Compromising on Medicaid Expansion: Real Alternatives, or GOP trap?

Tomorrow, the big news for the Affordable Care Act will be the opening of the state-level insurance exchanges. But the other major part of the law, Medicaid expansion, proceeds apace. Republican governors in many states have simply rejected Medicaid increases, presumably on the grounds that providing poor people with health insurance is a nefarious communist plot. However, some GOP-dominated states like Michigan or divided-control states like Arkansas are working with the Department of Health and Human Services to develop alternative routes for expanding Medicaid coverage to the working poor. The challenge for the Obama administration (and progressive activists) is to determine which plans stay true to the spirit of the ACA and which ones may dangerously undermine it.

Obviously, the biggest goal is to increase coverage, but we also need to be mindful of the various strings that conservative governors and legislators might attach to the modified plans seeking waivers from the Department of HHS. 

Medicaid expansion was originally supposed to automatically apply to all states, but the Supreme Court’s 2012 ruling on the Affordable Care Act made it optional. Not surprisingly, 14 states with unified Democratic control immediately signed up for the expansion; the opportunity to provide universal health insurance to residents under 138 percent of the poverty line fulfilled a longstanding progressive dream – all made possible by the federal government picking up 90 percent of the long-term costs.

Of 24 states under complete GOP control, only two took the traditional expansion (North Dakota and Arizona) while 17 rejected it entirely. Six of the 12 states with divided control governments agreed to the standard expansion, while three have passed for now. (Here's a handy map with the state decisions)

That leaves six states under GOP control (Pennsylvania, Ohio, Michigan, Indiana, Tennessee and Florida) and three states under with split control (Arkansas, Iowa and New Hampshire)  that are either still actively considering the expansion or have proposed a non-traditional style of expanding Medicaid more agreeable to Republican majorities.

And that’s where things have gotten interesting. Follow me below the break for details.

The Affordable Care Act: Obama's greatest achievement on gender equality?

As we count down the days to the opening of the health-care exchanges, it's worth mentioning that the Affordable Care Act is easily the biggest law promoting gender equality since the Violence Against Women Act of 1994 for the Family Medical Leave Act of 1993.

Barrack Obama has taken his share of flack on women's issues. Most recently, people have challenged his record of high-level executive-branch appointments for women, which has been considerably better than George W. Bush's but weaker than Bill Clinton's. On the other hand,Obama has appointed a record percentage of female judges -- by a country mile. (He's still not appointing women at their prevalence level in the population, but he's getting close)  And the pay gap between men and women is stubbornly constant, with women (still) making roughly 77 cents on average for every man.

But starting January 1, 2014, the ACA will remove several billion dollars in annual gender discrimination.

Generation Y and "Entitlement"

Amen Mr. Weinstein.

I have a PhD from one of the finest universities in the country and I've taught more classes than many tenure-track professors have, but after applying for 85 academic jobs in two years, I've come up empty. It's a simply terrifying experience for most of us on the market --we're generally far better qualified than our peers who graduated in the 1960s and 1970s were, but we're being shut out. I'll be writing more on the problems of contingent short-term labor in academia over the coming months, but they're pretty similar to the ones journalists and others of our generation face.

And Weinstein nails my attitude toward people who look at us in the 22-35 crowd with contempt:

This state of affairs does not exist because we're entitled and have simply declined to work as hard as the people that birthed us. American workers have changed from generation to generation: Since 1979, the alleged Dawn of the Millennial, the average U.S. worker has endured a 75 percent increase in productivity...while real wages stayed flat.

Any lecturer with a PhD. patching together a 4-4 course load across three different universities for $19,000 a year gets it.

As I've written, I'm one of the lucky ones -- no student debt, decent health, a soon-to-be spouse with a decent job.  I always wonder if I have the right to complain -- well, here's Weinstein's answer to that question:

So no, we shan't be doing as well as our parents, and no, we shan't be shutting up about it. If anything, those of us who have been cowed into silence because college-educated poor problems aren't real poor problems should shed our fears and start talking about just how hard it really is out there, man.

 So, complain it shall be, though with the awareness that some one is always worse off -- and an emphasis on effective action as well.

As usual, invoking Atrios' sentiment in the titles of his posts sums up the point pithily.

Home-care workers get federal wage protections

The Obama administration just announced that home-care workers qualify for federal  wage protections under the Fair Labor Standards Act. This is a big deal. Most of these workers already make at least the minimum wage, but they don't qualify for overtime salaries because they were literally classified as babysitters.

According to the Department of Labor, there are about 2 million workers that qualify for the new protections --nearly 50 percent of whom are minorities.

It's not surprising that a job classification dominated by minorities (and women, but that's another story) was exempt from the FLSA. The exemptions were part of the price that Jim-Crow-era Southern politicians extracted as their price for the passage of much of the New Deal. They wanted relief from the Great Depression, but only would agree to social programs that did not interfere with the peculiar institutions of the south that kept African Americans on the bottom of the labor and social structure. (It's also why every Southern Democrat joined pro-business owner Republicans in backing the anti-labor Taft-Hartley Act) For those looking for a good history on the subject, Ira Katznelson's When Affirmative Action Was White details the whole depressing process.

Today's long-overdue step eradicates a small part of the poisonous legacy over despite the opposition of for-profit nursing homes.

Finally: Elections have consequences. This wouldn't have happened in a Mitt Romney administration.