Minneapolis Star Tribune, July 1
Minnesota avoids a policy mistake on health ’reform’
Study says Medicaid work requirements don’t accomplish proponents’ goals.
The prestigious New England Journal of Medicine offers the latest evidence that Minnesota dodged a policy bullet in 2018 when Republican lawmakers tried but ultimately failed to enact work requirements for those on medical assistance.
Sudden sweeping health care changes, especially ones that could kick thousands of poor people off the benefits to which they are legally entitled, should be based on data, not wishful thinking. There is scant evidence that enacting work requirements, which requires enrollees and government staff to file reams more paperwork, actually does what its proponents intend.
Their goals are worthy: boosting employment and transitioning medical assistance recipients to private health insurance. But the question is whether simplistically adding red tape, which is all the new work requirements do, would accomplish these objectives.
The new Harvard study, published in the medical journal in June, analyzed results in Arkansas, the first state to implement work requirements. Their conclusion strongly suggests the answer is no. Instead, this so-called reform creates confusion and leads to fewer people having coverage. The results ought to serve as a flashing red light to any Minnesota lawmakers considering resurrecting this ill-advised policy.
Medicaid serves some of the nation’s poorest people - including about 1 million Minnesotans. The income limit to qualify for medical assistance in the state is $16,611 a year (133% of the federal poverty level) for most adults. The state has another program, MinnesotaCare, for those earning a bit more.
The study should also serve as a warning to the Trump administration, which has made the policy “a central feature of its plans to restructure” the Medicaid program, according to a Kaiser Health News report. Medicaid is jointly run by the states and the federal government and serves more than 70 million poor, elderly and disabled Americans.
The administration is encouraging other states to implement similar burdensome paperwork requirements by approving plans to do so in eight states. Six other states have applied to do the same. In March, a federal judge blocked or halted two states from moving forward. But as Kaiser Health News reported, health experts predict vigorous legal challenges that will wind up before the U.S. Supreme Court.
The Harvard researchers had a real-world case to study, underscoring the credibility of their findings. Arkansas enacted the requirements in 2018 for adults ages 30 to 49, though it was one of the two states whose program was halted by the legal ruling earlier this year.
The program’s early results do not inspire confidence. An estimated 18,000 people were booted out of the program for failing to comply. Sadly, many were likely working already or eligible for an exemption from the requirements. But they still may have lost coverage due to widespread confusion about the changes.
Access to smartphones, computers and news sources isn’t a given for those who struggle financially. About a third of those who the requirements applied to in Arkansas hadn’t heard about the policy, researchers found. About half were unsure if they were now in the group that needed to comply.
Nor did the work requirements promote employment, which isn’t that surprising given the medical conditions, lack of transportation or affordable child care and other challenges that often accompany poverty. The percentage of people with a job actually dipped in the group of adults targeted for the requirements. Meanwhile, the percentage of people in this group without insurance ticked upward.
The Arkansas program didn’t have much time to roll out before the judge’s ruling. But the dismal early results sound a loud warning about this approach. Those who continue to advocate for this “reform” haven’t done their homework.
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St. Cloud Times, June 28
Early debates are key to shaping presidential field
While this week’s presidential debate spread across two nights involving 20 candidates from one party is a record, it is not all that surprising given recent history.
More importantly, that history makes it clear if you truly care about who is on your next presidential ballot, you need to not just pay attention now, but ardently support your choice - starting now!
Sure, for the 2020 election, that applies mostly to Democrats because Republican incumbent Donald Trump faces no realistic challenge within his party. But four years ago, these early debates mattered just as intensely to Republicans.
Why? Because in an era of two dominant parties, massive amounts of campaign cash and 24/7 candidate coverage, these debates are most voters’ best chance to see most of the candidates on a level playing field before primaries and caucuses slice and dice voters’ choices.
Before too long - and no doubt influenced by these early debates - that aforementioned campaign cash will stack up in specific candidates’ corners, giving them the money to build more momentum.
Don’t think so? Please note this is at least the fourth straight presidential election in which eight or more candidates are meeting on the national stage for their party’s nomination more than a year ahead of Election Day.
While these debates are not necessarily always starting earlier in the election cycle, the number of candidates in them is definitely growing - as is the media coverage.
This time there are 20 widely diverse Democrats who filled a prime-time stage on a major network for four hours. And news networks dedicated even more hours into the night discussing the debates. Expect to see similar events in late July, mid-September and possibly more before America rings in 2020.
Last cycle, it started on Aug. 6, 2015, when 17 Republican presidential candidates began debating each other. Host Fox News used national polls to put the 10 most popular on the same prime-time stage for two hours while the rest battled in a one-hour debate televised earlier that day.
Nine similar debates ensued over the next six months as the 17-member field gradually shrank. How gradually? It was not until February of 2016 that the field dipped to seven - allowing all candidates to be on one stage with no more “under card” debates. By March, only four remained.
As a harbinger of 2016, the Republican race for its nomination in 2012 featured debates or forums that started in May of 2011 and included from five to nine hopefuls. Seven months, 14 debates and the Iowa caucuses later, the field sat at four.
Even the 2007-08 featured eight Democrats vying in 17 debates to narrow that field to four.
Clearly, these televised debates - available on everything from that big-screen living-room television set to the smartphone in most every American’s pocket - have become the preferred way for candidates to campaign to the masses early and often.
Voters who care about their presidential ballot should make time to take them in.
Not only do the candidates need your support, but they’re counting on your cash to help them get to the next big step - caucuses and primaries in 2020.
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The Free Press of Mankato, July 1
High court abandoned voters in gerrymandering case
After next year’s census the majority parties in most states will redraw legislative district boundaries that will be in place for a decade.
That work often leads to political gerrymandering - incumbents in charge drawing districts that all but ensure their party will garner enough votes to keep their majorities for the decade to come, while slicing and dicing up the other party’s boundaries in a manner that keeps them in the minority.
Many of the most egregious cases of rigging districts have been challenged in court with lower courts ruling that political partisanship was so obvious it violated equal protection and First Amendment rights.
That’s why there was optimism that the Supreme Court would put an end to the misuse of incumbent power to rig the maps in their favor.
But last week, writing for himself and four conservative colleagues in cases from North Carolina and Maryland, Chief Justice John G. Roberts Jr. claimed the high court had no authority or business in deciding a “political” issue like gerrymandering.
While the two cases before the court included maps rigged by Democrats in one case and Republicans in the other, the number of unfairly drawn maps in the country have primarily been from Republican legislatures, following their sweep into the majority in many states during the last census.
Roberts, curiously, even claimed the smart, highly educated justices wouldn’t even be able to judge if a map was drawn unfairly because there are different definitions of fairness.
Actually, lower courts and citizens have had no problem recognizing when gerrymandering is done to disenfranchise voters of one party or the other.
The disappointing, if not surprising, decision by the conservative court leaves it up to voters to try to correct the unconstitutional rigging of political maps.
In states where voters can put initiatives on the ballot, many are putting measures up for vote that would have independent panels of experts draw the political boundaries rather than politicians.
After the 2010 census, the GOP-controlled Minnesota Legislature drew a legislative district map that DFL Gov. Mark Dayton vetoed. That led the state Supreme Court to appoint a judicial panel to draw the boundaries. Having the judicial panel draw the boundaries was preferable to a politically motivated map, but Minnesota should have a permanent system of independent panels drawing boundaries.
Minnesota does not have initiative and referendum, so residents have no option to put such a measure on the ballot.
But voters here can and should pressure their elected officials to set up an independent panel to draw future political maps.
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