- Created on 07 October 2013
Photo: ABC News
As the Affordable Care Act (ACA) takes effect this month, it might be helpful for people to know how its prototype in Massachusetts is working, after nearly seven years.
Virtually every resident in the Commonwealth is insured. More private companies offer insurance to their employees than ever before. Over 90 percent of our residents have a primary care physician. Primary care is less likely to be delivered in expensive emergency rooms. Preventive care is up. Health disparities are down among women, minorities and low-income people. Most importantly, on many measures, we are healthier.
Those are the facts. The stories are better. I met a young woman named Jaclyn, a cancer survivor who got life-saving care through our version of an exchange. She had no way to afford care before health care reform -- it saved her life.
A self-employed man named Ken ignored his gastrointestinal symptoms for years because he couldn't afford to see a doctor or pay for possible treatments. Once insured, he was seen and treated for Stage III colon cancer and is cancer free today.
Over all these years, expanding health insurance to everyone has added only about 1 percent of state spending to our budget. Those budgets have remained responsible, balanced and on-time.
Expansion hasn't hurt our general economy. Unemployment has remained lower than the national average and economic growth has been higher. At one business incubator, a young entrepreneur told me he moved his start-up to Massachusetts because he wanted to be sure his young family had health insurance while his business got off the ground. Today that young man's company is employing others.
The nation's great health care challenge, with or without universal coverage, is controlling health care costs. Though health insurance premiums had been rising faster than inflation for many years before our reforms went into effect, we are now getting control of them. Average base rates increased more than 16 percent three years ago. They average less than 2 percent today. Some of that progress is the result of tools made available by the ACA. Indeed, early results show that for some individuals and small businesses, premiums may drop as much as 20 percent percent because of Obamacare.
In other words, health care reform works in Massachusetts. And it will work in America. We need it to. In one form or another, health care significantly affects business, household and government budgets, people's ability to get a job, and a child's readiness to learn. Accessible, affordable, quality care in all cases improves lives and in many cases saves lives. It gives peace of mind and economic security to families. It increases productivity for large and small employers as well as for students. It creates jobs and contributes to our economic strength. It's a powerful statement of who we are.
As the ACA is implemented this month, the entire country will begin to enjoy the benefits that we have seen from health care reform here in Massachusetts, and much more. Small businesses benefit from the ACA through new tax credits that make health insurance more affordable. With more carriers and plans to choose from, there is a more competitive rate-setting environment. People with pre-existing conditions can no longer be denied insurance. People who get really sick can no longer be kicked off their insurance. And kids can stay on their parents' plans a bit longer, until they can get their own.
Tea Party Republicans don't want the Affordable Care Act. Do they really mean they don't want these kinds of improvements in the lives of millions of Americans? I don't think so. Would they rather we address these issues with a government program instead of through the market-based, individual choices that are the framework of the ACA? I don't think that's true either. Have they proposed an alternative way to accomplish these goals? Nope. Despite a presidential election, a decision by the United States Supreme Court, and over 40 failed repeal attempts, it's clear that what Tea Party Republicans don't like about Obamacare is the "Obama" part of it.
In Massachusetts we're proud to be home to many "firsts." The first Thanksgiving. The first battles of the American Revolution. The first public library, the first typewriter and the first subway. Even the first chocolate chip cookie. Recently, the first state to achieve universal health care, the model for the ACA.
Firsts are hard. There are and will be challenges. But it has been and will be worth it. Just ask Jaclyn or Ken or any of your neighbors.
- Created on 04 October 2013
A damaged Capitol Hill police car is surrounded by crime scene tape after a car chase and shooting in Washington, Thursday, Oct. 3, 2013. On Thursday, police shot and killed 34-year-old Miriam Carey, of Stamford, Conn., after a car chase that began when Carey tried to breach a barrier at the White House. (AP Photo/ Evan Vucci)
(CNN) -- The images filled the screen. A black car hitting barricades at the White House and on Capitol Hill, marked police cars being rammed, and the popping sounds of shots fired. More images rolled in, of heavily armed United States Capitol Police officers and of tourists running with scared and confused expressions.
In the aftermath of the scene that unfolded Thursday, a Connecticut woman is dead and a 1-year-old girl is in protective custody. The natural question people are asking is: Was it necessary for the police to shoot?
Washington Metropolitan Police Chief Cathy Lanier said that, yes, officers of the Capitol Police and Secret Service acted within commonly accepted use-of-force policies and practices in reaction to an intentional series of violent acts.
But some have wondered whether police overreacted in this case. This is a question that comes up every time there is a shooting by police.
In fact, many studies have found that police use force less often than the public realizes. For example, a 12-month study by the U.S. Bureau of Justice Statistics found that only 1.4% of people who had contact with the police had force used or threatened to be used against them.
I certainly concede that sometimes bad officers do bad things, and occasionally good officers do bad things accidentally. However, I also have found that most officers are honorable men and women making split-second decisions while trying to serve their communities.
So how should you judge the use of force by law enforcement officers?
Consider reasonableness: Police officers are trained to quickly assess possible threats. Force, particularly deadly force (with firearms, in this case), may be used if officers can explain their perception of the physical threats that put them and/or others at substantial risk of serious bodily injury or death. We can't Monday-morning quarterback the officers based on information that comes out later. We can only look at what a reasonable officer knew or should have known, and did or should have done, in a given situation.
Departmental policies and police training in the United States reflect the "objective reasonableness" principle put forth in the U.S. Supreme Court's 1989 Graham v. Connor decision, which applies a three-part test to assess the seriousness of the offense, the suspect threat, and the suspect's resistance or evasiveness.
And let's also consider facts, not emotional spin. Even though at first blush it appears to be a justified shooting, there should be no rush to final judgment in either direction before an examination of the facts in a fair and impartial investigation. As Lanier indicated in her press conference Thursday night, the Metropolitan Police will be investigating, with support from the Capitol Police and Secret Service.
In the wake of last month's Naval Yard shooting, and with the specter of other past violent acts -- such as the shooting of two heroic U.S. Capitol Police officers by a man who breached security in July 1998 -- law enforcement in Washington has been on heightened alert.
Cars can be used for delivering explosive devices. And let's not forget, as at least two injured federal officers experienced in this incident: The car itself is a 2,000-pound weapon that can cause serious injury or death when used as a battering ram.
Would a reasonable officer -- faced suddenly with a driver trying to ram barricades at high-profile targets like the White House, ramming police cars and injuring uniformed officers repeatedly -- perceive a serious offense, threat, or evasiveness?
Whether the driver was mentally ill was not a factor that the officers had the luxury of contemplating as they quickly assessed the threat and decided on a course of action.
Pending the final facts, it appears that all three prongs of the "objective reasonableness" standard were present.
- Created on 03 October 2013
WASHINGTON — President Barack Obama (pictured far right) laid the blame for the government's partial shutdown at the feet of House Speaker John Boehner (pictured), escalating a government-shutdown confrontation that was leading headlong into a potentially more damaging clash over the nation's borrowing authority.
Speaking at a construction company in Washington's Maryland suburbs Thursday, Obama cast Boehner as a captive of a small band of conservative Republicans who want to extract concessions in exchange for passing a short term spending bill that would restart the partially shuttered government.
"The only thing preventing people from going back to work and basic research starting back up and farmers and small business owners getting their loans, the only thing that is preventing all that from happening right now, today, in the next five minutes is that Speaker John Boehner won't even let the bill get a yes or no vote because he doesn't want to anger the extremists in his party," Obama said.
The dispute over the shutdown deepened worries about a bigger problem rumbling ever closer — a mid-October deadline for increasing the government's borrowing limit before it runs out of money to pay creditors. The U.S. Treasury warned on Thursday that failure to raise that debt ceiling could spark a new recession even worse than the one Americans are still recovering from.
"The President remains hopeful that common sense will prevail," the White House said in a written statement after an unproductive meeting at the White House about the political standoff that has idled 800,000 federal workers and halted an array of services Americans expect from their government.
Boehner, R-Ohio, complained to reporters that Obama had used the meeting simply to declare anew that he won't negotiate over his health care law.
House Republicans, pushed by a core of Tea Party conservatives, are insisting that Obama accept changes to the health care law he pushed through Congress three years ago as part of the price for reopening all of government. Obama refuses to consider any deal linking the health care law to routine legislation needed to extend government funding or to raise the nation's debt limit.
"We're probably through negotiating with ourselves," Rep. Jeb Hensarling, R-Texas, chairman of the House Financial Services Committee, said on MSNBC.
Republicans who initially sought to defund the health care law in exchange for funding the rest of government have gradually scaled back their demands but say they need some sort of offer from Obama.
Expressing frustration after the White House meeting, Boehner said: "All we're asking for here is a discussion and fairness for the American people under Obamacare."
The White House said Obama would be happy to talk about health care — but only after Congress moves to reopen the government "and stop the harm this shutdown is causing to the economy and families across the country."
If the shutdown dispute persists, it could become entangled with the even more consequential battle over the debt limit. The Obama administration has said Congress must renew the government's authority to borrow money by Oct. 17th or risk a first-ever federal default, which many economists say would dangerously jangle the world economy.
Treasury's report Thursday said defaulting on the nation's debts could cause the nation's credit markets to freeze, the value of the dollar to plummet, and U.S. interest rates to skyrocket.
The shutdown stalemate is already rattling investors. Stock markets in the United States and overseas faded Wednesday, and Europe's top central banker, Mario Draghi, called the shutdown "a risk if protracted." Leading financial executives met with Obama, and one Goldman Sachs CEO, Lloyd Blankfein, said politicians should not use a potential default "as a cudgel."
Democratic Sen. Claire McCaskill said the House could easily defuse the worsening situation.
"Get us through this six weeks and then let's sit down and figure out how we pay our debts and bring down federal spending," McCaskill of Missouri, said on MSNBC.
Republicans planned to continue pursuing their latest strategy: muscling bills through the House that would restart some popular programs.
Votes were on tap for restoring funds for veterans and paying members of the National Guard and Reserves. On Wednesday, the chamber voted to finance the national parks and biomedical research and let the District of Columbia's municipal government spend federally controlled dollars.
Democrats demanded that the entire government be reopened, and the White House and Senate Majority Leader Harry Reid, D-Nev., made clear that the GOP's narrower bills have no chance of survival. They said the strategy showed that Republicans were buckling under public pressure, with Rep. Louise Slaughter, D-N.Y., saying groups like veterans were being "used as a pawn in this cynical political game."
Republicans countered that Democrats were being inflexible and were to blame for the continued closure of programs the GOP was trying to reopen. A favorite target was Reid, who has made clear that the Senate will be a graveyard for the Republican effort.
"The Senate's refusal to work with the House is an all-time low," Rep. Trey Radel, R-Fla., said.
Reid told reporters that Obama and Democrats are "locked in tight" on not diluting the health care law.
In an interview afterward, Senate Minority Leader Mitch McConnell, R-Ky., scoffed at the President's stance.
"He can't get his way exactly the way he wants it because he doesn't control the entire government," McConnell said on CNBC's "The Kudlow Report."
Democrats continued lambasting Boehner and freshman Sen. Ted Cruz, R-Texas, the tea party hero, who has helped sell fellow conservatives in both chambers on keeping the government shuttered until Obama retreats on his coveted health care law.
Rep. Jim Jordan, R-Ohio, and other House conservatives said they met with Cruz and other Senate conservatives Wednesday to update each other on what was happening.
"We think we just have to keep talking about our message, which is real simple: 'Treat people fairly,'" Jordan said.
Republican leaders and many rank-and-file GOP lawmakers, especially in the Senate, had been reluctant to link demands for curbing the health care law to legislation keeping government open, concerned that voters would blame Republicans for any shutdown.
But Wednesday, Republicans solidly opposed an unsuccessful Democratic move to force the House to vote on a Senate-passed bill keeping government open until Nov. 15 without any strings on the health care law.
"Now that we've jumped off the cliff, lit ourselves on fire, we've entered the valley of death," said Rep. Devin Nunes, R-Calif., who has criticized the conservatives' strategy. "So now we've got to keep running and we have to hold together."
The House has approved legislation keeping the entire government funded through Dec. 15. It also would impose a one-year delay in the health care law's requirement that individuals buy health insurance, which would threaten to cripple the program, and block federal subsidies for health coverage bought by lawmakers and their staff.
As the politicians battled, mail continued to be delivered, air traffic controllers remained at work, and payments were being made to recipients of Social Security, Medicare, Medicaid and unemployment benefits.
Taxes were still due, but lines at IRS call centers went unanswered.
Halted were most routine food inspections by the Food and Drug Administration and some loan approvals for many low- and- middle-income borrowers were thrust into low gear by the Housing and Urban Development Department. National parks were closed.
Workers were furloughed based on how essential their jobs were to the nation: Only 3 percent of NASA employees were kept on, while 86 percent at the Homeland Security Department were working.
- Created on 02 October 2013
CNN host Don Lemon lays blame for the government shutdown squarely on the GOP.
The government shut down at midnight on Tuesday after Congress failed to reach a spending agreement.
"I am so mad this morning," Lemon said Tuesday on Tom Joyner's radio show. "As I've been watching lawmakers over the last few weeks debate the issues that led to the shutdown--you know what that is, health care--I felt helpless and I felt betrayed to say the least... One, because of the false narrative that both sides caused this shutdown. That's not true. It was caused by Republicans, mainly Tea Party Republicans."
He lamented the intricacies and unfairness of the country's health care system, and said the best way to avoid it altogether was to live a healthful lifestyle.
"Today, I am making a pledge to myself and to you, and I hope you join me, to do whatever is in your control, big or small, to make your health, your life better," Lemon said. His 30-day pledge includes eating better, getting a check-up, exercising and cutting out soda and juice as well as alcohol.