Explainer

The House Just Voted to Put People With Disabilities One Step Closer to Institutions

This afternoon, House Republicans voted to roll back the Affordable Care Act’s protections for people with pre-existing conditions, slash hundreds of billions of dollars from Medicaid, and otherwise harm the health care of seniors, people with disabilities, veterans, and the vast majority of Americans. The American Health Care Act (AHCA), or Trumpcare, is an extraordinary statement of contempt towards any member of the public who might actually need health care in the coming years (hint: that’s all of us).

Though some of the damage that this bill does has been well publicized, there is a particularly odious impact of Trumpcare getting very little attention: It threatens to force seniors and people with disabilities into nursing homes and institutions.

For the last several decades, disability rights advocates have fought to expand funding for Medicaid-funded home and community-based services, so that seniors and people with disabilities can live in their own homes, control their own lives, and be fully included in society. Thanks to generations of advocacy, millions of Americans with disabilities receive Medicaid-funded home care today.

When the Affordable Care Act was passed, legislators started to prioritize funding for programs that provide people with disabilities with services in their homes, rather than relegating those who require additional support to institutions and nursing homes. Through the ACA, Congress created several programs designed to reward states with additional Medicaid funds if they expanded in-home care for seniors and people with disabilities.

The AHCA sunsets this program in 2020

One of the most successful of these programs is the Community First Choice State Option (CFC), which provides funding for services that help seniors and people with disabilities get out of bed, dress, and perform other activities necessary for daily life. A 2015 review of the four states that have been using the CFC the longest found that the program was serving over 500,000 people—today, that number is likely much larger. But the AHCA sunsets this program in 2020, cutting about $12 billion in funding from in-home care from seniors and people with disabilities over the next decade.

That is only a small part of the $839 billion in Medicaid cuts AHCA imposes overall, which themselves will devastate Medicaid-funded services to seniors and people with disabilities across the country. AHCA also sets “caps” on each states’ Medicaid funding that will grow at a much slower rate than the existing Medicaid funding system, cutting hundreds of billions of funding over the next decade relative to current law. In addition, the caps also freeze in place state funding decisions at the time they’re made—so a state that offered relatively stingy benefits to people with disabilities or children in 2017 would no longer be able to access additional federal funds to expand those services in the future.

Some Republican House members realized the harm AHCA will cause to their constituents with disabilities. Rep. Daniel Webster (FL-10) bemoaned the likely impact AHCA’s Medicaid cuts would have on seniors living in his district, so he introduced an amendment to exempt nursing homes from AHCA’s caps on Medicaid funding during the March push to pass the bill. The amendment did not offer protections for home care, so it actually would have worsened Medicaid’s longstanding bias in favor of institutional care.

The GOP leadership still refused to adopt Webster’s amendment. For them, even weak protections for seniors and people with disabilities go too far.

Despite stating clearly on Tuesday that his “concern that Florida will be penalized under the American Health Care Act because demand for Medicaid-funded nursing home beds has not been fixed,” Webster voted in favor of the American Health Care Act today—in exchange for “assurances” from the Trump White House that his concerns will be addressed in the future.

Republicans in the House continue to put their faith in Donald Trump, instead of insisting on meager protections of their own constituents’ needs. For too many members of Congress, the needs of seniors and people with disabilities are taking a backseat to trusting Donald Trump —and advancing his health care bill—at all costs.

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Explainer

Congressional Democrats’ $15 Minimum Wage Bill, Explained

Last week, Democratic leaders in the Senate—including Bernie Sanders, Patty Murray, and Charles Schumer—announced legislation to raise the minimum wage to $15 per hour by 2024.

Five years ago, when fast-food workers formed the Fight for $15 movement, it seemed like a pipe dream. Sanders’s 2015 bill advocating for a $15 federal minimum wage received just five co-sponsors, and throughout the 2016 presidential campaign Hillary Clinton supported a more modest $12 per hour wage. But last week’s bill already has support of nearly half the Democrats in the Senate, and has champions lined up in the House.

With Republicans in control of both Congress and the White House, the bill stands little chance of passing. But raising the minimum wage is one of the best tools we have to fight poverty, so it’s worth understanding the details of the legislation that Congressional Democrats have united behind.

Here’s How the Bill Works

If enacted, the Raise the Wage Act of 2017 would raise the federal minimum wage by $2 this year, to $9.25. That would immediately raise wages in 37 states. Thereafter, the wage would increase by about a dollar per year until it reaches $15 in 2024. Ultimately, that will raise wages in 48 states (New York, California, and the District of Columbia, which make up nearly one-fifth of the national workforce, have already enacted their own $15 minimum wage legislation).

After 2024, increases would be linked to growth in the median wage. That’s actually a big deal. In the past, the minimum wage has only increased when new legislation specifically raised it. That’s a slow process, and Congress typically doesn’t bother to do it until inflation has caused the minimum wage to lose a lot of value.  There have been several proposals to link the federal minimum wage to inflation, so that it would increase automatically each year, but none of them have ever become law. This bill skips right over inflation and links to the median wage, which tends to grow faster than inflation does. That would ensure that wage growth for low-wage workers would keep pace with the rest of the workforce, which would curb inequality and make a meaningful statement about the value of their work.

The bill would also gradually phase out subminimum wages for tipped workers, young people, and people with disabilities. Their minimum wages—currently set at $2.13 per hour for tipped workers, $4.25 per hour for young people, and as low as pennies per hour for disabled people—would be raised gradually until they are even with the federal minimum wage.

By the time the minimum wage hits $15 in 2024, it will likely have the same purchasing power as about $12.50 to $13.50 does today (depending on inflation). That’s about 70 percent to 85 percent greater than the current federal minimum wage, and about 30 percent more than the minimum wage’s peak value in 1968. It would be just enough to keep a family of four out of poverty—unlike the current minimum wage, which leaves a family of four well below the federal poverty line.

Here’s Who It Would Help

According to analysis by the Economic Policy Institute, nearly 3 in 10 American workers—more than 41 million people—would see higher wages under the Raise the Wage Act of 2017. Two-thirds of affected people work full time, and well over half are women. And, although white workers would be the largest group to benefit in terms of population size, the bill would disproportionately help workers of color. More than 4 in 10 African American workers—and one-third of Latino workers—would get a raise. Children also stand to gain a lot, since nearly 1 in 4 have a parent who would be affected.

The average affected worker is 36 years old, and is a primary breadwinner who uses their earnings to support their family. These low-wage workers are not only older, but also more productive and better educated than their counterparts in prior generations. Nearly half (46.5 percent) have at least some college experience.

Here’s What It Would Do for the Economy

The average directly affected full-time, year-round worker would see his annual earnings rise by more than $5,000 by 2024—an increase of nearly one-third. The bill would increase consumer spending and reduce taxpayer spending on public-assistance programs such as nutrition assistance since workers would be able to make ends meet on their own.

To be sure, economists can’t predict the full effects of a $15 minimum wage, even if it is phased in slowly. We can be confident that the increased consumer spending would give local economies a boost, but we can’t be positive that there would be no adverse effect on employment.

There are benefits beyond pure economic growth

Even if employers responded to the wage hike by cutting workers’ hours, or if workers ended up spending a few extra days between jobs, the benefits would likely far outweigh the negatives. First of all, the wage hike is big enough that workers who experience a reduction in hours may still break even or come out ahead in terms of annual earnings. Second, there are other legislative options that could make sure disadvantaged workers do not feel negative effects. This includes, for example, expanding our Unemployment Insurance system to cover low-wage workers who spend a few extra days searching for their next job; extending short-time compensation and partial unemployment benefits for workers who experience reductions in hours; and creating subsidized employment, national service, paid training, and apprenticeship opportunities for folks who are unable to find work.

It’s also worth remembering that there are benefits beyond pure economic growth and workers’ pay. A $15 minimum wage would help increase family stability and close stubborn gender and racial wage gaps. Rigorous research also shows that higher minimum wages improve infant health, reduce crime, and decrease poverty.

It’s a Political Long Shot—but Not Introduced in Vain

Since Republicans have the majority in Congress, this bill can’t pass without their support. And, even though the bill is popular with the public and would help Trump keep his promise to give his supporters higher wages at virtually no cost to government, it’s unlikely that Congressional Republicans are going to reverse course and suddenly support minimum wage hikes.   

But even if Congress doesn’t pass this bill, it will likely encourage wage hikes on a local level. Sen. Sanders’ previous $15 proposal, inspired by the Fight for $15, preceded successful state and local bills such as those in California, New York, the District of Columbia, and Seattle. Similarly, Sen. Murray and Rep. Scott’s bill for $12 by 2020 provided the wage target for Arizona and Colorado’s laws. With a strong majority of voters across party lines supporting a higher minimum wage, more states and localities can be expected to take matters into their own hands by adapting federal legislation.

Correction: This article originally stated that the Raise the Wage Act of 2017 would immediately raise wages in 48 states. It will immediately raise wages in 37 states, and eventually raise wages in 48 states.

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Analysis

These Families Were Directly Threatened by Trump’s Agenda in His First 100 Days

Media coverage of Donald Trump’s first 100 days as president has largely focused on what Trump didn’t do during his brief time in office—from his stalled attempt to repeal the Affordable Care Act, to his reversal on campaign promises like exiting NAFTA or building a wall funded by Mexico. Indeed, Trump has either failed to accomplish, stalled, or outright abandoned many of the goals he set when he entered office.

But this narrative overlooks the very real harm Trump has inflicted on the country—and, more importantly, on individuals affected by his policies. From undocumented immigrants, to people living near coal ash, to low-income families who would feel the effects of budget cuts—Trump has already done real damage to American families.

Here are three people who illustrate the human impact of Trump’s agenda during his first 100 days in office:

1. Kim Brewer

Kim Brewer is a mother of four who lives in Dukeville, North Carolina, near a major coal-fired power plant named Buck Steam Station. According to Brewer, her first two children were born healthy. But after moving to Dukeville, she gave birth to two daughters with severe birth defects. Ava was born with Chiari malformation, a brain defect linked to exposure to toxic chemicals—including coal ash, which is generated by coal-fired power plants. Her youngest daughter, Laney, has spina bifida, which is also linked to coal ash. Both girls have also been diagnosed with epilepsy.

Buck Steam Station stores its coal ash in an unlined pit near a local waterway. The ash contains a variety of toxic chemicals—including arsenic, lead, mercury, and thallium (an active ingredient in rat poison). Living near coal ash sites is linked to heart disease, cancer, respiratory illness and stroke—the leading causes of death in the country. It’s especially toxic when it leaks, as Buck Steam Station did in 2014, contaminating groundwater, wetlands, and rivers.

In December, the Obama administration released a new rule protecting waterways from coal ash. Experts estimated the rule would have improved water quality in over 250 miles of streams every year.  But days after taking office, Trump signed legislation that quashed the rule—one in a spate of bills designed to undermine environmental protections.

Trump could still do more to protect people from coal ash, but if his Cabinet appointments are any indication, that won’t happen anytime soon. Scott Pruitt, Trump’s pick to run the Environmental Protection Agency, has delayed a separate rule regulating the safe storage of coal ash; and Trump’s nominee to run the Justice Department’s Environment and Natural Resource Division—the office in charge of prosecuting coal ash violations—is a former lobbyist for the coal industry.

2. Juan Carlos Fomperosa Garcia

No community has borne the brunt of Trump’s policies more than immigrants—both undocumented and documented. Juan Carlos Fomperosa Garcia, a 44-year-old father of three American citizens, worked for years in construction in Arizona.

Last month, he and his daughter, Yennifer, visited the local Immigration and Customs Enforcement Office (ICE) for what he hoped would be a routine check-in. They planned to return home afterwards to celebrate the 17th birthday of Fomperosa Garcia’s son.  Instead, after an hour, ICE officers came to the waiting area and told Yennifer that her father had been detained.

The next day he was deported.

According to The Arizona Republic, Fomperosa Garcia had a worker’s permit and a pending asylum application to stay in the country—and had never committed a crime. “My father is not a criminal,” Yennifer said through tears at a press conference following his detention. “He’s not one of those people that…President Trump says. He’s not a rapist, he’s not a drug dealer and he’s not a murderer. My father’s an honest, working man, a family man that loves everyone he meets. He cares too much and that’s the only crime.”

“Please, everyone, be aware. They are taking everyone,’’ she told the crowd.

Fomperosa Garcia is just one victim of Trump’s mass deportations. Trump initially said he would focus on “bad hombres” or criminals, but ICE officers have since targeted people with minor violations, so-called “collateral arrests,” and even DREAMers who came to the country as children.

3. Martha Daniels

Martha Daniels was displaced from her New Orleans home after losing everything in Hurricane Katrina. She now lives in Houston, where she relies on Meals on Wheels, a partially federally-funded program that connects volunteers with people who can’t buy or cook their own meals—often seniors.

For many, Meals on Wheels provides more than just nutrition assistance. It is a source of companionship and, importantly, regular health check-ins for seniors living alone—seniors like Daniels.

In January, a Meals on Wheels volunteer paid a routine visit to Daniels’ home. Instead of displaying her normal bubbly personality, Daniels was sitting stiff in her lounge chair and not breathing well, according to Houston CBS affiliate KHOU. She was rushed to the hospital, where the doctor told her she was suffering from a mild heart attack. Physicians said she may not have lived through the night if she hadn’t been brought to the hospital.

“If she wouldn’t have checked on me, who knows who would have come,” Daniels said.

Under Trump’s budget, people like Daniels may not have access to Meals on Wheels and its life-saving volunteers. Trump would eliminate the Community Development Block Grant and the Community Services Block Grant —two of the main sources of funding for the program. Despite inaccurate statements by the Trump administration, Meals on Wheels receives more than one-third of its funding from the federal government—and cuts of this scale would make it hard for many local community-run programs to keep their doors open.

When we talk about Trump’s First 100 Days, we need to remember that his policies are not an abstraction. They are causing immediate—and in some cases irreparable —damage to communities across the country. For all the infighting, lies, and scandals of his administration, Trump is making progress on remaking the country in his image. And that should give everyone who lives here pause.

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First Person

Trumpcare Cuts Mental Health Coverage. That’ll Mean More Suicides—Like My Dad’s.

After he failed to secure enough votes to repeal the Affordable Care Act (ACA) last month, Donald Trump is rushing to push another version of his health care bill through the House of Representatives. Like last month’s bill, this legislation would cause tens of millions to lose their health care coverage. And, in an effort to win the votes of the ultra-conservative House Freedom Caucus, the new bill would charge those with pre-existing conditions more for insurance and allow states to opt out of the Affordable Care Act’s essential health benefits requirements. Essential health benefits are a crucial part of the ACA, since they require insurance companies to cover services that they used to skimp on—like emergency services, pregnancy and maternity care, pediatric services, substance use disorder services, and rehabilitative care. Plus one more: mental health care.

Health insurance companies did not have to cover mental health care until the Affordable Care Act made it mandatory. If that requirement is repealed, people will get less treatment. Without treatment, some people will succumb to their illnesses. That means more suicides.

That’s not hyperbole. It’s not hysterics, or fear-mongering.  I’ve seen it happen. My dad killed himself a few weeks after my 12th birthday.

Even 12 years after my dad’s death, I’m haunted by the memories of that night. I can still see my mom crying as she broke the news to her two kids, the shock on my older brother’s ghostly white face, and the red and blue lights of a police car swirling on our living room walls. The sight of police lights still makes my stomach drop.

My father’s suicide has shaped my life. It brought isolating numbness, crushing grief, and  strange looks from the people in my small town who were uncomfortable with its taboo. My family’s income, which was decidedly middle class before my dad’s death, was more than halved by his passing. We made it work because we had Social Security survivors benefits, free and reduced price lunches, and could take out a home equity loan that we still carry today. That made it possible for my mother—an actual, honest-to-God superhero—to keep my brother and I fed and clothed on less than $40,000 a year.

Every year, more than 44,000 Americans die by suicide.

Though Trump and the House Freedom Caucus may treat it as such, mental health is not a fringe issue. Every year, more than 44,000 Americans die by suicide. On average, it affects demographics that voted for Trump the most: 70 percent of suicide victims in 2015 were white men, with the rate of suicide being highest among middle-aged men. Like my dad.

My dad died, at least in part, because he wasn’t in treatment. Under Trumpcare, millions of Americans will find it difficult to seek treatment as well. Trump is gambling with their lives to pass a health care plan that will cut taxes for the wealthy.

If the bill passes, I could struggle to afford the therapy that helps me deal with the grief of losing my father. And there will be more 12-year-olds, like me, who will lose their loved ones. I can picture them now: hugging their knees, and watching the red and blue lights dance on the walls of their house as their world comes crashing down.

I don’t wish that on anyone. I just wish our president felt the same.

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Analysis

Trump’s Budget Breaks His Promise to “Put Miners Back to Work”

For the past year, Donald Trump has promised that he will “put our miners back to work” and pull coal country out a decades-long decline. Appalachian voters clearly believed him—they showed up for rally after rally, and on Election day nearly 95 percent of Appalachian counties went red for Trump.

It was never a secret that Trump’s promises would be hard to keep, but it’s still stunning that his first budget actively attacked the region. Along with a laundry list of other programs slated for elimination, Trump proposed nixing the Appalachian Regional Commission (ARC), which was created to spur economic development in the 420 counties that make up Appalachia.  Since it was founded in 1962, ARC has helped cut Appalachian poverty in half, and has brought more than 300,000 jobs to the region. In the past year alone, its grants have created or retained 23,760 jobs, and provided training or education to nearly 50,000 students and workers.

While Trump is billing himself as coal country’s savior, he is gutting the agency that’s doing the saving.

 

I’ve seen what ARC can do for communities. Take, for instance, the town of Mentone, Alabama: nestled in the heart of Appalachia atop Lookout Mountain, and home to an estimated 390 people. It’s where my cousins grew up, and where I spent the better part of every summer from elementary school to high school. Mentone is where I learned to love the outdoors, where I learned to canoe, and where I learned to target shoot with bow and arrow and a .22.

Entire communities were left without their livelihoods.

Admittedly, Mentone was never a titan of industry. But nearby Fort Payne, Alabama, was the “Sock Capital of the World” for decades. In the 1990s, an estimated 1 in every 8 socks worldwide—and half of the socks in the United States—came from Fort Payne. Even now, there’s a good chance you own Fort Payne socks. But in the mid-2000s, under President George W. Bush’s free-trade agreements, many of Alabama’s sock manufacturers closed shop and moved overseas for cheaper labor. Over the next decade, the number of people working at the sock mills fell from 8,000 to just 600.

Entire communities were left without their livelihoods. And that’s when the Appalachian Regional Commission stepped in.

As the industry left, ARC invested resources into Fort Payne and the surrounding communities to support transitioning workers and their families. In 2007, it provided $200,000 for access roads to bring new businesses to Fort Payne, and $175,000 for a job training program in Jackson County, Tennessee—just on the other side of Lookout Mountain. In 2009 and 2010, the commission contributed $100,000 to a joint effort between Jackson and DeKalb Counties to enable the counties to update their water systems, along with an additional $400,000 for Fort Payne’s sewer system. From 2009 to 2016, the commission invested almost $1 million in Fort Payne’s education system, so that northeast Alabama’s kids had access to educational and technological resources—buoying the system instead of allowing the shrinking tax base to gut it.

Just last year, the commission funded the bulk of a project to expand Fort Payne’s visitor center for Little River Canyon—the gorge that runs atop Lookout Mountain. The Canyon attracts more than 460,000 visitors each year, along with an estimated $16 million in local economic activity. An expansion could mean more tourists, more jobs, and more income for the surrounding communities.

For towns like Mentone and cities like Fort Payne, a grant from the Appalachian Regional Commission is the difference between moving ahead and falling behind.  By attacking the commission, President Trump has turned his back on the communities that trusted him to represent them.

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