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Obamacare Is a Boon for the Working Poor, and That's Probably Good for All of Us

| Tue May 5, 2015 9:00 AM EDT

While Kevin Drum is focused on getting better, we've invited some of the remarkable writers and thinkers who have traded links and ideas with him from Blogosphere 1.0 to this day to contribute posts and keep the conversation going. Today we're honored to present a post from Andrew Sprung.

One thing I've always appreciated about Kevin is that his commitment to economic justice is grounded in political realism. That balance was on display in his postmortem on the Democrats' drubbing in November:

[W]hen the economy stagnates and life gets harder, people get meaner. That's just human nature. And the economy has been stagnating for the working class for well over a decade—and then practically collapsing ever since 2008.

So who does the WWC [white working class] take out its anger on? Largely, the answer is the poor. In particular, the undeserving poor. Liberals may hate this distinction, but it doesn't matter if we hate it. Lots of ordinary people make this distinction as a matter of simple common sense, and the WWC makes it more than any. That's because they're closer to it. For them, the poor aren't merely a set of statistics or a cause to be championed. They're the folks next door who don't do a lick of work but somehow keep getting government checks paid for by their tax dollars. For a lot of members of the WWC, this is personal in a way it just isn't for the kind of people who read this blog.

And who is it that's responsible for this infuriating flow of government money to the shiftless? Democrats. We fight to save food stamps. We fight for WIC. We fight for Medicaid expansion. We fight for Obamacare. We fight to move poor families into nearby housing.

This is a big problem because these are all things that benefit the poor but barely touch the working class.

As Kevin acknowledges, this is an age-old problem for Democrats. It's "unfair" in that there's overwhelming evidence that safety-net programs like food stamps, Medicaid and the Earned Income Tax Credit "have positive effects on health, educational attainment, earnings and employment years later," as Jared Bernstein recently wrote.

There's no denying the perception that Kevin fingers is a political force, and it's one partly grounded in reality, in that safety net programs (for the non-elderly at least) do most directly benefit those at the bottom of the income distribution.

The Affordable Care Act is a really stark exemplar of this good policy/tough politics conundrum. For almost its entire life its approval ratings have been underwater, pulled down in part by low marks from working class Americans. Most of the Affordable Care Act 's supporters assume that the law has remained unpopular because, as Jonathan Chait put it, "[Republicans'] lies got halfway around the world before the truth could get its pants on." And that's largely true. But it's also true that its impact on Americans' incomes look something like this:

That chart is a very simplified takeaway from a study by Brookings economists Henry Aaron and Gary Burtless, one that starkly illustrates whom the ACA spends money on via premium subsidies and Medicaid benefits. It's the bottom 20 percent of the income distribution.

Recent ACA enrollment data bears this out. Of the 11.7 million buyers of private health plans on the ACA exchanges, over 60 percent have incomes under 200 percent of the federal poverty level. The 11 million beneficiaries of the Medicaid expansion all have incomes under 138 percent FPL. Taken together, those numbers mean about 80 percent of the law's direct beneficiaries have incomes below 200 percent FPL.

Sliced another way, about half (48 percent) of private plan buyers in the 37 states using healthcare.gov had incomes ranging from 150 to 300 percent FPL, a more or less working class range. But more than half of those were at the lower end, 150 to 200 percent FPL.

The truth is, the ACA private plan market works best for people with incomes under 200 percent FPL. That's the cutoff point for the beefy if little-known cost-sharing subsidies that reduce deductibles and copays and make the coverage comparable to (or, for those under 150 percent FPL, better than) that offered by high-quality employer-sponsored policies. A recent study by Avalere Health showed that people with lower-incomes who qualify for such subsidies are snatching up private plans from ACA exchanges—but uninsured buyers at higher income levels haven't been nearly as enthusiastic. It would be great if more generous subsidies could make the exchange plans more attractive to those relatively better-off Americans on the upper end of the scale, but Democrats allocated what the political traffic would bear.

A genuine long-term bend in the healthcare cost curve would be worth all the Bowles-Simpson-type spending cut/tax hike plans ever conceived.

So how do the ACA's offerings to the uninsured benefit the working class, white or otherwise? For starters, 200 percent of FPL, the upper end of the sweet spot for ACA benefits, is a working class income; it's just under $40,000 for a family of three, and about two-thirds of median income. According to the Kaiser Family Foundation, 34 percent of Americans have incomes below that threshold.

But income in the U.S. is volatile. According to the economist Stephen J. Rose, in 2010, 7 to 8 percent of working-age U.S. adults were below the poverty line, but in the five years prior, about 18 percent spent at least one year in poverty. The same ratio may not hold for the 200 percent FPL level, but it seems fair to assume that half of U.S. households will fall below it at some point.

Pre-ACA, health insurance status was also highly volatile. A 2008 study by Mathematica Policy Research found that while nearly 18 percent of non-elderly adults were uninsured as of January 2001, 35 percent had been uninsured at some point over the three years prior. Of those, 60 percent went without coverage for at least a year. Extend the volatility caused by our employer-based health insurance system over a lifetime, and a very large percentage of Americans who don't always live in poverty are likely to need an affordable fallback at some point.

There's much more to be said (and studied) about how the ACA may benefit the working class and indeed all of us. The law will have multiple positive and negative impacts on employer-sponsored insurance, on the way care is organized and paid for, on hospital consolidation, Medicare, and so on.

Meanwhile, Republicans will continue to hammer Democrats over every real and perceived negative effect. (Watch out for that in 2018, when the most generous employer plans will be subject to the so-called Cadillac Tax, which could spur cuts to some workers' coverage). And it's not at all clear that Democrats will get much credit for some of the law's biggest upsides.

In the longest view, if the ACA really is contributing to a long-term slowdown in the growth of US healthcare spending—admittedly a big 'if,' though the data is promising—it could secure the nation's fiscal future and be a boon to everyone, poor or not. As Peter Orzag kept telling us back in 2009, "healthcare reform is entitlement reform." A genuine long-term bend in the healthcare cost curve would be worth all the Bowles-Simpson-type spending cut/tax hike plans ever conceived.

At the same time, the ACA has already cut the ranks of the uninsured by 15 million, reducing the uninsured rate among non-elderly adults from 17.6 percent to 10.1 percent, as estimated in a just-published Urban Institute study. In states that accepted the Medicaid expansion, it's cut the uninsured rate of the poor in half. For the middle class—very broadly defined by Urban as those in households between 138 percent and 400 percent FPL—it's raised the insured rate by 7.6 percentage points.

That's a monumental accomplishment, and Democrats paid for it in political blood. We should honor them for that.

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Just When You Thought Fox News' Baltimore Coverage Couldn't Get Worse, It Made This Mistake

| Mon May 4, 2015 5:21 PM EDT

On Monday afternoon, Fox News alarmed social media with a dramatic news report of a man being shot by police in Baltimore. It might have been news to some that Fox was breaking a story on a police shooting—rather than discrediting such an account. But the network, eager to claim a scoop, quickly promoted this story. On-the-scene reporter Mike Tobin reported the supposed shooting and his reporting was quickly tweeted to a large audience by one of Fox News' biggest stars, Greta Van Susteren: 

"About 2:45 we saw a guy running from the cops right at the intersection of North and Pennsylvania where the epicenter of the unrest here," Tobin described on a phone call for a breaking news segment on Fox. "As he was running away, that officer drew his weapon and fired and struck the individual who was running away. He was a young black male and what we saw on the sidewalk as the crime scene unfolded over there, there was a revolver on the ground."

Note that Toobin said "we saw" the shooting. But there was one problem. The incident did not happen. There was not a shooting for him to see.

Moments after the story was published, Fox's Shepard Smith was forced to issue an apology for the network's sloppy work:

Of course, this is yet another cautionary tale about recklessly reporting possibly incendiary events. It's also noteworthy that it was Fox News, which typically discounts such stories, that rushed out this embarrassing and potentially dangerous report. Will there be an internal review? Shep, let us know.

Tales From City of Hope #12: I Am Bursting With White Blood Cells

| Mon May 4, 2015 12:12 PM EDT

Yesterday's white blood count was 0.2. Today's is 1.1. That's super duper exponential. Go, little stem cells, go!

Surely this deserves a bit of bonus catblogging. Of course it does.

America's Big Trade Deals and the Case of the 4 Fishy Phone Calls

| Mon May 4, 2015 12:00 PM EDT

While Kevin Drum is focused on getting better, we've invited some of the remarkable writers and thinkers who have traded links and ideas with him from Blogosphere 1.0 to this day to contribute posts and keep the conversation going. Today we're honored to present a post from David Dayen, a veteran blogger and currently a regular contributor to Salon and The Fiscal Times, among other publications.

I was planning on commandeering Kevin's site to finally shape this place up and do some dogblogging, but management was, shall we say, unreceptive. So let's use this space to do what all great blogging is known for: pointless speculation!

I did a story for The New Republic looking back at the 1993 CNN debate between Al Gore and Ross Perot, showing how Gore's messages on selling NAFTA mirror Barack Obama's messages on selling the Trans-Pacific Partnership today. Both men claim that their progressive trade agreements differ from the raw deals of the past; that opponents were isolationist Luddites who want to return to some unrealistic pre-globalized world; and that this new deal would create a benchmark for global trade, which some Asian power (Japan or China, depending on the era) would take control of were their plan defeated.

But the debate itself is amazing for several reasons, not the least of which being that a sitting Vice President had to go on Larry King and take phone calls. Everyone remembers Perot saying "Can I finish" incessantly, so much so that it became a Dana Carvey tag line.  And maybe you remember Gore pulling out a picture of Smoot and Hawley and giving it to Perot as a present ("You can put it on your wall"). But come with me through this Internet rabbit hole and look at something else.

Ross Perot gets asked four questions from the phone lines. I have no knowledge about how they were screened. But these don't sound like regular people to me; they sound like plants. You can listen yourself:

43:45 The caller is from "Washington, DC." And he says, and I quote, "How can the US expect to compete on a long-term basis in an increasingly interdependent economic world, while Europe and the PacRim nations unite on their own respective trade alliance?" Who in the world talks like that? It reads like it came out of a Brookings Institution paper.

54:30 A expat caller from Zagreb, Croatia (!) asks Perot for specific answers on what he would do as an alternative to NAFTA. This happens to be a question Gore asked repeatedly throughout the debate.

1:01:35 This call comes from McLean, Virginia, the Washington suburb populated mostly by lobbyists. The caller coincidentally has statistics at the ready on electronic exports to Mexico ("nearly tripled" over the past five years, "worth about $6 billion), and demands that Perot agree that removing tariffs on these products will produce "high-tech, good-paying jobs" in America.

1:06:35 This is perhaps the weirdest call. An American woman "who has been living in Mexico City for many years" calls in, following up on Gore's claim that the Japanese would "take over" a free trade agreement with Mexico if NAFTA is defeated. "There are thousands of Japanese here. They are waiting. They are lurking! What are you people doing? Why-" At this point she gets cut off, but Gore repeats the question and adds a line the caller never said: "Why don't you wake up?"

This is weird. The questions not only sound way too hyper-informed and scripted, they dovetail with every talking point Gore used in the debate, from how passing NAFTA was critical to setting a benchmark for trade with the world, to how NAFTA would create jobs at home through rising exports to Mexico, to how Japan loomed to take advantage of any potential failure, to how Perot was just carping from the sidelines without his own plan.

It's a strong accusation to suggest these questions were planted, and honestly I have no idea. However, I did find an article from 1994 in some left-wing rag called Mother Jones, detailing a host of dirty tricks the Clinton Administration engaged in to blunt the influence of Ross Perot:

Last September 2, the day Perot was to appear on Jay Leno's "Tonight Show," a White House adviser got on the horn to L.A. After chatting with a "Tonight Show" writer, he faxed some questions to Leno […]

(Perot co-author) Pat Choate claims the administration sent people to UWS rallies to "take notes" and "heckle" Perot. He also accuses the administration of manipulating the press: "Journalists are getting anti-Perot stuff in the mail," he says. "Most of it has no return address." (Several reporters who cover Perot say they have no knowledge of this, and the White House denies both charges.) […]

Last April 22, Perot appeared before the Senate Banking Committee to testify on NAFTA. The White House didn't like him testifying, and it liked even less the idea of C-Span televising his appearance. So, Choate claims, a White House aide called Senate Majority Leader George Mitchell, who called Brian Lamb, the chairman of C-Span. Some sort of deal was struck, and Perot's testimony never graced the airwaves.

Because Mother Jones is a responsible publication, the author added that the rumor about C-SPAN could be false, but that it showed how the Clinton White House seized on Perot's natural paranoia to undermine him in the trade debate. Throwing in suspicious-sounding questions on CNN could serve the same purpose.

We're 22 years on from this event, and investigating the provenance of these fishy phone calls would be somewhat irrelevant. Four phone calls were not the reason NAFTA passed; there's no "NAFTA-ghazi" conspiracy theory to be had. But I nevertheless find it fascinating. Has anyone ever studied this? Does it just sound odd to my modern ears, or is there more there? When Kevin Drum ends blog posts with a series of questions, is it a clever device or does he genuinely want to ask his audience for answers?

John Oliver Perfectly Describes the "Woman-Battering Human Landfill" That Is Floyd Mayweather

| Mon May 4, 2015 11:01 AM EDT

While issuing a takedown of Bud Light's awful new #UpForWhatever tagline last night, which included a clip of a woman calling the campaign a tad "rapey," John Oliver snuck in quite the perfect description of another awful subject, Floyd Mayweather.

"That's true, but it would be great if you could use a slightly more serious word than 'rapey'," Oliver said. "It's somewhat diminishing—It's like saying Floyd Mayweather is a smidge assaulty. It's technically correct but it'd be more appropriate to say he's a woman-battering, human landfill. That'd be more on the money."

Watch below:

 

 

Let John Oliver Explain How Standardized Testing Makes Kids Anxious and Vomit Under Pressure

| Mon May 4, 2015 9:31 AM EDT

Every year, students around the country are subjected to an insane amount of mandatory, standardized testing. So much so, the average number of tests a student completes by the time they graduate high school is a staggering 113, according to the latest "Last Week Tonight." As host John Oliver noted on Sunday, all the stressful bubble-filling is taking an inevitable toll—with teachers reporting their students throwing up under the pressure so often, official testing guidelines specifically outline how to deal with kids vomiting on their test booklets.

"Something is wrong with our system when we just assume a certain number of students will vomit," Oliver said. "Standardized tests are supposed to be an assessment of skills, not a rap battle on '8 Mile' Road."

Watch below as Oliver explains how our education system arrived at this extreme point:

 

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Re-live the Kingbees' Rockabilly Revival

| Mon May 4, 2015 6:00 AM EDT

The Kingbees
self-titled
Omnivore

The rise of punk and new wave back in the late '70s and early '80s was accompanied by a mini-rockabilly revival, the most notable commercial success being Brian Setzer's Stray Cats. Another eminently satisfying act was Los Angeles' Kingbees, a spunky trio fronted by Jamie James, a spirited dude seemingly possessed by the ghost of Buddy Holly. There's nothing profound on the expanded edition of this crisp 1980 debut album—just a bunch of snappy originals, including the semi-hit "My Mistake" and deft covers of Don Gibson ("Sweet Sweet Girl to Me"), Eddie Cochran ("Somethin' Else") and Buddy himself ("Not Fade Away"). But if you need a quick pick-me-up, check out "Shake-Bop" or "Ting-a-Ling." They'll put a spring in your step, guaranteed.

Tales From City of Hope #11: We Have Liftoff

| Sun May 3, 2015 1:53 PM EDT

Yesterday's white blood count went from just under 0.1 to just over 0.1. Let's call it 0.05 growth. Today's count is 0.2. That's growth of 0.1.

And that, my friends, is exponential growth. Sure, we could use another data point or three. And some more significant digits. And if we're being picky, a coefficient or two. But screw that. To this Caltech1 dropout, it looks like exponential growth has kicked in. Booyah!

In more visually exciting news, I know you all want to see my shiner, don't you? I can feel the bloodlust all the way from my hospital bed. So here it is, you ghouls. As usual with these things, it looks a lot worse than it feels. In fact, I can barely feel it all. But it's clear evidence that, yes, the bathroom really is the most dangerous room in the house.

1Did you know that the proper short form for California Institute of Technology is Caltech, not CalTech? They've been trying for decades to get the rest of the world to go along, but with sadly limited success.

"Hell Is Empty and All the Devils Are Here."

| Sat May 2, 2015 5:25 PM EDT

Here is a thing.

Here is another thing:

Floyd Mayweather is a serial batterer of women.

Have a nice day.

Tales From City of Hope #10: Rebound Is Here!

| Sat May 2, 2015 1:19 PM EDT

Yesterday my white blood count was <0.1. How much less? No telling, but my doctor called it an "honorary" 0.1.

But! Today my count is 0.1. Not much difference, you say, but it doesn't matter. It's higher than yesterday, and that means my transplanted stem cells are busily engrafting themselves and morphing into various blood products. Progress will be slow at first, but Friday was officially my bottom. Within a few days, my counts should start taking off much more rapidly. Huzzah.

In less good news, I slipped in the bathroom last night and got a pulled neck muscle and a black eye for my trouble. All I need now is a swastika tattoo and I'll have the whole skinhead look down cold.