It's Obamacare.

[ProSense]

Compare it to the MA health care law, which was a product of the MA Democratic legislature. Democrats made significant changes to Mitt Romney's proposal. In fact, Romney opposed those changes, and upon signing the bill into law, vetoed them. Romney's vetoes were overturned by the legislature.

In Fall 2005, the House and Senate each passed health care insurance reform bills. The legislature made a number of changes to Governor Romney's original proposal, including expanding MassHealth (Medicaid and SCHIP) coverage to low-income children and restoring funding for public health programs. The most controversial change was the addition of a provision which requires firms with 11 or more workers that do not provide "fair and reasonable" health coverage to their workers to pay an annual penalty. This contribution, initially $295 annually per worker, is intended to equalize the free care pool charges imposed on employers who do and do not cover their workers.

On April 12, 2006, Governor Mitt Romney signed the health legislation.[23] Romney vetoed eight sections of the health care legislation, including the controversial employer assessment.[24] Romney also vetoed provisions providing dental benefits to poor residents on the Medicaid program, and providing health coverage to senior and disabled legal immigrants not eligible for federal Medicaid.[25] The legislature promptly overrode six of the eight gubernatorial section vetoes, on May 4, 2006, and by mid-June 2006 had overridden the remaining two.[26]

http://en.wikipedia.org/wiki/Massachusetts_health_care_reform#Legislation

Here's how the veto was reported:

Mitt Romney health care vetoes overturned by Massachusetts House (Mitt Romney Archive, 2006)

By The Republican Newsroom

This story from The Republican’s archive is part of our look back at Republican presidential candidate Mitt Romney’s years in Massachusetts politics: as Senate candidate, gubernatorial candidate and governor. It was published on April 26, 2006.

By The Associated Press

BOSTON — Sending a sharp rebuke to Gov. W. Mitt Romney, House lawmakers voted overwhelmingly yesterday to overturn his vetoes to the state's landmark health-care law, including the controversial $295 fee on businesses that don't offer insurance.

The predominantly Democratic House broke from debate of the state budget to begin the override process, first voting to restore a portion of the law guaranteeing dental benefits to Medicaid recipients.

The House overrides had been expected, and Senate President Robert Travaglini said yesterday that he expects the Senate will override all eight of Romney's vetoes. The Republican governor's spokesman said the differences were not essential to the larger goal of health care coverage.

- more -

http://www.masslive.com/mitt-romney-archive/index.ssf/2012/04/gov_mitt_romney_health_care_ve.html

Obamacare was the biggest expansion of Medicaid since the program was established.

Not only that, the health care law increased the Medicaid drug rebate percentage to 23.1 percent.

http://www.medicaid.gov/AffordableCareAct/Timeline/Timeline.html

The President has proposed the same rate for Medicare (http://www.democraticunderground.com/10022670043 ), which would save even more than the Senate proposal (http://www.democraticunderground.com/10022725266), $164 billion to $141 billion, respectively.

The RW hate Medicaid, and would never expand it.

The Benefits Of Medicaid Expansion: A Reply To Heritage’s Misleading Use Of Our Work

by Stan Dorn Stan Dorn

In a publication released in numerous states as well as a JAMA Forum article and a recent list of ten supposed “myths” about Medicaid expansion, the Heritage Foundation repeatedly cites our paper for the proposition that “40 of 50 states are projected to see increases in costs due to the Medicaid expansion,” and that expansion would force such states “to dig deep into their already overstretched budgets.” Even in the 10 remaining states, according to Heritage, the budget gains we projected to result from expansion were speculative and uncertain, since they supposedly relied on states cutting payments for hospital uncompensated care.

These claims distort our work. We identified 10 states in which Medicaid expansion would yield net savings based on just one factor—namely, unusually generous prior Medicaid coverage, for which states could claim enhanced federal matching funds. The modest additional gains resulting from uncompensated care savings did not tip any state from the red into the black.

<...>

For example, a report one of us prepared along with colleagues in Ohio found that, while a Medicaid expansion would increase that state’s Medicaid costs by about $2.5 billion from 2014 through 2022, it would also save Ohio $1.5 billion by reducing state spending on current programs in favor of the largely federally financed expansion. Such programs cover so-called “medically needy” adults, women with breast and cervical cancer, and adults who are waiting for disability determinations. At the same time, expansion would increase state revenue by as much as $2.8 billion, in part because of the economic activity galvanized by more than $31 billion in new federal Medicaid funds, but also because of prescription drug rebates and taxes on Medicaid managed care premiums. The overall result: at least $1.8 billion in net state budget gains.

We also found that Medicaid expansion would create more than 27,000 Ohio jobs, reduce the number of uninsured by more than 450,000, cut health costs for employers and residents by $285 million and $1.1 billion, respectively, and lessen budget shortfalls facing Ohio’s counties. Analysts in states like New Mexico, Oregon, Michigan, and Virginia similarly concluded that Medicaid expansion would yield state savings on high-risk pools, public employee coverage, and mental health care and substance abuse services for the poor uninsured. In fact, every comprehensive fiscal analysis of which we are aware has found that Medicaid expansion yields net state budget gains...Medicaid is far from a perfect program. In particular, spending constraints cause states to limit payments to Medicaid providers, reducing their willingness to serve Medicaid patients. That said, Medicaid expansion would improve access to care for millions of uninsured—including poor veterans and their families; create thousands of new jobs; provide significant revenue to hospitals facing significant Medicare cuts; lower health care costs for employers and consumers; provide fiscal relief to localities; and in substantially more than 10 states—perhaps even most states—yield net budget gains that could be reinvested in education, transportation, tax cuts or other priorities. Why would state leaders focused on achieving practical results for their constituents reject a policy that produces such benefits?

http://healthaffairs.org/blog/2013/05/03/the-benefits-of-medicaid-expansion-a-reply-to-heritages-misleading-use-of-our-work/

Krugman:

I Have Seen The Future, And It Is Medicaid

One of the papers at Brookings was an attempt at prognosticating the future of health care costs — for what it’s worth, their best guess was slightly below CBO’s, so it was consistent with CBO’s relatively not-scary long-term fiscal forecasts. But what struck me most was this chart, showing cost growth in different forms of health insurance:

<...>

That flat red line at the bottom is Medicaid.

Everyone who’s serious about the budget realizes that to the extent we do have a long-run fiscal problem — which we do, although it’s far from apocalyptic — it’s mainly about health care costs. And then there’s much wringing of hands about how nobody knows how to control health costs, so maybe we should just give people vouchers, and if they still can’t afford insurance, too bad.

Meanwhile, we have ample evidence that we do know how to control health costs. Every other advanced country does it better than we do — and Medicaid does it far better than private insurance, and better than Medicare too. It does it by being willing to say no, which lets it extract lower prices and refuse some low-payoff medical procedures.

Ah, but you say, Medicaid patients have trouble finding doctors who’ll take them. Yes, sometimes, although it’s a greatly exaggerated issue...But the problems of access, such as they are, would largely go away if most of the health insurance system were run like Medicaid, since doctors wouldn’t have so many patients able and willing to pay more. And as for complaints about reduced choice, let’s think about this for a moment. First you say that our health cost problems are so severe that we must abandon any notion that Americans are entitled to necessary care, and go over to a voucher system that would leave many Americans out in the cold. Then, informed that we can actually control costs pretty well, while maintaining a universal guarantee, by slightly reducing choice and convenience, you declare this an unconscionable horror.

- more -

http://krugman.blogs.nytimes.com/2013/09/21/i-have-seen-the-future-and-it-is-medicaid

http://www.democraticunderground.com/10023707846

More on Medicaid and Obamacare:

Health Law Offers Dental Coverage Guarantee For Some Children

By Michelle Andrews

Tooth decay is the most common chronic health problem in children. By the time they enter kindergarten, more than a quarter of kids have decay in their baby teeth. The problem worsens with age, and nearly 68 percent of people age 16 to 19 have decay in their permanent teeth, according to the Centers for Disease Control and Prevention.

Starting in 2014, the Affordable Care Act requires that individual and small-group health plans sold both on the state-based health insurance exchanges and outside them on the private market cover pediatric dental services. However, plans that have grandfathered status under the law are not required to offer this coverage.

<...>

The changes in the health law apply specifically to children who get coverage through private plans. Dental services are already part of the benefit package for children covered by Medicaid, the state-federal health program for low-income people. But many eligible kids aren't enrolled, and even if they are, their parents often run into hurdles finding dentists who speak their language and are willing to accept Medicaid payments.

<...>

Under the health-care law, pediatric dental health coverage sold on the exchanges cannot have annual or lifetime limits on coverage.

- more -

http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/011513-Michelle-Andrews-on-kids-dental-care-coverage.aspx

Obamacare: It's. The. Law.



http://www.democraticunderground.com/10022853977

Thanks President Obama.

[ProSense]

1. Seniors benefit.

Long before this Supreme Court decision, through the Affordable Care Act, seniors began to see positive changes in their prescription drug costs, access to preventive health care, and more. Thanks to the Supreme Court’s decision the following provisions will continue to be provided to seniors:

Medicare Improvements

The ACA contains several important improvements to the Medicare program, many of which are already helping seniors today.

1) Closing the donut hole

a. Medicare Part D covers the cost of medications up to a certain point. Between that point, and a catastrophic coverage threshold, the older adult must pay out of pocket for medication (this gap in coverage is often called the Part D “donut hole”). One in four beneficiaries fall in this gap, and end up paying an average of $3,610 out of pocket on drug expenses.

b. The ACA requires drug manufacturers to reduce prices for Medicare enrollees in the donut hole. Beginning in 2011, brand‐name drug manufacturers must provide a 50% discount on brand‐name and biologic drugs for Part D enrollees in the donut hole. By 2013, Medicare will begin to provide an additional discount on brand‐name and biologic drugs for enrollees in the donut hole. By 2020, Part D enrollees will be responsible for only 25% of donut hole drug costs.

c. This is a benefit seniors are getting now, and will continue to get as a result of this decision.

2) Improving senior’s access to preventive medical services

a. Prior to the ACA, Medicare beneficiaries were required to pay a deductible and 20% copay for many preventive health services.

b. The ACA eliminated cost‐sharing for many preventive services and introduced an annual wellness visit for beneficiaries.

c. The ACA also eliminated cost‐sharing for screening services, like mammograms, Pap smears, bone mass measurements, depression screening, diabetes screening, HIV screening and obesity screenings.

d. This is a benefit seniors are getting now, and will continue to get as a result of this decision.

<...>

Medicaid Long Term Services and Supports Improvements
Several provisions in the ACA will make it easier for seniors to get long‐term services and supports at home and in the community. Medicaid provides funding for long‐term care services in institutions, such as nursing homes and in the community. Seniors prefer to receive care in their homes, and it is generally less expensive, however, most states spend their Medicaid primarily on institutional care. The ACA includes incentives to encourage states to shift Medicaid spending from institutions to the community, so that individuals who require long‐term care services may receive care in least‐restrictive environment. These incentives are not directly impacted by the Court’s decision to limit the Medicaid expansion. Elements of the ACA that enhance home and community long‐term care include:

1) Community First Choice Option (CFCO) provides participating states with a six percentage point increase in federal Medicaid matching funds for providing community‐based attendant services and supports to individuals who would otherwise be confined to a nursing home or other institution.

2) Balancing Incentive Payment Program targets increased federal matching funds to states that spend less than half of their Medicaid long‐term care expenditures on community‐based care. This spring, six states received grants to improve their community‐based care.

3) Extending Medicaid’s spousal impoverishment protection provisions to spouses of individuals who seek long‐term care in the community. This rule goes into effect in 2014.

- more -

http://www.ncpssm.org/Portals/0/pdf/aca-analysis.pdf

[ProSense]

20. Mental health and addiction treatment covered

New Federal Rule Requires Insurers to Offer Mental Health Coverage

By ROBERT PEAR

WASHINGTON — The Obama administration issued a final rule on Wednesday defining “essential health benefits” that must be offered by most health insurance plans next year, and it said that 32 million people would gain access to coverage of mental health care as a result.

The federal rule requires insurers to cover treatment of mental illnesses, behavioral disorders, drug addiction and alcohol abuse, and other conditions.

Kathleen Sebelius, the secretary of health and human services, said that in addition to the millions who would gain access to mental health care, 30 million people who already have some mental health coverage will see improvements in benefits.

White House officials described the rule as a major expansion of coverage. In the past, they said, nearly 20 percent of people buying insurance on their own did not have coverage for mental health services, and nearly one-third had no coverage for treatment of substance abuse.

- more -

http://www.nytimes.com/2013/02/21/health/new-federal-rule-requires-insurers-to-offer-mental-health-coverage.html

How Obamacare Could Revolutionize Addiction Treatment

By Sy Mukherjee

Obamacare’s treatment of alcoholism and other drug addiction as chronic diseases that must be covered by insurance plans could lead to as many as 40 million Americans entering rehabilitation programs, according to California Health Report.

Government data shows that about 24 million Americans aged 12 and older require treatment for a substance abuse issue — but only 11 percent of them received it at a specialty facility. These facilities charge an average of $4,000 for admission, and even outpatient facilities cost an average of $1,500 per course of treatment.

Obamacare could help eliminate those cost barriers for people seeking treatment. “I don’t think there’s another illness that will be more affected by the Affordable Care Act,” said Dr. Thomas McLellan, former deputy director of the White House Office of National Drug Control Policy, in an interview with California Health Report.

Substance abuse and drug addiction haven’t always been perceived as chronic illnesses. But since opiate abuse (which has steadily been on the rise in America), alcoholism, and other addictions cost about $120 billion per year in health care spending, the health law puts special emphasis on both treatment and prevention by forcing insurers to cover rehab and encouraging doctors to screen for potential addictions.

- more -

http://thinkprogress.org/health/2013/09/12/2609501/obamacare-revolutionize-addiction-services/

[ProSense]

56. Multi-state plans

Multi-State Plan Program and the New Health Insurance Marketplace
http://www.opm.gov/healthcare-insurance/multi-state-plan-program/#url=Factsheet

New Loan Program Helps Create Customer-Driven Non-Profit Health Insurers
http://www.cms.gov/CCIIO/Resources/Grants/new-loan-program.html

[ProSense]

57. Accountable Care Organizations

More Doctors, Hospitals Partner to Coordinate Care for People with Medicare

Providers Form 106 New Accountable Care Organizations

Doctors and health care providers have formed 106 new Accountable Care Organizations (ACOs) in Medicare, ensuring as many as 4 million Medicare beneficiaries now have access to high-quality, coordinated care across the United States, Health and Human Services (HHS) Secretary Kathleen Sebelius announced today.

Doctors and health care providers can establish Accountable Care Organizations in order to work together to provide higher-quality care to their patients. Since passage of the Affordable Care Act, more than 250 Accountable Care Organizations have been established. Beneficiaries using ACOs always have the freedom to choose doctors inside or outside of the ACO. Accountable Care Organizations share with Medicare any savings generated from lowering the growth in health care costs, while meeting standards for quality of care.

“Accountable Care Organizations save money for Medicare and deliver higher-quality care to people with Medicare,” said Secretary Sebelius. “Thanks to the Affordable Care Act, more doctors and hospitals are working together to give people with Medicare the high-quality care they expect and deserve.”

ACOs must meet quality standards to ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe, and timely. The Centers for Medicare & Medicaid Services (CMS) has established 33 quality measures on care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and patient and caregiver experience of care. Federal savings from this initiative could be up to $940 million over four years.

The new ACOs include a diverse cross-section of physician practices across the country. Roughly half of all ACOs are physician-led organizations that serve fewer than 10,000 beneficiaries. Approximately 20 percent of ACOs include community health centers, rural health centers and critical access hospitals that serve low-income and rural communities.

The group announced today also includes 15 Advance Payment Model ACOs, physician-based or rural providers who would benefit from greater access to capital to invest in staff, electronic health record systems, or other infrastructure required to improve care coordination. Medicare will recoup advance payments over time through future shared savings. In addition to these ACOs, last year CMS launched the Pioneer ACO program for large provider groups able to take greater financial responsibility for the costs and care of their patients over time. In total, Medicare’s ACO partners will serve more than 4 million beneficiaries nationwide.

Also today HHS issued a new report showing Affordable Care Act provisions are already having a substantial effect on reducing the growth rate of Medicare spending. Growth in Medicare spending per beneficiary hit historic lows during the 2010 to 2012 period, according to the report. Projections by both the Office of the Actuary at CMS and by the Congressional Budget Office estimate that Medicare spending per beneficiary will grow at approximately the rate of growth of the economy for the next decade, breaking a decades-old pattern of spending growth outstripping economic growth.

For more information on the HHS issue brief, “Growth in Medicare Spending per Beneficiary Continues to Hit Historic Lows,” visit: http://aspe.hhs.gov/health/reports/2013/medicarespendinggrowth/ib.cfm

Additional information about the Advance Payment Model is available at http://www.innovations.cms.gov/initiatives/ACO/Advance-Payment/index.html.

The next application period for organizations that wish to participate in the Shared Savings Program beginning in January 2014 is summer 2013. More information about the Shared Savings Program is available at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/index.html?redirect=/sharedsavingsprogram/

For a list of the 106 new ACOs announced today, visit: http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/News.html

http://www.hhs.gov/news/press/2013pres/01/20130110a.html

[handmade34]

2. rec...

[ProSense]

18. Comment 17 mentions VT Health Connect. n/t

[NYC_SKP]

3. COBRA just went up to over $1,400. It will drop by 1/2 under Obamacare. (nt)

[davidpdx]

4. It's funny because we are already seeing people on DU

bitching and moaning about the ACA and how it will bankrupt them. Not sure if you saw the thread, but some of the rebuttals left the OP going "but...but...but". One person even told the OP if he stopped smoking he could pay for his premium from the money he saved. I thought that was hilarious.

[ProSense]

12. Even In Texas The Republican Caricature Of Obamacare Is Meeting Reality

Even In Texas The Republican Caricature Of Obamacare Is Meeting Reality

by Egberto Willies

Texas Governor Rick Perry has been one of the biggest obstructionists to the Affordable Care Act (Obamacare) in Texas along with the entire Republican Party nationally. Inasmuch as Texas is the state with the highest rate of uninsured citizens he refused Obamacare’s expansion of Medicaid. For those with pre-existing condition in Texas who were either in the high priced high risk Texas insurance pool or were uninsured because of the cost of these high risk pools, Obamacare comes to the rescue even here in Texas.

My wife has Lupus, a pre-existing condition. As a small business owner I had a group plan with a professional engineering organization. After being extorted with rates that effectively cost us north of $20 thousand a year over a decade ago I migrated to a high deductible catastrophic policy for my daughter and myself, an inexpensive student policy for my daughter while in college, and the Texas High Risk pool for my wife. It was expensive but less than the previous policy. Over the long run it is evident that this would become unsustainable as all these policies increased in value at a much faster rate than inflation.

Then came Obamacare. Obamacare means that effective October 1st, once again my wife, my daughter (while still in college and less than 26 years old), and me will be once again on the same policy at an affordable price. I already checked pricing and they are less expensive, reasonable, and provide much better coverage.

The real reason for this post however is the hypocrisy of the Republican Party in Texas. Republicans run Texas, not because it is a Red State but because it is the state with the worst voter participation. They run all departments. They run all agencies including the high risk pool. Today my wife received the following letter.

<...>

Important to note is that the letter correctly echoes the benefits of Obamacare for the millions in Texas and the United States with preexisting conditions. It correctly states that someone with a preexisting condition can no longer be denied coverage. It states forcefully (with an underline) that everyone is guaranteed the same rate given one’s age. It also correctly states that many will qualify for subsidies.

The letter even goes further in promoting Obamacare. It correctly states that there are no more lifetime maximums (in other words insurance companies cannot stop paying up to some maximum; bankruptcies be gone). It correctly states that 100% coverage for preventative care is provided, and all policies now cover doctor visits hospitalization, and prescriptions. In other words charlatans can no longer sell worthless policies. Most importantly, the letter sends Texans to the correct website that will provide them accurate information instead of all the lies and misinformation provided in an orchestrated manner by the Republican Party. The misinformation and lies will directly cause the unnecessary deaths of many, mostly their own constituents and base.

This letter from a Texas agency is the best justification for Obamacare. This Texas government agency placed the wellbeing of Texans over politics.

http://www.dailykos.com/story/2013/09/22/1240684/-Even-In-Texas-The-Republican-Caricature-Of-Obamacare-Is-Meeting-Reality

[TBF]

50. We are in a similar type of position and paying just as much in premiums -

about $2500/month to cover the family (it is very good coverage - no referrals needed, dental & eyecare etc) ... and we also subsidize other employees.

As much as I advocate single payer I am not dumping on ACA because I think it is our bridge to get there. So many people have been bankrupted or otherwise held hostage by healthcare costs and this bill is so needed.

There are many things Obama has done that I question (especially things done by Holder), but this one thing may in fact be his biggest legacy. And that is positive.

[ProSense]

53. Sounds good. n/t

[Scurrilous]

5. Thanks.

K & R

[sheshe2]

6. And~

Kicking for Obamacare!

From June 2012~

I live in Massachusetts. And here in Massachusetts, we live under the predecessor of ObamaCare — the Massachusetts Healthcare Reform Act, signed into law by former governor Mitt Romney in 2006. Under RomneyCare, as Rick Santorum supporters called it during the primaries, 98 percent of the state’s residents have affordable health insurance. Meanwhile, Massachusetts has not gone broke. It’s unemployment level is 6 percent this month, falling from 6.3 percent in April and better than the national average of 8.3 percent. No one is even considering overturning the 2006 law, sources from Blue Cross Blue Shield told me earlier this year. Mike Widmer, president of the non-partisan Massachusetts Taxpayers Association, told me the same thing when I was covering the New Hampshire primaries for Forbes. Companies are not going belly up because of RomneyCare. Private insurers operate in the state along side the non-profit health insurers like Harvard Pilgrim and Blue Cross Blue Shield. There have not been massive layoffs in the industry because of the law.

http://www.forbes.com/sites/kenrapoza/2012/06/29/obamacare-is-constitutional-get-over-it/

Thanks ProSense

[ProSense]

13. Thanks for that. n/t

[bluestate10]

28. I live in Massachusetts. Romney signed the law, but the Democratic legislature is

responsible for what I feel is one of the best laws enacted in my lifetime. I am not a regular visitor to doctor's offices, but when I go, I see people getting quality preventative care. Interestingly, I have noticed that more older people are wintering in the state instead of going to places like Arizona and Florida. My expenditures on health care have dropped since the law was enacted.

[sheshe2]

31. Hello bluestate!

You are right, it was our Democratic legislature that insisted on key points. Romney tried a veto, he lost and Massachusetts won!

Go Mass~

[Iliyah]

7. K & R

[cynzke]

8. In Georgia....

In competition with the insurance carriers granted by the state to administer the ACA programs, Blue Cross, Aetna and Cigna are offering low cost "alternative plans". Private insurance carriers are not going to sit aside and miss out on this.

[ProSense]

16. Interesting. In states like Georgia,

where the federal government will be running the exchanges, Republican governors and officials are publicly contributing to the misinformation. Behind the scenes, they know they can't stop it.

[TBF]

9. We need single payer -

but I'll take what I can get and continue to fight for more.

K&R for the OP

[ProSense]

10. Single Payer movement in the era of Obamacare

Single Payer movement in the era of Obamacare

by Shockwave

If you believe that healthcare is a basic human right and understand why Single Payer IS the final destination of healthcare reform and you want to get it done as soon as possible, read on.

<...>

If you are involved in the Single Payer movement in California this diary may help you understand what we face and whet we can do to get things done.

I am one of those Single Payer activists who understands that Obamacare will benefit many and it is truly amazing that this effort, that President Obama should get full credit for, is the best that could come from a dysfunctional and extremely polarized DC.

And I support those who keep up the fight to prevent its sabotage by all the Republicans in red states and in DC.

I consider the ACA a giant first step towards an America where healthcare is recognized as a basic human right and there is a system that allows ALL who live here to have access to affordable medical attention without the fear of going bankrupt.

And I understand that California is leading the country in the implementation of Obamacare. But it's not about being better than other states like Texas and Georgia where Obamacare is being sabotaged or ignored. It's about joining Vermont to help lead the country to a place where ALL are covered, where the private insurance blood suckers are gone, where medical results and costs are in line with other developed nations, where if you need to see a doctor (or a dentist) you make an appointment and you don't worry whether you will be able to pay the rent (given that 76% of all Americans live paycheck to paycheck).

So how do we get it done? <...>

Bill Zimmerman has just published an article that sets the tone;

Why California can lead the way to Single Payer in the U.S.

Recently Public Citizen, a member of California’s AllCare Alliance, released a report entitled, “A Roadmap to Single-Payer: How States Can Escape the Clutches of the Private Health Insurance Industry.” “We’re looking for a few pioneering states with the courage and fortitude to let common sense prevail over the insanity of our current patchwork system, “said Lisa Gilbert, director of Public Citizen’s Congress Watch division. “Once they succeed, we expect most opposition to single-payer and our reliance on privately insured health care to become historical relics.”

By the time California votes to move to a single payer system – the earliest date possible is 2017 when the Affordable Care Act allows states to set up their own systems – Congress will have gone through two more election cycles. Voters will be less white, and probably less conservative, and the changing composition of the House of Representatives may allow for passage of single-payer waiver legislation for states, perhaps even with “state’s rights” support from a few Republicans.

California, Vermont and possibly other states moving to single-payer will put increasing pressure on Congress to grant other state waivers. Once subject to such pressure, Congress could theoretically pass a federal bill to give (improved) Medicare to all, but it is politically far more likely that they will simply let the states set up their own systems, which can then become models for a larger federal program. California, once again, could be the engine driving national change.

One of the features of Obamacare is the "waiver". The idea is that states can apply for this "waiver" and implement their own plan starting 2017 if this new plan covers more people and is affordable.

So lets take a look at what the ACA says about the "innovation waiver";

SEC. 1332 ø42 U.S.C. 18052¿. WAIVER FOR STATE INNOVATION.
(a) APPLICATION.—
(1) IN GENERAL.—A State may apply to the Secretary for the waiver of all or any requirements described in paragraph
(2) with respect to health insurance coverage within that State for plan years beginning on or after January 1, 2017. Such application shall—
(A) be filed at such time and in such manner as the Secretary may require;
(B) contain such information as the Secretary may require, including—
(i) a comprehensive description of the State legislation and program to implement a plan meeting the requirements for a waiver under this section; and
(ii) a 10-year budget plan for such plan that is budget neutral for the Federal Government; and
(C) provide an assurance that the State has enacted the law described in
subsection (b)(2).

So this is the milestone that any state has to go through. The Vermont single payer activists lead the way. Even Vermont will apply for the "innivation waiver" to get federal funds starting in 2017 to help pay for their Single Payer system.

Here in California the Single Payer organizations (linked logos below) will announce soon the plan to achieve the "waiver" milestone by January 1st 2017. The Single Payer plan that will be proposed will be based mostly on SB 810, which was approved by SEnate and Assembly twice and vetoed twice by Arnold Schwarzenegger and in 2012 it was stopped by 6 blue dogs in the Senate before it could get to Jerry Brown's desk.

In California, one of the key issues is that Obamacare will leave out over 3,000,000 undocumented workers. These 3,000,000 are an integral part of our society and mostly but not all are Latinos. And as Joan McCarter pointed out, Latino organizations worry about funding for Obamacare outreach efforts;

Hispanic health centers and community organizations say they don’t have the funding or resources to carry out the complicated sign up process for the 10 million Latinos who will be eligible for new public and subsidized health coverage options.

Latino organization outreach is a key to success.

And we should coordinate the efforts around the country.

So here in California we need to work with Sacramento at all levels. It will be a lot of hard work but there are thousands of committed activists.

One way you can help is by joining one of the Single Payer organizations and help us organize and direct the grassroots movement that will be instrumental in convincing Sacramento to go along.

And this week on Thursday August 1st you can join other activists to watch The Healthcare Movie in Santa Monica at 7:30PM and celebrate the 48th anniversary of Medicare. You can buy tickets here.

- more -

http://www.dailykos.com/story/2013/07/30/1226609/-Single-Payer-movement-in-the-era-of-Obamacare

Note:

Kos Media, LLC Site content may be used for any purpose without explicit permission unless otherwise specified

Remember Section 1332 of the health care law?

State single payer waiver provisions in the Senate healthcare bill - legislative language and fact sheet from Vermont Sen. Bernie Sanders

Why the 1332 Waiver in the Senate Health Reform Bill is the Only Opportunity for State Single Payer Systems Under the Bill

The health care reform bill passed by the Senate requires that all states set up Exchanges through which private insurance companies could sell their plans. Because federal laws preempt state laws, the federal health care reform bill would supplant any state attempt to set up a single payer system in lieu of an Exchange, which by its nature calls for multiple payers to compete. If the Senate bill is enacted, the only opportunity for states to move toward a single payer system is found in Section 1332. This section would allow a state with a plan that meets certain coverage and affordability requirements to waive out of the requirement to set up an Exchange for private insurance companies. Only with such a waiver could a state move in the direction of a single payer system.

- more -

http://www.pnhp.org/news/2010/march/state-single-payer-waiver-provisions-in-the-senate-healthcare-bill-legislative-langu

Release: President Endorses State Waiver Proposal

Vermont Delegation and Gov. Shumlin Hail Obama Endorsement of State Health Reform Waiver Legislation

WASHINGTON, Feb. 28 - The Vermont congressional delegation and Gov. Peter Shumlin today hailed President Obama's endorsement of legislation allowing states to provide better health care at a lower cost starting in 2014.

At a meeting of the National Governors Association Monday morning, Obama announced his support for amending the Affordable Care Act to allow states like Vermont to seek a federal waiver to the new law three years earlier than currently allowed. States would be required to design plans that are at least as comprehensive and affordable as the federal model and cover at least as many people

Last month Sens. Bernie Sanders (I-Vt.) and Patrick Leahy (D-Vt.) introduced in the Senate and Rep. Peter Welch (D-Vt.) introduced in the House legislation that would advance the date waivers would be accepted from 2017 to 2014. The three joined Gov. Shumlin at a Montpelier press conference to announce the legislation, which would provide Vermont the flexibility it needs to adopt reforms Shumlin is pursuing.

Leahy said, "This is a wise decision that keeps in focus the goal of continually improving health care in America. I applaud President Obama and Secretary Sebelius for supporting efforts by Vermont and other states to go above and beyond what the Affordable Care Act requires. They know that the federal government does not have a monopoly on good ideas, and innovations by the states will prove - and improve --- the benefits of health insurance reform, on the ground, and in practice. While some in Washington want to turn the clock back and repeal the new health reform law, Vermont and other states want to move ahead. Vermont has already been working hard to improve the state's system of health care, and passage of the delegation's waiver bill will move our state one step closer to that goal."

Sanders said, "At a time when 50 million Americans lack health insurance and when the cost of health care continues to soar, it is my strong hope that Vermont will lead the nation in a new direction through a Medicare-for-all, single-payer approach. I am delighted that President Obama announced today that he will, in fact, support allowing states to innovate with health coverage models sooner rather than later. I worked hard to draft and secure the waiver provision in the health reform law and I am very pleased the president now agrees that we should make it available in 2014 as originally intended. While there is a lot of work to be done, I look forward to working with Sens. Leahy, Wyden, Inouye, Brown and others in the Senate and Rep. Welch and others in the House to get this done as soon as possible."

Welch said, "President Obama's support for allowing states to innovate sooner is a good news for Vermont and all states looking to tailor health care reform to individual states' circumstances. This legislation will give Vermont a green light to lead the nation in providing quality health care at a lower cost. I'm hopeful that Democrats and Republicans alike will support this practical step to give states flexibility to achieve progress their own way."

Shumlin said, "I was excited to learn about this today during a visit to the White House. All along officials from Health and Human Services have expressed a willingness to work with us, as long as we don't compromise standards under the law. I think this is an excellent example of how we can work together to control skyrocketing health care costs and implement meaningful health care reform as soon as possible."

A fact sheet on the delegation's "State Leadership in Healthcare Act" is available here.

http://www.sanders.senate.gov/newsroom/news/?id=44a664de-8e92-43f4-a871-d26e0b5a252d

FACT SHEET

"State Leadership in Healthcare Act‟

Section 1332 of the Patient Protection and Affordable Care Act – the “Waiver for State Innovation” – allows states to waiver out of some of the requirement of federal health reform if they meet certain standards. The provision in the new law was authored by Sens. Bernie Sanders (I-Vt.) and strongly supported by Sen. Patrick Leahy (D-Vt.) and Rep. Peter Welch (D-Vt.).

The Sanders-Leahy-Welch “State Leadership in Healthcare Act” moves the availability of state waivers from 2017 to 2014. This would allow a state to avoid the expense of setting up an exchange – which is otherwise required in every state in 2014 – only to dismantle it later.

The federal waiver would allow a state to:

a) Collect all the federal funding and use for financing coverage for individuals through a plan designed by and for that state.
b) Coordinates this waiver process with Medicare, Medicaid and CHIP waiver processes that may be required depending on the design of the system. The state

The federal waiver would not allow a state to:

a) Offer lower quality or less affordable care to their residents than would be available in the exchange.
b) Obtain waivers from the health insurance market reforms implemented under the law such as those benefiting ending the use of pre-existing conditions to exclude individuals from coverage or those allowing young adults to stay on their parents’ plans longer.

How does the waiver provision of the law work?
Step 1: The state passes a law to provide health insurance to its citizens.
Step 2: The Secretary of Health and Human Services and Secretary of the Treasury review the state law and determine that the plan is:

a) At least as comprehensive as its residents would receive in the exchange;
b) At least as affordable;
c) Deficit neutral to the federal government; and,
d) Covers at least as many people.

Step 3: If the federal government finds that the alternative state system meets these requirements without certain federal rules, states can get a waiver. The state plan could receive waivers from:

a) The section requiring establishment of the exchange
b) The designs for how federal subsidies would have to reduce premiums and co-pays.
c) The employer penalty for providing coverage
d) The individual mandate.

http://www.sanders.senate.gov/graphics/011411state_waiver_fact_sheet.pdf

The Affordable Care Act: Supporting State Innovation
http://www.healthcare.gov/news/factsheets/2012/02/state-innovation02222012a.html

[ProSense]

17. Adding this: Vermont Health Connect forums set for Monday

Vermont Health Connect forums set for Monday

SPRINGFIELD, Vt. (AP) — Representatives of the new Vermont Health Connect exchange will be fanning out across the state in the coming weeks to talk to residents and small business owners about the new health insurance system.

On Monday morning, Congressman Peter Welch and Director of Health Care Reform Robin Lunge will give a talk and answer questions at the First Congregational Church in Springfield about the coming changes.

Navigators, who are people specially trained to help consumers find their way through the new health insurance system, will be on hand late Monday afternoon at Vermont Cares in Burlington.

Vermont is getting ready to launch the new Health Connect exchange, or health insurance marketplace, on Oct. 1.

http://www.boston.com/news/local/vermont/2013/09/23/vermont-health-connect-forums-set-for-monday/6KGsQOY1Tfb6QNpC9zwLeJ/story.html

[TBF]

23. Thank you for both posts -

I am watching from Texas, so it is slow-going. BUT I believe all of this is driven by conditions. Our demographics show Texas potentially blue in 15-20 years but with other states pushing (and Texas residents watching) there is no reason that can't be sped up. As Tip O'Neil reminded us, all politics is local. Texas folks are gonna see what everyone else is getting and they are going to wonder why they can't have it. Then we will see change.

[ProSense]

37. You're welcome. See comment 12 for a post about Texas. n/t

[IronLionZion]

24. Has Vermont gotten their waiver to start Green Mountain Care?

I haven't found any info on this, but I hope it works. Last I heard was they did not get their waiver yet due to financing issues.

Then hopefully a big state like California will do it next.

[ProSense]

33. The issue with the waiver

"I haven't found any info on this, but I hope it works. Last I heard was they did not get their waiver yet due to financing issues."

...is the date. It's in the health care law, but doesn't take effect until 2017. There is an effort to push up the date.

Vermont's exchange is 100 percent federally funded.

[bluestate10]

29. The ACA will lead to Single Payer. Not because the ACA will fail as some here on DU pray

for, but because the ACA will work so well that the general public will ask whether coverage can get better. Most sane people vote with their wallet. The ACA will bring many financial benefits to average Americans, those people will want even better health care coverage, giving an opening for implementation of Single Payer.

[TBF]

30. That is the hope -

I'd love to get the insurance companies out of basic care. I think it would be cheaper overall (preventative basic care would cut ER cuts substantially to start with ...). Maybe those companies could provide secondary coverage for people who desire more (paid out of pocket).

[SidDithers]

36. Nailed it...

IMO, ACA is the first step in a long road to single payer.

Once one state, Vermont seems the closest, enacts their own state-wide single payer plan, other states will watch closely to see how well it is received, and how successful it is. Soon, another state or 2 will enact their own state-wide single payer plans. Then a few more, and eventually, citizens in every state will be clamoring for their state governments to implement a single-payer plan.

The people who thought a national single-payer plan could have been imposed, top down, from the federal government are deluded. The only way that single-payer will come about in the US is from the bottom-up, state by state.



Sid

[Fumesucker]

49. That's why single payer advocates were locked out of the negotiations

So that we could get single payer.

Do you realize how conspiratorial that sounds?

[ProSense]

51. Yet the law

"That's why single payer advocates were locked out of the negotiations

So that we could get single payer.

Do you realize how conspiratorial that sounds?"

...includes a path to single payer: http://www.democraticunderground.com/10023715400#post10

That's not "conspiratorial."

[Cryptoad]

14. Thanks Pro Sense and Thanks Mr President! nt

[ProSense]

15. The Next Real Fight for Obamacare Will Be in 2014

The Next Real Fight for Obamacare Will Be in 2014

Richard Kirsch

Progressives must get out in front of the battle to preserve the biggest expansion of the social safety net in decades.

It's been 100 years since ideological conservatives joined with doctors and insurance companies to kill the first movement in the United States for what was then called "compulsory health care." Now, on the eve of their epic loss, those who deeply hate the idea that we have a collective responsibility to care for each other are desperately trying to stop history's clock.

Beneath the tested rhetoric from opponents like the Heritage Foundation and Texas Senator Ted Cruz about a government takeover or Obamacare killing jobs and the economy, we can find expressions of the driving force behind the right's obsession. One telling quote is from Missouri State Senator Rob Shaaf, who declared, “We can’t afford everything we do now, let alone provide free medical care to able-bodied adults.” Another is the proud statement from Steve Lonegan, the Republican candidate for U.S. Senate in New Jersey, who told me in a debate on Obamacare at the FDR Library, “I only care about me and my family.” <..> celebrations of extreme individualism are bald expressions of the "47 percent of Americans are takers" ideology that has become the driving fixation of Republicans, with the latest example being the vote in the House to deny food stamps to 4 million people because they are unemployed.

The right most fears the establishment of another new program based on our common humanity...If this is a defining moment for the right, it is also for the left. As Jonathan Chait wrote this week, in a great restrospective on Republican opposition to the ACA, “The transformative potential of Obamacare is not a conservative hallucination.”

For all its faults, the Affordable Care Act is the biggest expansion in half a century of the progressive belief that we all do better when we all do better. Almost 50 years ago, Medicare was greeted by Ronald Reagan – then a mouthpiece for the American Medical Association – as a foot in the door to a totalitarian takeover. The right has long understood how high the American view of the role of government would be lifted if people came to rely on government for something as essential to a person's well-being as health care.

- more -

http://www.nextnewdeal.net/next-real-fight-obamacare-will-be-2014

Rand Paul: Subsidizing Health Care Of Fed Workers=Unconstitutional-Yet He Relies On It For Himself
http://www.democraticunderground.com/10023715751

[SomethingFishy]

19. It's a step in the right direction, no doubt about that!

On our way to Medicare for all!!

While as usual I'm not quite as thrilled with the bill as you are Pro, I do think Obama fought against an incoming tide and got all he was going to be able to for now. Once the idiot republicans see their bills go down it should be much easier to get a nationalized health care system for all.

Kudo's to Obama.

[ProSense]

22. I really believe

"Once the idiot republicans see their bills go down it should be much easier to get a nationalized health care system for all."

...that the Republicans biggest fear is that people will like the benefits and realize that there is room for improvement.

[Cha]

21. Really good to know, ProSense.. thank you for all

the blue links!

[BKH70041]

25. Stepping Back For A Clearer View

Despite some of the claims I've read at this site, ObamaCare has never had bipartisan backing in Congress and overly broad public support. But for a few, Republicans completely voted against it. That means only Democrats are politically invested in it. Non-Democrats have little incentive to be patient if it gets off to a bad start, and Democrats have a lot to lose if it fails. What that does is explain the emotional need to believe that it is sure to be a great success by its supporters.

Now it could very well turn out to be a success. The problems rise if a significant portion of the American people believe that ObamaCare imposes hardships on them in order to give benefits to complete strangers. Will people view it as an assault rather than being seduced by what it claims it has to offer?

More than likely it won't be as bad as the nay-sayers are painting it to be, but it won't be as wonderful as the supports say either. The truth lies somewhere in-between. More than likely it's going to turn out like a lot of things in life; it's going to suck, but realizing it's what we have to work with we'll muddle through it.

[ProSense]

26. No,

"Despite some of the claims I've read at this site, ObamaCare has never had bipartisan backing in Congress and overly broad public support. But for a few, Republicans completely voted against it. That means only Democrats are politically invested in it. Non-Democrats have little incentive to be patient if it gets off to a bad start, and Democrats have a lot to lose if it fails. What that does is explain the emotional need to believe that it is sure to be a great success by its supporters."

...not a single Republican supported the law. They suck!

[BKH70041]

27. To Clarify

I should have been more clear that I was making reference to the latest "continuing resolution" vote in the House where Virginia's Scott Rigell was the lone Republican who voted "no," howbeit on grounds other than ObamaCare. Still, it is recorded as a "no."

[bluestate10]

32. If the ACA is ging to fail or even mildly stink, republicans should be falling all over themselves

to get it enacted. Republicans should be demanding enactment even earlier than October 1. The fact is, the ACA will succeed. People will get better health care coverage for less money. People that don't want to take care of their health will be confronted with the reality that they need to pay more attention to preventative actions that will improve their health. People that get sick for no action of their making won't be left to slowly die. Children will get health care and have a chance for a better life, regardless of their economic standing. I live in a state that has enacted health care reform, I'm proud of my state and what has been accomplished here.

[BKH70041]

34. Generally when an entitlement is in place...

... it never goes away. I would have to say that's why they're trying to defund it, because once it's in, that's it, we're stuck with it whether good or bad. I have no reason to doubt they believe it to be bad.

But if they wanted to get rid of it, I agree what you lay out would be the best way to go forward, that is, "I know no method to secure the repeal of bad or obnoxious laws so effective as their stringent execution." - Ulysses S. Grant

http://www.brainyquote.com/quotes/quotes/u/ulyssessg134449.html

[Rex]

40. It will be the best thing to happen to this country since Medicare and Medicaid.

But believe what you will.

[BKH70041]

41. I had to deal with Medicare with both my parents.

It was no picnic.

[Rex]

42. Oh I don't think it is a ride in the park.

BUT how would they have fared without Medicare or any kind of program to help them out?

[BKH70041]

43. I have no dispute with Medicare.

That isn't really part of it.

Insurance companies ration healthcare by what they're willing to pay. Medicare does the same. Personally I think ACA will lead to Medicare for all, but they'll ration care even more than they do now. But like I said, it's what we'll have to work with, so we'll make due. At least everyone will be covered for the basics, and those who can afford better care will get it. It's the American way.

[Rex]

44. It is the Democratic way!

Left up to the GOP, we would all be fighting over scraps from the master table.

[SidDithers]

35. DU rec...nt

Sid

[ProSense]

38. Bottom line: Obamacare really is for the 99%

Bottom line: Obamacare really is for the 99%

by nyceve

The right wing, led by the moral reprobates at Freedom Works are determined to sabotage enrollment in the Affordable Care Act. They are targeting 18- 34 year olds, the cohort most critical to the success of the ACA.

Fox News, we are being told in an excellent diary by Jon Perr is, as usual, substituting lies and distortion for fact.

As President Obama said yesterday at his news conference, there are 53 days left before the Health Insurance Exchanges open on October 1st. I'm reminding today myself why progressives, that means you and I, must organize to fight any effort to defund, destroy or otherwise tamper with Obamacare. The ACA is light years away from perfection, but it's what we have--today. It will assist many good, hard working Americans who are in desperate need of help

Powerful unions like National Nurses United and other progressive organizations are going to beat the drum--loudly, and remind Americans that those politicians who seek to defund Obamacare are the people who give themselves the best healthcare.

If you listen to these videos which I made during my visits to Free Health Clinics in 2009 during the height of the healthcare fight, it seems to me, you come to only one conclusion, Obamacare is for the 99%.

The people here describe the barbaric depravity of American healthcare that we hope and expect will go away come January 1st. It is sobering to listen to these fine people describe the toxic waste dump of the pre-Obamacare U.S. healthcare system.

Most of all, we hope that more people like Karen Black will not die because they don't have funds for treatment.

Keith needs a leg, with insurance, he will get it.

Keith who needed a prosthesis when I met him in Little Rock in 2009 could not get one because he didn't even qualify for Medicaid. Now, hopefully he will either qualify for Medicaid or receive a subsidy to purchase insurance on the Arkansas exchange.

I'll be praying for Keith on January 1st.

<...>

Frank Wood has been uninsured most of his life.

Frank Wood is uninsured and hadn't seen a doctor in over six years. He needed medication for a skin condition which cost $60 a tube. Now, he too will either qualify for Medicaid or a subsidy.

Let's pray for Frank on January 1st

<...>

Cindy Howell has probably filed for medical bankruptcy by now.

Cindy Howell describes going deeply into debt to continue paying for her BC/BS insurance in Texas. She says her policy doesn't even pay for preventive services. Well now, thanks to Obamacare, insurers will be required to pay for preventive care like mammograms and colonoscopy, well child care with no cost sharing.

<...>

One of the more positive sounding admonitions from health care reform opponents was that the United States had "the best health care in the world," so why would you mess with it? Not if you ask the 50 million uninsured, and the rest of us inadequately insured with high deductibles and co-pays who think long and hard before spending absurd sums for medical care.

I want to leave my uninsured brothers and sisters with something I turned up in the course of doing health care research.

Here's a tip about a company called StatLabs which provides lab testing to people in certain states (Florida, Georgia, North Carolina, South Carolina, Tennessee, Texas or Virginia) without the need to first go for an expensive medical visit. I'm sure that the reason this is only available in a few states is because in the other states, the doctor lobby effectively blocked such a sensible solution to obtaining a medical test.

http://www.dailykos.com/story/2013/08/10/1229011/-Bottom-line-Obamacare-really-is-for-the-99

[Rex]

39. Needs to be a law in place that when you try and repeal a law

40 times - while the national infrastructure crumbles around you, you go to jail for obstruction.

[ProSense]

45. This isn't part of the health care law, but it certainly deserves exposure.

Kerry gave a speech mentioning the "National Deaf-Blind Equipment Distribution Program."

Remarks at a High-Level Meeting of the United Nations General Assembly on Disability and Development

Remarks
John Kerry
Secretary of State
United Nations

New York City

September 23, 2013


Good morning. And it’s a great pleasure for me to be able to be here with all of you, an honor to be here for my first high-level meeting at the United Nations General Assembly as Secretary of State.

Before we begin, I want to just reiterate that we are monitoring very closely and with great concern the situation in Kenya. Ruthless and valueless terrorists remain a serious challenge everywhere in the world, as we all know, whether it’s in downtown Manhattan or in a mall in Nairobi or anywhere else in the world, and all of us have a responsibility to remain vigilant. We stand with the Kenyan people. The President has talked to their President; I’ve talked to their Foreign Minister. They are a resilient people, and they will need the world’s support in the coming difficult days.

But the bottom line is that this tragedy is a reminder, a terrible reminder, to all of us that we all share a stake in one another. And that is especially important to keep in mind as the international community prepares to renew the development goals for 2015 and beyond. What happens in one country, we are reminded day to day, matters to many others, to all of us. And what matters in one culture has to be considered elsewhere. That is a bottom line with respect to the topic that we are discussing here today. The way we treat people of all backgrounds, including how we treat disabled and non-disabled alike, this is how we demonstrate our values, and it’s how we define who we are.

Through our development agenda, we have a very important opportunity to show the world that we value everyone’s contributions, and that we leave no one behind, including those with disabilities. It is clear, and we have seen here in the United States over the last years, that we can make an enormous number of lives better in that process.

The principle behind this is really very, very simple: Our societies, all of our societies, are stronger when every single one of our citizens, able bodied and disabled alike, all get to live up to their full potential. And that’s why here in our country, many states have established standards, and they steadfastly enforce them – laws like the Americans with Disabilities Act, which we passed in 1990 and we believe is really a gold standard with respect to how we treat people and how we open up the world for opportunities. We encourage the international community to look at, study, and, hopefully, emulate this law.

Thanks to laws like the Americans with Disabilities Act, nearly one in five Americans are now protected from disability-based discrimination, and all Americans benefit from the contributions of our fellow citizens with disabilities. We see this every day in everyday life in the workplace, in schools, in education all across our nation.

Thanks to other groundbreaking non-discrimination laws like the Individuals with Disabilities Education Act, nearly 60 percent of students with disabilities are in general education classrooms for 80 percent or more of their school day. Nearly 350,000 infants and toddlers with disabilities and their families now receive early intervention services. And more than 6.6 million children and youth receive special education and related services designed to meet their individual needs.

This year the Federal Communications Commission issued the first-ever National Deaf-Blind Equipment Distribution Program in order to help meet the needs of deaf-blind individuals. And since then, hundreds of deaf-blind individuals have gained access to communication technologies through this program, allowing them to lead independent lives and stay connected with their family members and their friends.

In too many countries, however, we still see the rights and the dignity that we have been blessed to be able to now almost take for granted, that it is not existent in many of those places. So as we work to ensure equal access to public spaces, communications technology, education, and more, and though we’ve seen progress internationally, everybody here knows that we still have a lot to do.

Though disabled persons comprise 15 percent of the world, 8 in 10 live in developing countries. And there’s obvious reasons for that. And in those developing countries, 9 out of 10 children with disabilities don’t go to school. Compared with 5 or 10 years ago, many more countries now have laws prohibiting discrimination on the basis of disability, and many more countries require buildings to be accessible. But all countries, we believe, can work harder to enforce these laws, and to ensure that disabled people have as much right and ability to access their local supermarket or their school or even election booths.

Frankly, this is as much an economic issue as it is a human rights issue. But it is also profoundly a family issue, a personal issue, and a moral issue. None of the change that is needed is possible without the partnerships that we’re building at the international level, including meetings like this, where the world can come together to learn from each other’s experience of how we can make rights a reality for disabled people. No one can forget, however, that the most important partnerships we build are, in the end, those that we build with persons with disabilities themselves. We cannot afford to forget that disabled individuals are not only the beneficiaries of development efforts and investments, but they are also leaders, and they are the agents of progress. And they do so on an equal basis with others.

I’m honored today to be joined by Judith Heumann and Charlotte McClain-Nhlapo, who are well known to you all as longtime leaders in the international disability movement. We’re honored that they have brought their expertise and leadership into our government to guide United States policy and practice that leaves no one behind in our diplomacy or in our development, including persons with disabilities.

So we’re here because we see the possibilities of diplomacy, the promise of development, and the potential of every single person. And in fact, I think all of us understand and we have learned gracefully in our country that the possibilities are, frankly, unlimited. So I hope everyone will leave here with a commitment to do everything that we can to make sure that we are pursuing the policies of inclusivity and that we mean it when we say we will not leave anyone behind. Thank you very much. (Applause.)

http://www.state.gov/secretary/remarks/2013/09/214538.htm

National Deaf-Blind Equipment Distribution Program

Background

The Twenty-First Century Communications and Video Accessibility Act of 2010 (CVAA) authorizes the Federal Communications Commission (FCC) to provide funding for local programs to distribute equipment to low-income individuals who are deaf-blind (who have hearing loss and vision loss). The FCC may use up to $10 million annually from the interstate Telecommunications Relay Service fund for this purpose.

Pilot Program

In 2011, the FCC established the National Deaf-Blind Equipment Distribution Program (NDBEDP) as a pilot program. The pilot program will run for two years, beginning July 1, 2012. The FCC may extend the program for a third year. The pilot program will provide valuable information that the FCC will use to help develop and implement an effective and efficient permanent deaf-blind equipment distribution program.

- more -

http://www.fcc.gov/guides/national-deaf-blind-equipment-distribution-program

This Is A BIG F***ing Deal For The Deaf Community!
http://www.dailykos.com/story/2010/10/08/908795/-This-Is-A-BIG-F-ing-Deal-For-The-Deaf-Community
http://www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=433&topic_id=470277

Kerry Laments Rejection Of Disabilities Treaty

Sen. John Kerry (D-MA) on Tuesday lamented the death of a United Nations treaty aimed at securing rights for disabled people around the world, which failed to garner a two-thirds vote required for ratification due largely in part to Republican opposition.

“This is one of the saddest days I’ve seen in almost 28 years in the Senate and it needs to be a wakeup call about a broken institution that's letting down the American people,” said Sen. Kerry. “We need to fix this place because what happens and doesn’t happen here affects millions of lives. Today the dysfunction hurt veterans and the disabled and that’s unacceptable. This treaty was supported by every veterans group in America and Bob Dole made an inspiring and courageous personal journey back to the Senate to fight for it. It had bipartisan support, and it had the facts on its side, and yet for one ugly vote, none of that seemed to matter."

http://livewire.talkingpointsmemo.com/entry/kerry-laments-rejection-of-disabilities-treaty

The 38 Republican Senators who voted against the treaty for disabled rights
http://www.democraticunderground.com/10021926064

Senate Republicans reach new low in rejecting UN treaty on rights of disabled
http://www.dailykos.com/story/2012/12/04/1167170/-Senate-Republicans-reach-new-low-in-rejecting-UN-treaty-on-rights-of-nbsp-disabled

[Scurrilous]

46. Boink

[ProSense]

47. :-) n/t

[Martin Eden]

48. K&R for the straight facts. n/t

[ProSense]

52. Thanks. n/t

[ProSense]

54. Quote:

[bunnies]

58. "everbody*"

*except those making less than fed. poverty wage in states that dont expand medicaid.

[ProSense]

59. Like I said,

Last edited Sat Sep 28, 2013, 01:32 PM - Edit history (1)

"*except those making less than fed. poverty wage in states that dont expand medicaid. "

...blame the SCOTUS. Reposting (http://www.democraticunderground.com/10023732942#post35)

How long will these states hold out?

Mooching Off Medicaid

By PAUL KRUGMAN

Conservatives like to say that their position is all about economic freedom, and hence making government’s role in general, and government spending in particular, as small as possible...When it comes to conservatives with actual power, however, there’s an alternative, more cynical view of their motivations — namely, that it’s all about comforting the comfortable and afflicting the afflicted, about giving more to those who already have a lot. And if you want a strong piece of evidence in favor of that cynical view, look at the current state of play over Medicaid.

Some background: Medicaid, which provides health insurance to lower-income Americans, is a highly successful program that’s about to get bigger, because an expansion of Medicaid is one key piece of the Affordable Care Act, a k a Obamacare.

There is, however, a catch. Last year’s Supreme Court decision upholding Obamacare also opened a loophole that lets states turn down the Medicaid expansion if they choose. And there has been a lot of tough talk from Republican governors about standing firm against the terrible, tyrannical notion of helping the uninsured.

Now, in the end most states will probably go along with the expansion because of the huge financial incentives: the federal government will pay the full cost of the expansion for the first three years, and the additional spending will benefit hospitals and doctors as well as patients. Still, some of the states grudgingly allowing the federal government to help their neediest citizens are placing a condition on this aid, insisting that it must be run through private insurance companies. And that tells you a lot about what conservative politicians really want.

- more -

http://www.nytimes.com/2013/03/04/opinion/krugman-mooching-off-medicare.html

After Medicaid was initiated, one state held out for 15 years.

<...>

Over time, however, the lure of federal dollars proved strong enough to win over resistant states. Eleven joined the program in 1967. Another wave of eight, largely Southern states came on board in 1970. Arizona proved the last holdout, not joining Medicaid until 1982.

- more -

http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/07/09/six-governors-say-they-will-opt-out-of-medicaid-how-long-will-they-hold-out/

Similarly, SCHIP was implemented in 1997. Yet only 87 percent of eligible children are covered.

As Krugman points out, the incentive to comply is there. These are different times, and the exchanges (in most of the OP states the federal government is running the exchanges), multi-state plans and other factors will make a lengthy holdout unlikely.

Multi-State Plan Program and the New Health Insurance Marketplace
http://www.opm.gov/healthcare-insurance/multi-state-plan-program/#url=Factsheet

New Loan Program Helps Create Customer-Driven Non-Profit Health Insurers
http://www.cms.gov/CCIIO/Resources/Grants/new-loan-program.html

[ProSense]

55. Add this here:

Final Word On Obamacare Coverage: Cheaper Than Expected
http://www.democraticunderground.com/10023727018

[spanone]

60. k&r...