Tag Archives: ACA

Without Medicaid Expansion, Harris County Healthcare Workers Laid Off

Home to an estimated 4.4 million people, there’s not too much that is small about Harris County, Texas.  It is the 3rd-largest county in the United States of America, and of course is the home for most of the city of Houston.

As a rapidly-growing county, no one should be surprised that there is also a rapid need for expansion of health services.  So many people may be shocked to hear that one of the country’s largest public health systems is actually laying people off this week, with more lay-offs possible in the near future.  And as Kyrie O’Connor of the Houston Chronicle notes, these lay-offs have little to do with falling oil prices…

Facing an expected budget shortfall of $71.8 million, Harris Health System is in the midst of laying off about 113 employees, an agency spokesman confirmed Tuesday. A number of vacant positions where employees have already left won’t be filled, bringing the total to 261.

Harris Health, formerly known as the Harris County Hospital district, is the county’s primary public health service agency serving low-income people. It employs 8,237 workers.


Harris Health officials have blamed the deficit on several factors, chief among them the state’s decision not to opt for expanded Medicaid from the federal government. They also cite decreased payments to the agency from other federal programs. Expanded Medicaid would have offset those cuts. Harris Health says it has expanded its services in recent years in response to growing demand.

“We are this community’s safety net health system. Nobody provides healthcare to those most in need better than Harris Health,” Masi said. “We will continue to deliver high-quality health services as efficiently as possible with the resources we have available.”

The board is scheduled to meet Thursday to consider proposals to offset the $71.8 shortfall and possibly to tentatively adopt a budget. At last week’s meeting, the members discussed the possibility of approving a budget with a $11.8 million shortfall, to preserve as many of the threatened patient services as possible.

Harris Health officials state that this round of lay-offs “will not result in a cut in services”, which is hard to believe at this point.  And even if that is the case, what happens when the next round of cuts come through??

These people do not have to lose their jobs at all, as legislators in Austin have it in their power to accept the Medicaid Expansion, or come up with a unique Texas solution right now.  But thanks to their selfishness, real Texans are paying real consequences.  As smart Republican leaders like Harris County Judge Ed Emmett already know, it is anything BUT Conservative to be letting go of health professionals in a place growing as rapidly as Harris County.  It’s time to drop the political games around the ACA and do what’s best for Texas.

These may be the first round of area layoffs due to the state’s refusal to expand Medicaid, but they likely will not be the last.  If you ever cared about this issue enough to write your lawmakers in Austin, now is the time to do it.

ACA Has Helped Create Nearly 1 Million Jobs

Honestly this shouldn’t be too surprising, but the Affordable Care Act isn’t just giving people more access to quality healthcare.  It’s also putting Americans to work and saving many of our nation’s hospitals, as reported by Dan Diamond of Forbes magazine

Obamacare was once called “The Job-Killing Health Care Law.” But the latest jobs report suggests that the broader economy—and the health care sector, specifically—is adding jobs at a healthy rate.

  • Since the Affordable Care Act was signed into law in March 2010, the health care industry has gained nearly 1 million jobs—982,300, to be more precise—according to Bureau of Labor Statistics estimates released on Friday.
  • Meanwhile, the rest of the economy has added 7.7 million jobs since March 2010, and for the first time, more people are working since the recession began five years ago.
  • Private-sector jobs also grew for the 51st straight month, Justin Wolfers observes at The Upshot, which ties the longest consecutive streak on record and overlaps with the passage of Obamacare 50 months ago. But that streak is piddling compared to health care, which just reported its 131st straight month of job gains.

Booming growth in the heath care industry shouldn’t come as a surprise. The health care sector was gaining about 25,000 jobs per month in the years before the Affordable Care Act, and the law’s infusion of newly insured patients will help bolster providers’ bottom lines.

Besides the obvious job creation needed to handle millions of additional patients and insurance plans, the ACA has also created jobs by upping compensation for hospitals, especially in states that took some form of Medicaid expansion.  Hospitals and doctors have previously had to shoulder the cost for any patient that was treated and then could not pay for their care.  But now thanks to the ACA, those hospitals are able to provide a better quality of service because more of their overall care is compensated.  As previously discussed in this blog, the Medicaid expansion has often proven a necessary life line for our nation’s rural hospitals, some of which were forced into debt for seeing so many patients that couldn’t pay.

The healthcare needs of the United States will only continue to grow as a larger and larger share of the population ages.  But thankfully because of actions taken back in 2010, we’ll be much better prepared for them with more people working, and more avenues to quality care.


Time to Kill Obamacare

Perhaps this isn’t the post title that one expects to see on a left-leaning blog, but just bear with me.

When suggesting that we  kill Obamacare, it is not suggesting that the law and new practices be actually killed, like some of the theories Conservative writer George Will has put forward.  He thinks the Affordable Care Act can be struck down arguing that it is unconstitutional, but this is simply inaccurate.  Though it’s true that the law originated in the Senate, and it definitely incorporates monetary elements, those do not describe the crux of the legislation.  The purpose of the ACA is not to raise revenue, but to facilitate the ability for more Americans to have health insurance.  Though taxes share many commonalities with penalties, they are fundamentally different.  A tax is something that is owed under any circumstance… everyone pays taxes simply because they are citizens.  But a penalty is only paid when someone doesn’t comply with an existing law.  Jim gets a traffic ticket for running a red light, but Suzy stops at the light.  Was Jim taxed because he operates a vehicle??  No… he was issued a fine.  Suzy complied with traffic laws, and because she did this, she was not fined.  If George Will or anyone else tries to assert this argument that the ACA can be struck down, politely remind them of the difference between taxes and penalties.  It’s constitutional… deal with it.

But even with the law being constitutional, here’s why we should kill Obamacare.  Poll after poll suggests that while Americans typically agree with provisions of the ACA, they still don’t like Obamacare.  If you’re someone that follows politics on a regular basis, then the conflict here is blatantly obvious… the Affordable Care Act is Obamacare… we’re talking about the same thing!!  Just remember that the majority of Americans could tell you much more about Real Housewives than they could about the Houses of Congress.  Even after 4 years of wrangling, there are some genuinely intelligent people that still have no clue how the health insurance market has changed.  But thanks to an effective messaging blitz by the GOP, they do know that they don’t “like” the word “Obamacare”.

Here’s the big secret folks… before the ACA was signed into law, we had a wide array of health insurance options.  Today, more than 6 months after its full implementation, we still have a wide array of health insurance options. Despite the many lies that are out there, Obamacare isn’t some scary big government program.  It’s just a law that looked at our country’s health insurance market, determined what works and what doesn’t, and set some ground rules so companies would offer better plans to more people.

Obamacare is all politics.  But the policy of the Affordable Care Act is what’s changing people’s lives.  That’s what the Left needs to be talking about.  Let people know that the ACA made insurance more affordable, easier to obtain and much easier to understand. Give voters examples of how health insurance can improve their lives and take away the fear of the uncertain.  Instead of trying to sell negative terminology, let’s discuss why the insurance market of today is better than when Obama took office.

Long after President Obama’s term ends, the only ones that will remember the term Obamacare will be those reading politics and history books. Democrats can’t win the messaging war on this one, but they can stand by their record of having helped over 8 million people find more affordable healthcare.  It’s time to evolve past the politics debate, and let people know about the real policy and its real results. 


Arkansas: ACA ‘Private Option’ Still In Jeopardy

In 2013 Arkansas lawmakers made a solemn promise to the state’s people. They crafted a landmark compromise to cooperate with the Affordable Care Act, and bring life-saving healthcare options to hundreds of thousands of Arkansans. What resulted was Arkansas’ Private Option… a deal that that uses ACA money originally meant to expand Medicaid, but instead covers citizens through the health insurance marketplace.

Before the plan was enacted, I had my reservations about this plan over just using Medicaid… especially if it could be applied to other states like Texas. But after a few months in, one thing is clear. The Private Option is a rousing success. Over 100,000 people have enrolled in healthcare plans, reducing the state’s uninsured population by one fifth in just four short months. Enrollment has been surprisingly swift, with hundreds, if not thousands of new enrollees coming from every one of the state’s 75 counties. It doesn’t matter if the county is politically red or blue, everyone needs healthcare.

It’s not just the new enrollees that benefit. For Arkansans that were already receiving Medicare and Medicaid, the ACA and Private Option increased their quality of care by lowering costs of prescription medications for patients, and providing new benefits such as wellness visits, dental and optical care, and even partnership with fitness centers to promote wellness. With fewer uninsured patients to see, the expansion saves money for the state government and lessens the burden on hospitals. The more than $90 million dollars in savings will be used to give Arkansas families a tax cut. I am convinced that this is a model that would work well for larger states like Texas and Florida.

Sadly, all of these monumental achievements are in jeopardy. Though passed in the Senate, a faction of 27 Republican legislators in the Arkansas State House have voted repeatedly to not only kick those one hundred thousand people off of their health insurance, but also raise taxes for Arkansas families and businesses. The only word that can describe one’s reasoning for such a vote is lunacy. Here’s more from David Ramsey of the Arkansas Times

For some, politics come into play, but those in the hardcore opposition – the Ballingers and the Hendrens – have sincerely held reasons for that belief. I certainly do not think that they wish to kick 100,000 people off of coverage out of spite, or lack of care. They simply believe that the private option is bad public policy.

But the outcome of their preferred policy — ending the private option — is precisely to kick 100,000 people off of the coverage they’ve gained this year through the private option, and to ensure that around 100,000 more eligible people never gain that coverage at all. It’s time for opponents to own that.

If there was ever a time for public pressure at the Arkansas state capitol, that time is now. These greedy politicians need to know that the Private Option is literally a matter of life and death. People across the state are able to go to the doctor for the first time in years. They now have peace of mind that if they face some serious illness, their family won’t have to endure financial ruin just to care for them. Many people have the potential to live longer and healthier lives because of the grand bargain crafted Little Rock. For everyone in Arkansas, I sincerely hope this isn’t thrown away.

(photo credit: Arkansas Times)

Health Reform Facts Made Simple

Though the Affordable Care Act has been the law for over 3 years, there’s still plenty of political wrangling going on. But the truth is, many people still don’t understand exactly what “Obamacare” is, why we need it, and how it is transforming the American healthcare system. This 2010 video from the Kaiser Foundation is the best I’ve found that boils everything down to simple and clear examples. It leaves out the politics and just gives the facts.

Check it out…

Texas Health Scare: Helping vs Hurting

Here’s more evidence that Texas GOP Congress members really are in a pickle over the Affordable Care Act (aka Obamacare), despite what they say to the contrary. From reporter Emily Wilkins of the Dallas Morning News

Aides to Dallas Rep. Jeb Hensarling’s office recently said that he would gladly help any constituent having trouble enrolling in a health plan under the Affordable Care Act.

“Providing outstanding constituent service is a top priority,” an aide said, and that includes “their dealings with all federal agencies and bureaucracies.”

The next morning, Hensarling joined other House Republicans in voting for the 41st time to repeal the law. That illustrates how Texas Republicans are in the position of helping constituents with a program they are simultaneously attempting to derail as the next major step of Obamacare is drawing near.

On Oct. 1, the insurance marketplace will open and 6 million uninsured Texans must pick a plan or face a tax penalty. Organizations working to help North Texans understand the new health care act said they haven’t heard much from federal lawmakers. [note: the enrollment period starts October 1st, 2013 and ends March 31st, 2014.]

“I’ll leave it up to their offices to determine if they feel responsibility to get the word out,” said Tim McKinney, chief executive of United Way of Tarrant County. “I would hope they would.”


Texas Republicans in Congress universally oppose the new health care law. But a sampling found none who said they would turn away constituents with problems accessing its benefits.

Rep. Michael Burgess, R-Lewisville, calls the law “bad for America” and contends it has the potential to destroy the economy. But he’s kept his staff in touch with the Department of Health and Human Services. And Burgess arranged a meeting with the Center for Medicare & Medicaid Services after he felt he wasn’t getting as much information as he needed.

“I’ll share with anyone who calls the information I have,” Burgess said.

Even Sen. Ted Cruz, a leader in efforts to strip funding for implementation of the law, promised to help Texans participate if they call.

“I am honored to represent 26 million Texans,” he recently told CNN. “And dealing with the government is inherently frustrating. It’s inherently confusing, and one of the things our office takes very seriously is trying to help Americans deal with the government.”

To be clear, when the Republicans threaten to “defund Obamacare” they’re basically telling a bald-faced lie. Whatever your conception of Obamacare may be, we are already living under much of the law’s provisions, and reaping substantial benefits from them. Right now, several provisions of the Affordable Care Act are Federal law, including…

— guaranteed coverage for all children with pre-existing conditions.

the right to appeal a health care claim that is denied.

— extension for young adults to stay on their parent’s plan until age 26. That includes anyone that is married or not even living with parents.

— the eradication of lifetime limits. That means if you get sick with an expensive disease, your insurance company can’t drop you once health care expenses pass a certain point.

And a whole lot more. With 20 states already participating in the ACA Medicaid Expansion, millions of Americans now have access to affordable care that they previously did not have available. All of these changes are part of Obamacare. So when the GOP runs around and says they want to repeal it, what they really want to do is take away your right to appeal, stop covering children with pre-existing conditions restore lifetime limits on coverage, and yank Medicaid coverage for the millions that received it under the expansion. They are also betting on you not being able to read, talk to someone about the law, and discover for yourself why so many of these changes are important. This is what they are threatening a government shut-down for… to ruin people’s lives who are already benefitting from Obamacare.

Which is what is so laughable about this article… the audacity of them to proclaim how horrible the Affordable Care Act is, but then to simultaneously be a valuable government resource on the law for their constituents? Do they know that by pledging to “help” their constituents enroll and navigate the exchanges, they are actually making the law even more impossible to dismantle than it already is? 

Senator Ted Cruz is correct on one point… he and his offices do in fact represent all 26 million Texans in the United States Senate, and some of those 26 million Texans will enroll using the Healthcare Exchange. The same goes for Senator Cornyn, Congressman Ted Poe, and all the other 35 Congressional Representatives. But on this issue, the Republicans are not representing Texas very well.

As my former choir director says, “At any point in time, you can only be doing one of two things… helping or hurting. You can’t do both at the same time.” Despite what they may say to reporters, the Texas GOP is squarely in the HURTING column on Obamacare, and the general welfare of the people they serve. They continue to lie and misinform Texans about the provisions of the existing law, and new provisions coming up. Rather than helping constituents to understand the law and it’s wide-range of changes, they skip all substantive information, and instead champion creepy ads like the one from Koch Brothers’ spawn Generation Opportunity.

So please, whatever you do, don’t believe the GOP when they say they’re going to “help” constituents with any part of the Affordable Care Act. The only things they want to help are their political careers.

Previous articles in the Texas Health Scare Series: The Silent Majority, What’s Our Alternative?, MediCaid or CrisisCaid?, and Why Medicaid Matters.

The ABCs of the GOP: I is for


One thing is absolutely crystal clear about politics… it is hard work. Whether it be the media members that have to cover this ever-evolving rollercoaster of stuff, the super-smart staffers that have to be on-call all hours of the day and night, or the politicians themselves giving speeches and shaking the hands of millions of people, it’s HARD. Despite what they may say on TV, every person that you see as a Washington politician has worked very hard to get to where they are. Each one has run a successful campaign, and has the will of thousands and sometimes millions of voters.

From this, we know that the national Republican party works extremely hard to deliver their message and ideology. In many ways, delivery and discipline are their greatest strengths. But what is not a strong point of the current GOP?? Actually running the country. For their part, they are most just creating the illusion of doing that.

What more proof could you ask for than the 33rd vote to repeal the Patient Protection and Affordable Care Act… 33 repetitive votes in just 18 months. Eventhough Republicans know that the result of the vote will be the same as the 32 other times they’ve tried it, they decided to do it again. Clearly the choice to do something like this over and over again is wasting the time of the American people. It may give the illusion of actual legislation, but it’s nothing more than running out the clock.

Well maybe I’m wrong about that…

The votes didn’t just waste our time. They also wasted our money. In trying to hold up this illusion of total outrage, the House GOP spent $50 million dollars of our tax money. For the party that claims to be such careful stewards of the public purse, these votes seem to be a pretty outlandish and useless expenditure. Meanwhile every day in this country, more teachers, firefighters and polieceman are laid off from work. How many of them would still have their jobs if Congress had decided to put that money to better use?

Speaking of illusions, it’s pretty odd how the GOP works in that regard. After three years of constant fighting and posturing, Republicans suddenly joined Congressional Democrats last week and passed the highway and student loan bill. This legislation could have been passed years earlier, but Republicans have been using the controversial Keystone XL pipeline as their latest energy whipping boy. Yet when the clock finally ran down to the wire and 2 million American Jobs were on the line, the GOP decided to compromise and Keystone was left out of the bill entirely. I’m glad for this, don’t get me wrong. But isn’t it a little hypocritical? If Keystone was so important to them, why is it suddenly not mentioned for weeks? If your greatest concern is the sky falling due to the deficit, then why is it ok for you to BORROW $105 Billion more dollars without paying for it. They’ve just INCREASED the deficit by voting on this bill, yet there is no outrage, the sky is not falling, and China has not invaded our shores.

Maybe all of those temper tantrums are illusions too.