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Friday, March 24, 2017

No Healthcare Vote Today After All

Posted By on Fri, Mar 24, 2017 at 1:02 PM

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Looks like the votes just weren't there. News is breaking that President Donald Trump has asked House Speaker Paul Ryan to give up on a vote on the American Health Care Act.

While it's a gigantic embarrassment that shows the limits of Trump's bullying powers over GOP lawmakers, it's probably less embarrassing than losing the vote altogether.

And it's not like the legislation would have passed the Senate anyhow.

Where this fustercluck goes from here is anyone's guess.

ETA: Both Trump and Ryan have said efforts to repeal the Affordable Care Act are on hold, with Ryan telling reporters: “We’re going to be living with Obamacare for the foreseeable future.”

Trump, meanwhile, has blamed Democrats for failing to get behind the plan to repeal Barack Obama's signature bill. He said today that he'd move on to other parts of his agenda.

U.S. Rep. Tom O'Halleran (D-AZ01) celebrated the collapse of the repeal effort:

The American people made their voices heard and helped defeat the AHCA. This health care bill would have devastated our rural and tribal communities, harmed seniors, and eliminated tax credits for veterans eligible for government health care. Now we must get serious about crafting a bipartisan bill that improves our health care system and brings down the costs of health care and insurance premiums.

We need an open, transparent process that includes input from industry leaders and experts. No legislation should be drafted in closed-door meetings, hidden from the public. Neither party has all the solutions to our greatest challenges, and partisan gridlock is only setting us back. I continue to urge my colleagues to stop playing political games with the health and wellbeing of the American people and work together.

Congressman Raul Grijalva trolled Trump in his statement:


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"Martha McSally Is Not Answering"

Posted By on Fri, Mar 24, 2017 at 11:34 AM

COURTESY OF MARTHA MCSALLY'S OFFICE
  • Courtesy of Martha McSally's Office
As the Bullshitter-in-Chief pushes the House of Representatives to take a vote on the disastrous healthcare legislation GOP lawmakers have assembled, U.S. Rep. Martha McSally (R-AZ02)—who came out in support of the legislation earlier this week—appears to be done taking phone calls from constituents. Calling McSally's D.C.'s office yields the following message: "Martha McSally is not answering. This mailbox is full and cannot accept new messages."

McSally announced last night that she had pushed for an additional $15 billion to send to states to cover mental health and maternity care—which sounds great, except that, in an effort to bring the conservative Freedom Caucus on board, the latest amendments to the bill eliminate the 10 Essential Health Benefits of the Affordable Care Act. That means insurance companies will be able to offer skimpy (but cheap!) insurance plans that don't cover vital healthcare services.

An article in Vox explains the problem with eliminating Essential Health Benefits:

There’s just one small problem: The individual insurance marketplace could unravel without them.

Remember how the EHBs made the marketplace viable, because they helped pool risk among the whole of the population, requiring everybody to pay a little for basic health care even if they aren’t going to use it, instead of just attracting sick people who may need those services?

“Without these requirements, you are looking at an individual market where the only policies available are extremely skimpy or expensive,” said Matthew Fiedler, a fellow at Brookings who served as chief economist of the Council of Economic Advisers, where he oversaw work on the Affordable Care Act. In the past, insurers had strong incentives to design plans in ways that were unattractive to people with predictable health needs or sick people. And getting rid of the essential health benefits, Fiedler said, “would give them a powerful tool to avoid people that expect to need care.”

Within two or three years, Blumberg expects more comprehensive coverage plans to dry up. Since insurers can’t deny coverage outright, and many will be tempted to go down to more limited polices that attract healthy people, insurers offering comprehensive policies would likely attract more sick expensive patients, which would create a selection problem and make the plans unsustainable.

Getting rid of EHBs would also make the promise of covering people with preexisting conditions meaningless. If a cancer patient or person with diabetes can get coverage but the cost of their chemotherapy or insulin isn’t covered, that coverage isn’t meaningful anymore, Blumberg said.
McSally says the bill is getting better and better, thanks to her hard work:


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Thursday, March 23, 2017

We Look Smaller in Boston

Posted By on Thu, Mar 23, 2017 at 7:00 PM

COURTESY OF WIKIMEDIA.COM
  • Courtesy of wikimedia.com
Students attending a Boston public school have another world map, the Peters projection map, next to the one most of us are used to looking at.
Boston’s public schools began phasing in the lesser-known Peters projection, which cuts the US, Britain and the rest of Europe down to size. Teachers put contrasting maps of the world side by side and let the students study them.
If you haven't seen it before, take a look at the Peters projection map at the top of the post. The U.S. and Europe are pretty much the same size as they are on the Mercator map we're used to seeing, but some of the other land masses get a whole lot bigger. South America is now twice as large as Europe instead of the same size, and Africa is far larger as well. The map has a more accurate north-south arrangement, with the U.S. and Europe farther to the north instead of occupying the middle area. (Fun fact: in the standard Mercator map, Germany is pretty much dead center, except in the maps where the U.S. is moved to the central spot.)

History is written by the winners, and they get to draw the maps as well, putting themselves in the center of the world and shrinking everyone else down to size. The Peters projection map is a more proportional, less Eurocentric approximation of what the spherical world should look like when it's flattened out on piece of paper. Boston public schools are doing a little something to put the world back into its proper balance.
In an age of “fake news” and “alternative facts”, city authorities are confident their new map offers something closer to the geographical truth than that of traditional school maps, and hope it can serve an example to schools across the nation and even the world.
A map with the Mercator proportions and orientation, the one we're used to, is below.

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Wednesday, March 22, 2017

On the Theory and Practice of Bullshitting

Posted By on Wed, Mar 22, 2017 at 2:00 PM

COURTESY OF BIG STOCK
  • Courtesy of big stock
Bullshit has become such a pervasive form of political speech in the Trump world, it deserves attention as a specific rhetorical style. Most of us use the word to mean something is incorrect: "That's bullshit!" The first time I heard the term "bullshit artist" was in the 1971 film, Carnal Knowledge, where two college students, played by Jack Nicholson and Art Garfunkel, used it as a semi-complimentary exclamation after some amazing thing the other one said, the rough equivalent of "No way, dude!" But since American philosopher Harry Frankfurt published a short book, On Bullshit, in 2005, the term has been used to refer to a specific form of speech.

The staid and proper Fareed Zakaria talked about Frankfurt's book and about Trump as "bullshit artist" on CNN in August, 2016, during the heat of the presidential campaign and again a few days ago. They're both reasonably short and worth a listen.

Zakaria quotes Frankfurt's book to distinguish between lying and bullshitting. “Telling a lie," Frankfurt writes, "is an act with a sharp focus. It is designed to insert a particular falsehood at a specific point." Bullshit, on the other hand, "is neither on the side of the true nor on the side of the false . . . [It] has spacious opportunities for improvisation, color and imaginative play. This is less a matter of craft than of art.” Frankfurt concludes that "bullshit is a greater enemy of the truth than lies are.”

Trump is a legendary bullshit artist—he's been indulging in it throughout his adult life — who piles heaping helpings of narcissism and pathology on top. Our own Doug Ducey is a lower level practitioner, but skilled nonetheless. We see him practice his art regularly when he adopts the mantle of "friend of education." He never tires of complimenting himself for pushing Prop 123, without acknowledging that it resulted in schools getting a portion of what the state owed them by law, and mostly from the schools' own money, the state land trust fund, not the state budget. That makes him less antagonistic to public education than many of his Republican colleagues, but a friend of public education? Hardly. And he's in danger of doing himself injury as he pounds himself on the back for "supporting teachers" by adding a few hundred dollars to their yearly salaries. Both assertions are half true, half false and all bullshit.

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Does This Mean We Can Call It McSallyCare Now?

Posted By on Wed, Mar 22, 2017 at 1:08 PM

COURTESY OF MARTHA MCSALLY'S OFFICE
  • Courtesy of Martha McSally's Office
Congresswoman Martha McSally (R-AZ02) broke several weeks of silence on her position on the American Health Care Act, the GOP's replacement of the Affordable Care Act (aka ObamaCare), by announcing yesterday that she not only supports the AHCA, but is taking credit for several new elements in the bill.

In a prepared statement released yesterday, McSally called the Affordable Care Act "an unmitigated disaster in Arizona—leaving us without real choices statewide.

"The exchanges for 14 of the state’s 15 counties are devoid of competition because they are left with only a single insurer selling coverage," McSally said. "However, the transition to new system will take time and those on Medicaid and ACA exchanges deserve continuity and stability during the transition. Over the past weeks, I have proposed detailed, specific changes to the AHCA that would provide better coverage and a stable transition for seniors, the disabled, children, and middle class families. Through lengthy negotiations with House leadership and the executive branch, I am pleased to have played a role in moving this bill in the right direction."

McSally's support for the legislation earned her praise from House Speaker Paul Ryan (who said McSally's "unwavering commitment to her constituents and her tenacity throughout the negotiating process has led to positive changes and I believe this is a better bill as a result of her involvement”) and even a shoutout from President Donald Trump himself.

There have been changes to the legislation ahead of a rush to a vote on Thursday, March 23. They include $75 billion in tax credits for older Americans, who are projected to see their healthcare premiums skyrocket under the legislation. (How exactly that $75 billion will be doled out isn't spelled out in the legislation; instead, the Senate is supposed to figure that part out); turning Medicaid into a block-grant for states and allowing a requirement that able-bodied adults work if they want to have Medicaid coverage; and a faster repeal of taxes related to the Affordable Care Act. You can read more about the changes here if you're feeling wonky.

McSally's enthusiasm for the latest version of the legislation isn't shared by all of her GOP colleagues. It's coming down to white-knuckle time on Capitol Hill as tomorrow's vote on this legislation approaches—and it appears that the conservatives in the Freedom Caucus still aren't on board. As The Hill reports:

Speaking to reporters outside a Freedom Caucus meeting after a White House meeting, the group called on leaders to start over on ObamaCare, saying the replacement bill does not have the votes to pass Thursday.

"The opposition is still strong," said Rep. Mark Meadows (R-N.C.), the chairman of the group.

"They don't have the votes to pass this tomorrow. We believe that they need to start over and do a bill that actually reduces premiums."
Meanwhile, a new Morning Consult poll shows the legislation's popularity continues to plummet:

Since the Congressional Budget Office released its cost estimate of the Obamacare alternative last week, showing steep coverage losses, the legislation’s approval rating has dipped six points, from 46 percent to 40 percent. Obamacare’s approval rating, on the other hand, sits at 46 percent, as it did in February.
McSally has made a career of refusing to go out on a limb for controversial legislation. You have to wonder why she picked this slender branch to get out ahead of an issue.

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Tuesday, March 21, 2017

Arizona ACA Enrollment Down 3.3 Percent. Cost For People With Subsidies Down 13.3 Percent.

Posted By on Tue, Mar 21, 2017 at 12:12 PM

COURTESY OF BIGSTOCKPHOTO
  • Courtesy of bigstockphoto
This is one of those "All I know is what I read in the papers" (cowboy hat-tip to Will Rogers) posts. The AP has an article on current ACA/Obamacare enrollment in Arizona which is full of informative facts and figures. Unfortunately, the AP headline, which is factually true, leaves a skewed impression of what's actually happened.

The AP headline reads:


That's true, but it's misleading. My longer headline, I think, summarizes the information in the article more accurately:

Arizona ACA Enrollment Down 3.3 Percent. Cost For People With Subsidies Down 13.3 Percent.

Let's look at the numbers in the article. Here's the overall picture for the state, according to the article.
Overall, Arizona saw a 3.3 percent enrollment decline in marketplace plans that are a key component of former President Obama’s heath care law, to about 196,000 people.
By the way, though it doesn't mention it in the article, that number is only for those buying insurance on the ACA marketplace. It doesn't include adults and children on Medicaid, which totals about 400,000.

A loss of a bit more than three percent of participants in the ACA marketplace? That doesn't sound anything like the Republican "Obamacare on life support" meme we hear so often, which often uses Arizona as a prime reason for pulling the plug. It sounds more like a reasonable yearly ebb and flow. However, the loss is far higher among those who don't qualify for tax credits. It's 23 percent. If you're a family of four, you pay the whole ACA cost when your income hits $97,000. If I'm reading this correctly, that $97,000 figure is the family's Adjusted Gross Income, which is total income minus deductions, meaning a family's actual combined salaries plus other income sources would be considerably higher, certainly over $100,000. According to the article, only the top 20 percent of Arizonans who get their insurance through the ACA marketplace pay full price. While no one wants to pay the full cost of ACA health care, which averages $611 a month, the top 20 percent who make over a hundred grand can manage it.

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Friday, March 17, 2017

The Asterisk in Ducey's Plan to Fund All-Day Kindergarten in 'Lowest-Income Schools'

Posted By on Fri, Mar 17, 2017 at 3:30 PM

COURTESY OF FLICKR.COM
  • Courtesy of flickr.com
Need another reason to be wary of Ducey's promises? Here's one: his all-day kindergarten funding pledge. It's not quite what he said it is.

Here's what Ducey said in his 2017 State of the State address:
"My budget gives the lowest-income schools dollars to start or expand full-day kindergarten."
Note the word "schools" in the phrase "lowest-income schools." Apparently that's not what Ducey meant. He meant "lowest-income charter schools," but if the school is inside a district, that's not enough. The whole district has to qualify as "lowest income" or No Money For You.

This was news to me until someone sent me a story by Michael Hernandez, an intern at Arizona Public Media (Let's hear it for the future of journalism!): All-Day Kindergarten Funding Out of Reach for Tucson's Public Schools. For Ducey's funding pledge to kick in, 90 percent of your students qualify have to qualify for free or reduced lunch. If you're a charter school, it's just that simple—90 percent on free/reduced lunch, and you get the money. But a whole district has to meet that number to qualify. So TUSD doesn't qualify, or Flowing Wells. Even Sunnyside with 86 percent of its students on free/reduced lunch doesn't make the cut.

According to the article, no Pima County school district will get a penny from the program, but ten charters in the county qualify.

Even in this rare instance where Ducey puts together a plan that favors low-income schools, he makes sure charter schools get more than their share of the proceeds.

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Sheriff Mark Napier Says His Deputies Won't Be Taking Over the Work of Border Patrol

Posted By on Fri, Mar 17, 2017 at 2:31 PM

Mark Napier
  • Mark Napier
Pima County Sheriff Mark Napier laid out his thoughts on how he will interact with federal authorities on immigration matters in a prepared statement earlier today:

The absence of a secure border presents a public safety concern for Pima County. We know significant quantities of illegal drugs are transported across the border for distribution throughout the United States. Human trafficking occurs across the border and results in the victimization of vulnerable populations. Transnational threats may also exploit the insecurity of the border to make undetected ingress into the United States, which potentially poses a national security threat. For these reasons, I fully support the increased emphasis on securing the border and providing additional federal resources to enhance our efforts to combat these public safety challenges. The Pima County Sheriff’s Department looks forward to increased cooperation with our federal partners to address public safety concerns relevant to our proximity to the International Border.

While I support the increased attention given to the border and welcome additional federal resources, the Pima County Sheriff’s Department does not have the capacity to engage in proactive enforcement of federal immigration laws. We have approximately 500 sworn personnel to provide law enforcement services to an area of 9,200 square miles. During the current fiscal year, we were facing a projected deficit of $6 million just to provide essential services to the people of our county. Our correctional facility currently houses approximately 1,825 inmates. We have the capacity for 2,000. We lack sufficient capacity to detain significant numbers of people for federal immigration violations. The Pima County Sheriff’s Department does not have the ability from either an operations or incarceration perspective to engage in active enforcement of federal immigration violations. Federal authorities best address these violations of federal law.

If local law enforcement becomes proactive in immigration enforcement, we will not enhance public safety, but rather deteriorate it. People in our community without legal documentation must be able to come forward and interact with law enforcement as victims and witnesses to criminal activity. If these people cannot interact with local law enforcement out of fear of deportation, we create an entire block of our community that will be victims of crime with no recourse and will not be partners with the community in reporting crime. All people of Pima County must be able to interact with law enforcement without fear.

The Pima County Sheriff’s Department cooperates fully with our federal partners when, in the regular course of our duties, we develop a reasonable belief a person might be in this country without documentation. We contact federal law enforcement who then makes the determination about legal status and what steps might be required with respect to the enforcement of federal immigration laws. There are several thousand Border Patrol personnel in Pima County. They are able to respond rapidly to our requests for support. There is no need for personnel of the Pima County Sheriff’s Department to be cross-certified as immigration agents (287G Program).

The Pima County Sheriff’s Department cooperates and works collaboratively with all our federal law enforcement partners. We value these relationships. We recognize ICE Detainers and cooperate with them. We are required by state law to verify the immigration status of persons housed in our Adult Detention Center prior to their release. A relatively small portion of persons crosschecked through ICE result in an Immigration Detainer request. An ICE Detainer, as currently drafted, does not provide a legal basis for detaining a person. Therefore, we cannot engage an extension of detention based solely on the existence of an ICE Detainer. When we no longer have a legal basis to hold an inmate, and are aware of an ICE Detainer, we notify ICE that we are beginning out-processing of the inmate. This generally takes approximately two hours to complete. This provides sufficient time for ICE to take custody of the person. During calendar year 2016, the Pima County Sheriff’s Department processed approximately 35,000 persons into jail. Only 420 inmates had ICE Detainers. We acknowledged 100 percent of them and through collaboration/cooperation with ICE ensured that no person with an ICE Detainer was released into our community.

The human toll associated with immigration is real and a factor for our department. Every year, we recover approximately 150 bodies in the desert areas of Pima County. This necessitates we maintain an industrial refrigerator at our Ajo District Station, simply to store human remains. Victimization of undocumented border crossers is a significant issue and it goes largely unreported. We know that border bandits and Coyotes prey upon these people. Securing the border will prevent deaths and criminal victimization of border crossers. Dissuading illegal entry into this country is in fact compassionate public policy.

The Pima County Sheriff’s Department is committed to providing the highest level of public safety services to the people of our County. We proactively attack crime problems and criminal behavior without regard to the immigration status of the bad actors involved and will continue to do so.



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