Responding with my Wallet: Donations Following House Passage of AHCA

Angry Image

Image courtesy of jesadaphorn at FreeDigitalPhotos.net

I am disgusted that the House of Representatives passed that travesty of a bill, the AHCA, yesterday. While I know it has a long way to go to passage in the Senate, it still feels like a slap in the face the Congressional reps would put something like this together and pass it.

I’ve been angry since yesterday. I live in a blue state with a very blue rep (thank goodness for @RepRaskin) and blue Senators. When I’m mad about how Congress is acting, I have no one to call who doesn’t already share my feelings.

I was even more appalled watching @RepFredUpton, who was my rep when I was younger, putting forward an amendment to this bill that he knew did not give enough money to cover pre-existing conditions, even in high-risk pools. He has voted for many other bills that I do not agree with, but this might be his most striking vote. He can stand up for the health of our Great Lakes, particularly Lake Michigan (which is a point in his favor) but he can’t stand up for the health of his constituents? Many of my family members are still his constituents. Not all of them can access health insurance through an employer. Some of them, under this bill, would face exclusion due to pre-existing conditions. This is disgraceful.

I am mad. I felt like I did not have an outlet except for ranting on Twitter and a bit on Facebook. So I decided that my monthly donations this month would go toward pushing back against the GOP politically.

I donated through ActBlue.com to campaigns in swing districts. I also donated to VoteRiders.org. I felt it was important to push back against voter disenfranchisement. VoteRiders’ mission statement is noted below:

VoteRiders is a nonpartisan, nonprofit organization that provides practical assistance and information to ensure voters have the right kind of ID to vote in their state. VoteRiders is the leading organization focusing exclusively on voter ID.

Our current priority states, which have or are poised to enact stringent laws about which IDs are acceptable to vote, are: AL, AZ, FL, GA, IN, KS, MI, MO, ND, NH, RI, SC, TN, TX, VA and WI. Some of these states’ voter ID laws leave to others’ discretion whether a resident’s vote will count, or require documentary proof of citizenship to even register to vote. (Source: http://www.voteriders.org/what-we-do/)

I’m going to keep pushing. I’m going to keep showing up to say “This is not right! This is not ok!” I will not accept these things are normal. I will not condone them.

I am mad. And I’m going to do what I can to do something about it.

Great Article: “What Calling Congress Achieves” – The New Yorker

Excellent read. Keeping this here as much for context as motivation.
On constituent activity: “We all do plenty of things without knowing if or when or how or how much they will work: we say prayers, take multivitamins, give money to someone on Second Avenue who looks like she needs it. So, too, with calling and e-mailing and writing and showing up in congressional offices: it would be good to know that these actions will succeed, but it suffices to know that they could.”

http://www.newyorker.com/magazine/2017/03/06/what-calling-congress-achieves

Donating to the Cause. March Edition – The Environment

Image courtesy of anankkml at FreeDigitalPhotos.net

Image courtesy of anankkml at FreeDigitalPhotos.net

I committed to donating to worthy causes in 2017, feeling that it was necessary to put some monetary support behind efforts I feel align well with my values. I wrote a bit about the causes that I have decided to focus on in this post.

While one of my causes was protecting the Great Lakes and, by extension, promoting clean water efforts, I felt that it was imperative to focus on environmental issues this month. With reports that the Trump administration is planning to roll back critical environmental rules while also looking to severely cut the budget of the EPA, I can’t think of a better time to give to organizations focused on protecting our environment.

In the first two months of the year, I focused donations on some of the big names:

I also found an organization specifically focused on the Great Lakes, namely the Alliance for the Great Lakes.

But this month, I decided to donate to organizations specificially focused on the environment. A good article came out back in November 2016 discussing organizations to consider for donations. I chose three:

  1.  The Environmental Defense Action Fund (the active arm of the EDF to which I had previously donated; donations are not tax deductible)
  2. The National Resources Defense Council
  3. EarthJustice

I was particularly pleased by the NRDC’s website and its many calls to take action. I was able to sign a couple of pertinent petitions and get on the email list.

There’s only so much we can do, but something is better than nothing. Whether it’s calling and writing our representatives; attending town halls, forums, rallies, and marches; donating to charities; or joining local grassroots organizations, like the Indivisible movements, any action makes a difference. Even if it’s a small difference, a drop in the bucket, it’s one more than would have been there without you!

Looking at the GOP ACA Replacement Plan

Image courtesy of smokedsalmon at FreeDigitalPhotos.net

Image courtesy of smokedsalmon at FreeDigitalPhotos.net

A number of articles came out this week discussing what the GOP put out as their replacement plan for the Affordable Care Act (ACA). The plan is in the early stages (which is honestly shocking considering they have had 7 years to work on a viable alternative), but there are several talking points they have mapped out for GOP members of Congress.

According to PBS News, the following points were part of the GOP replacement plan, and I am quoting their policy brief:

  • Modernize Medicaid
  • Utilize state innovation grants
  • Enhance Health Savings Accounts (HSAs)
  • Provide portable monthly tax credits

I was more familiar with some of these concepts than others. For example, what are these “portable monthly tax credits” and how do they work? According to the same policy brief:

 Republicans want to repeal Obamacare’s expensive and rigid system of subsidies and replace them with a simple and flexible, advanceable and refundable tax credit to help Americans who do not receive insurance through their employer or a government program…

The credit is:
• Universal for all citizens or qualifed aliens not offered other qualifying insurance
• Age-rated
• Available for dependent children up to age 26
• Portable
• Grows Over Time

…The credit can be used to purchase any eligible plan approved by a State and sold in their individual insurance market, including catastrophic coverage. Additionally, if an employer does not subsidize COBRA coverage, the individual can use the credit to help pay unsubsidized COBRA premiums while he or she is between jobs. If the individual does not use the full value of the credit, he or she can deposit the excess amount into a health savings account.

The credit is not available to be used for plans that cover abortion [emphasis added].

This raises questions of whether the tax credits will really benefit all categories of individuals in the same way and at the same rate as the ACA subsidies. NPR news noted:

The elements of the plan include replacing the subsidies that help people buy insurance through Obamacare exchanges with fixed tax credits to buy coverage on the open market.

The major difference between the two is that the Obamacare subsidies increase as premiums rise so that consumers are responsible for the same premium amount, which is tied to their income. The tax credits proposed by Ryan are not tied to income but rise as a person ages and insurance rates increase.

“The important thing on the tax credits is that they’re not income adjusted and we don’t know how big they are,” Pearson [senior vice president at Avalere, a health care consulting group] says.

She says it’s unlikely they’ll be as generous as the Obamacare subsidies.

“This likely means that low-income people will have difficulty affording individual insurance,” she says.


Then there’s the point about being able to put additional money into health savings accounts. This line of reasoning has always bothered me because it feels like something that was thought up by individuals who have never had to live paycheck-to-paycheck. In order to put funds into an HSA (or an FSA, for that matter) you have to have enough income to do so. Said another way, you have to be making enough money that taking a portion of your check to set aside for potential health costs is not going to cause you financial hardship. For low-income families, that money may be needed to pay rent or put food on the table. There may not be any extra money in their paychecks to put aside in an HSA. The GOP plan would allow individual, self contributions in an HSA to jump from $3,400 to $6,550 and family contributions to jump from $6,750 to $13,100, but again, you have to have money you can easily set aside in the first place for this plan to be beneficial to you.


On modernizing Medicaid and creating state innovation grants, the NPR article noted:

The Republicans’ plan also calls for a major restructuring of the Medicaid health care program for the poor. It would repeal the Medicaid expansion that most states adopted under the Affordable Care Act, which allowed able-bodied people with incomes just above the poverty line to become eligible for Medicaid coverage.

It also noted that under the GOP plan the federal government would only pay a certain amount per person per year to the state, meaning that the state would have to come up with the remainder of the cost. This immediately begs the question as to where additional funds will come from to cover state subsidies.

This is all at a time when, as PBS News notes, “Treatment gaps persist between low- and high-income workers, even with insurance“. Low-income workers are more likely, right now, to end up in the emergency room and hospitals for treatment rather than getting preventative treatment. Part of that is likely a need for greater education on health literacy but it also has to do with the fact that low-income individuals don’t get preventative treatment because they know if a problem is found they’ll have to pay for it and the cost of getting it taken care of (such as paying for their deductibles) is something they cannot afford.


Finally, I also caught this article by NPR about the GOP wanting to return to high-risk insurance pools. As the article mentions:

The argument in favor of high-risk pools goes like this: Separate the healthy people, who don’t cost very much to insure, from people who have pre-existing medical conditions, such as a past serious illness or a chronic condition. Under GOP proposals, this second group, which insurers fear might be expected to use more medical care, would be encouraged to buy health insurance through high-risk insurance pools that are subsidized by states and the federal government.

Something like this used to exist in Minnesota, which had a high-risk pool called the Minnesota Comprehensive Health Association (MCHA). The problem is that returning to a system like the one that existed in MN could likely mean high monthly premium costs, exactly what the GOP says it’s trying to fix.

MCHA’s monthly premiums cost policy holders 25 percent more than conventional coverage, Gildemeister [an economist with Minnesota’s health department] points out, and that left many people uninsured in Minnesota.

“There were people out there who had a chronic disease or had a pre-existing condition who couldn’t get a policy,” Gildemeister says.

…And for the MCHA, even the higher premiums fell far short of covering the full cost of care for the roughly 25,000 people who were insured by the program. It needed more than $173 million in subsidies in its final year of normal operation.

That money came from fees collected from private insurance plans –- which essentially shifted a big chunk of the cost of insuring people in MCHA program to people who get their health insurance through work.

So the high-risk pools can be very costly, both to the individuals who buy into them and to the state that runs them (which means to tax-payers).

“The rub is, where that funding is going to come from?” she says. “And is the federal government or the state government willing to put up the funding needed to make some of these fixes?”

The national plan Ryan proposes would subsidize high-risk pools with $25 billion of federal money over 10 years. The nonpartisan Commonwealth Fund estimates the approach could cost U.S. taxpayers much more than that — almost $178 billion a year.

And my question is, if it’s going to cost us taxpayers so much more annually, how does that work when the GOP wants to cut taxes? How will the increased costs be sustained over time? Is this actually an economically viable option when applied on the national scale? The MN story leaves me with a lot of reason to doubt.

I’ll be following the GOP repeal-and-replacement stories closely in the future, but I must express that I have serious concerns about what they have put out initially. It seems that no matter how I look at current plans, many individuals, particularly some of the must financially vulnerable, will lose insurance due to unaffordability.

Incentivize Professional Development, Save Jobs 

How to save good jobs – The Washington Post
https://www.washingtonpost.com/news/on-leadership/wp/2017/02/10/how-to-save-good-jobs/?utm_term=.a4ef049f4b34

Saw this in the Washington Post today as I curled up with my Sunday paper. (As part of my activism around supporting journalism, I took out a subscription. Beyond catching articles I would likely have never seen online, I also discovered the glories of the coupons circulars).

It did not occur to me before, despite being an MBA, that current accounting principles and tax code impedes companies from doing more to hire and train a solid workforce. This may be because I was focused on Business Administration in my MBA, rather than Accounting, so I read nothing but praise for workforce professional development and training. But I never thought about how accounting principles could stack the deck against companies who wish to make that kind of investment. 

I have always believed in training for employees, both the kind that helps them do better in their immediate position and the kind that helps them expand themselves as individuals. Reading this makes me hope efforts will be made to adjust both tax code and accounting principles to incentivize investment in human capital. 

Do I believe this will “save ALL the jobs!”? No. But it could go a long way in the struggle against automation and help move employees to a higher level of activity. (Instead of being the guy who builds the thing, he’s the guy who runs the machines that build the thing. Or the guy who gets to focus on new, creative strategic directions for company activity).

It will be interesting to see if this suggestion goes anywhere over time.

Question of Dividing States’ Electoral Votes by Congressional Districts

https://fivethirtyeight.com/features/under-a-new-system-clinton-could-have-won-the-popular-vote-by-5-points-and-still-lost/?ex_cid=538twitter
So this article addresses the question of what the issues would be if states divided electoral votes based on congressional districts won versus winner-of-the-state takes all.

Some states already break up their electoral votes this way and still others (such as VA) are considering moving in that direction.

Article notes that right now a move like this nationally would favor Republicans because of how the congressional districts are drawn (which include issues of gerrymandering and urban grouping) and would make it much harder for Democrats to get the needed 270 votes to win a Presidential election.

This seems to be another point in favor of reasonable redistricting. (You could argue it’s it’s another point in favor of moving to a popular vote system, but that’s for another discussion). It would seem that with reasonable redistricting (either done by independent parties or by using the same login applied the same way across all states) you’d ensure that votes match hot voters really voted. 

Mind you, I get that it’s a complex issue and maybe no version of an electoral system will ever really reflect the majority views of the voters. Gives those of us trying to fight for a “best and fair solution” lots to think about.