obamacare. The proposal from three Republican senators is a golden opportunity for Democrats to contrast the specific benefits of the Affordable Care Act (ACA) with what a repeal and replace agenda would really mean for Americans’ lives and health.

When it comes to the politics of health care reform, my first adage is “the solution is the problem.” That is because once you get past vague generalities, like lowering cost and making coverage available, to proposing specifics, people will look to see how the proposals impact them personally. This is why health reform is such a political nightmare. Unlike most public policy issues, the impact is very understandable and real.

With the ACA as the law of the land, in analyzing the Republican proposal we must compare its impact to the law it would repeal. The pre-ACA model of health insurance is irrelevant. Here is how the Republican plan would impact people, compared with the ACA:

People who get health insurance at workbottom line: pay more for worse coverage.

Almost half of all Americans (48 percent), or 148 million people, obtain health insurance at work. The Republican plan would tax 35 percent of the average cost of health insurance benefits at work. This is a big tax increase on working people and is extraordinarily unpopular, as the Obama campaign used to devastating impact on John McCain. And while people would pay more, they would get less coverage, as the GOP plan would allow insurance companies to once again limit the amount of benefits they will pay out in one year and return to the day when employers could offer bare-bones plans.

While taxing health benefits would apply to all employer-provided coverage, the Republicans would give the 30 percent of people who work for businesses who employ fewer than 100 workers a tax credit. That might balance out the increased taxes for some people. However, doing so would create a huge set of economic distortions, as employers might seek to keep firm size under the 100-employee threshold.

Individuals who buy coverage on their own or who are uninsured – bottom line: insurance companies could again deny coverage for pre-existing conditions and offer bare-bones coverage, while the cost of decent coverage would go up for most people.

This is the group that the ACA is most aimed at helping, including the 5 percent of Americans who buy private health insurance and the 15 percent who are uninsured, totaling 64 million people. The ACA offers income-based subsidies to these people when they earn between 100 percent and 400 percent of the federal poverty level (FPL) and enrolls people under 133 percent of FPL in Medicaid, when states agree.

The Republican plan is toughest, in comparison with the ACA, on the lowest income people and on the higher-income middle-class, compared with Obamacare. But many families in between will do worse too.

The Republican plan would wipe out the expansion of Medicaid to people earning less than 133 percent of FPL, a provision the Supreme Court has made optional. It would cut back on Medicaid, ending the federal government’s offer to pay 90 percent of the cost of expanded coverage and replacing that with the federal government paying what it has paid historically, which is between half and three-quarters of the cost of Medicaid, with poorer states getting a bigger share. Crucially, the funding would only be for pregnant women, children and parents with dependent children who earn under the poverty level, as opposed to the ACAs funding of all adults up to 133% of FPL. That means many fewer people covered and states getting less Medicaid money. Republican governors may not complain, but you can bet hospitals will. Adults without dependent children would not be covered by federal Medicaid, which means millions will stay uninsured or lose coverage they now have, unless states pay for coverage without federal support.

For individuals not covered by Medicaid or employees of firms with fewer than 100 workers, the Republican plan would replace the ACA’s sliding-scale subsidies, which now go to 400 percent of FPL, with a subsidy that is the same for everyone of the same age who is under 200 percent of FPL and lowersubsidies for people from 200 percent to 300 percent. In addition, the subsidies would be higher for older people than younger. The Republican plan also would take away the requirements that insurance plans offer decent benefits and free preventive care and charge women the same prices as men for coverage, along with every other consumer protection, with the exception of keeping in place no lifetime caps for covered benefits.

Comparing the value of the Republican plan subsidies vs. the ACA subsidies for the people who would still qualify depends on income, age, and family size. Generally, it appears that the Republican subsidies are much less than the ACA for people under 150 percent of the FPL ($35,000 for a family of four) and much less than the ACA for younger people, but more for older people. However, insurance rates for younger people would go down some at the expense of older people, who insurance companies could charge a lot more than under ACA. And families with incomes above $70,000 for a family of four would lose subsidies entirely.

Seniors and the disabled on Medicare – bottom line: seniors would pay more for prescription drugs and preventive care.

By repealing the ACA, the Republican plan would take away its two concrete benefits for seniors. One is that preventive care services are now free under Medicare (as they are under all insurance). The other is that the ACA is lowering drug prices for seniors by slowly closing the “donut hole,” under which seniors must pay the full cost of prescription drugs even though they are paying premiums for drug coverage. In other words, the Republican plan is simply bad news for seniors, the constituency that they have scared the most about Obamacare groundlessly.

 

It is not surprising that Republicans have been reluctant to come up with a replacement for Obamacare. It’s much easier to throw darts – or bombs – at the ACA than to come up with a replacement that meets Republican ideological tenants of less regulation and less government. Any plan that meets the ideological test will be much worse for people in ways they can understand. It is our job to explain it to the public clearly: pay more, get less, put the insurance companies back in charge. This debate is not simply the political game Republicans want to make it. It is about our health and our lives. 

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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