Donald Trump and maga Republicans cannot govern! Americans need leadership but Republicans play partisan politics with our lives

There are no winners in a government shutdown, but Democrats are right to fight | Philadelphia Inquirer Editorial

Increasingly outrageous actions from Trump and his administration, including the absolute disregard for Congress’ power of the purse, have left Democratic leaders with little recourse.

Once this federal government shutdown ends — whenever that may be — it is inevitable someone will declare victory. 

Nevertheless, as things stand, there will be no real winners.

It won’t be the federal workers — including more than 100,000 in Philadelphia — who either get to sit at home or labor indefinitely without a paycheck. Nor will it be the wider economy, as the last shutdown cost Americans $3 billion. Let alone the dwindling trust that our leaders can get anything done.

Even so, what other choice did Democrats have?

In March, Senate Minority Leader Chuck Schumer (D., N.Y.) came under fire from many in his own party after he was seen as caving to Donald Trump when he corralled enough senators to vote to keep the government open. Back then, Schumer believed the opposite: that a shutdown would only empower and embolden the president’s ugly smash-mouth style of governance.

Months of increasingly outrageous actions from Trump and his vengeful administration, including the absolute disregard for Congress’ power of the purse, have left Democratic leaders with little recourse but to make their stand.

“How could we negotiate a bipartisan agreement and then have the president unilaterally through impoundment, or the Republican Party through rescissions, and the president unilaterally through pocket rescissions, undo it all without any input,” Schumer said after he and House Minority Leader Hakeem Jeffries (D., N.Y.) met with Trump and GOP congressional leaders Monday.

Representing the state of bipartisan discourse, irresponsible Donald Trump responded by posting a racist deepfake video to social media depicting Jeffries wearing a sombrero and a mustache while Schumer vulgarly disparaged Democrats and immigrants.

As the shutdown took hold on Wednesday, Republicans demanded Senate Democrats “abandon their radical demands and fund the government.” 

Those radical demands❓ That affordable healthcare access for millions of Americans be protected.

Trump’s cruel signature legislation, the 🤢 One Big Beautiful Bill Act, not only extended his first term’s tax cuts, but also added additional reductions — with the biggest benefits going to the wealthiest few. To offset the loss of revenue, Republicans in Congress instituted funding cuts to Medicaid and changes to the Affordable Care Act❗😥

Democrats want to reverse the Medicaid cuts and extend federal tax credits that reduce the cost of health insurance purchased through ACA (Affordable Care Act) marketplaces, which are set to expire by the end of the year. Taken together, Republican proposals are projected to leave 16 million people without health insurance by 2034.

In saner times, the GOP would see the Democrats’ demands as a win-win scenario. The party could be seen as compromising on the most unpopular aspect of legislation, so toxic that they are actively trying to rebrand it. Not to mention that communities that voted for Trump are likely to be deeply hurt by the cuts, including by the closures of hospitals in rural areas, which depend on Medicaid.

But these are not those times. Already, many Republican legislators are misrepresenting Democratic efforts, casting them as shutting down the government over giving free healthcare to people who are in the country illegally.💥🤥

This is as patently false as it is shameless.

Yet, while Democrats are right to hold the line on healthcare, they are unlikely to prevail in the shutdown, because there is no one on the other side willing to negotiate in good faith. Trump has already promised to use the shutdown to further gut the federal workforce. That the president’s plan may be legally questionable fails to deter an administration intent on flouting the law.

The best chance for those who will lose their healthcare is for Democrats to regain control of Congress. In the meantime, Democrats must remind voters that this clash is about policy differences, that they are willing to compromise, and that while what’s happening is not good, the alternative is worse.

This shutdown fight is worth having. But thanks to the selfish and partisan Republicans, America has already lost.

Donald Trump and maga Republicans including Senator Susan Collins must stand up for American health care!

Trump’s Harmful Policies Are Endangering Your Health

Editorial opinion published in The New York Times

Donald Trump turned Make America Healthy Again into one of his administration’s signature promises. It is a laudable goal, too. By several measures, the United States is the world’s least healthy high-income country.

Nevertheless, as is so often the case with Trump, he both identified a real problem and enacted a set of policies that will worsen that problem. With public health, the damage could be vast. His administration is rejecting basic medical knowledge and turning back the clock to an era when people were sicker and died sooner.

The administration’s hostility to lifesaving vaccines, led by the incompetent Robert F. Kennedy Jr., the secretary of health and human services, has already contributed to a rise in measles.  Trump’s cuts to scientific research will forestall future treatments of cancer, heart disease and childhood illnesses. His cuts to Medicaid, which pay for tax breaks for the wealthy, will leave millions of Americans without health insurance and, by extension, health care. His rollback of environmental regulations has allowed corporations to pump more pollution into the air and water, which will contribute to lung diseases and other ailments.

As disappointing as the pre-Trump trends in public health were, Americans remain far healthier than in previous generations. Life expectancy today is almost 80, up from less than 60 a century ago. In that century, we have conquered smallpox and polio. We have cleaned our cities of the smog that was once normal. We have made progress against cancers and cardiovascular diseases that once were death sentences. Trump and Kennedy are dismantling the eight decades of work that made that progress possible. There is a great deal to lose.

Here’s what they are doing to harm our health:

1. Exposing Americans to preventable diseases: The taming of infectious diseases, including polio, smallpox, measles, mumps, tetanus, influenza and, most recently, Covid-19, has been one of humankind’s greatest achievements. These diseases have all been made far less deadly, and in some cases virtually nonexistent, thanks to vaccines. Mr. Trump himself recently said that vaccines work, “pure and simple.”

Yet as his top health official he has appointed a conspiracist, Mr. Kennedy, who exaggerates or outright lies about the risks that come with these vaccines. Mr. Kennedy has filled an important federal panel, which shapes which vaccines are covered by insurers, with other conspiracists. Republican-led states are following the administration’s lead; Florida is trying to repeal vaccine mandates for schoolchildren.

These misguided changes are already having an effect. The Covid vaccine has become harder to get, even for some vulnerable people. Childhood vaccination rates, which were falling before Mr. Trump returned to office, seem likely to fall further as Mr. Kennedy fans parents’ fears. Already, measles outbreaks have occurred in Texas and elsewhere, and the effects may be far worse in the coming years as society risks losing the herd immunity that it had achieved.

We know about the consequences from these diseases because humanity has lived them. Before vaccines, illnesses like smallpox, measles and polio left people scarred, paralyzed, blind or dead. Many of the victims were children. The Trump administration is condemning more people to suffer and die from diseases that we know how to prevent.

2. Making a future pandemic more deadly: Nobody knows when the next pandemic will arrive. Whenever it does, the United States may be even less prepared than it was for Covid.


With Elon Musk’s help, Trump this year dismantled the United States Agency for International Development. He also withdrew from the World Health Organization, the global hub for tracking health emergencies, and emptied the White House Office of Pandemic Preparedness and Response. These moves may have their biggest effects on poor citizens of other countries who previously benefited from American aid, but they put Americans at risk, too.

Trump fired the experts and community health workers who once monitored the world for outbreaks and helped restrain those outbreaks before they spread. In the past few decades alone, these workers led the fight against SARS, Zika, Ebola, bird flu and other illnesses, and Americans were largely spared from their effects.

Perhaps the strangest part of Trump’s health policy is his turn against mRNA vaccines. In his first term, his administration helped make possible the stunningly rapid development of mRNA vaccines for Covid. Trump could claim mRNA as his greatest accomplishment. Instead, he caved to vaccine skeptics within the MAGA movement and canceled $500 million in contracts to develop future mRNA vaccines.😓😨😥 That will slow the development of treatments for a future pandemic, when every week without a vaccine can lead to thousands of additional deaths.

3. Eliminating future cures:  In addition to cutting mRNA funding, the administration has sharply cut medical research funding. Mr. Trump and his aides have justified these cuts by citing government efficiency and the “wokeness” of the universities that conduct much of the research. But science funding represents just 0.6 percent of federal spending, and most medical researchers have little to do with the wokeness wars. Their goal is to find effective treatments.

Without federal funding, much of this research — into cancer, cardiovascular disease, dementia, addiction, diabetes and more — will not happen. It involves basic science that tends to be unprofitable for any one company but can have enormous returns for society. In all, basic research may lose one-third of its federal funding.

Consider the work that a team of researchers at the University of Mississippi and Ohio State University is doing into glioblastoma, a form of brain cancer that is usually deadly within 18 months of diagnosis. The Trump administration cut the team’s funding without a good explanation, forcing the project to pause. After the funding was cut, Eden Tanner, a chemist on the project, received a flood of emails from people affected by the disease. “It’s really heartbreaking to tell them,” she said.

4. Dirtying the air and water:  One public-health success story of the past half-century has been the sharp reduction of air and water pollution. As a result of regulations and clean energy breakthroughs, we breathe and drink many fewer toxins than Americans did decades ago. Pollution-related illnesses, like severe asthma, have declined as a result.

This trend may now be over. The Trump administration is hollowing out the Environmental Protection Agency, rolling back regulations, withdrawing support for clean energy and promoting dirty energy that causes illnesses. One example: The administration has given hundreds of industrial facilities a two-year pass on pollution rules. Another example: The J.H. Campbell coal-fired power plant in West Olive, Michigan, was on the verge of closing until the Trump administration issued an emergency order, forcing it to stay open — even though the power company had not asked to keep it open. The plant continues to operate today, producing fine particle pollution that is associated with cardiac problems, asthma and other lung diseases.

The effects will be largest in red states, which tend to have more industrial facilities and lighter regulation. In Texas, coal plants are now allowed to release more than twice as much wastewater pollution as they were at the beginning of this year, as well as more than five times as much sulfur dioxide and more than six times as much carbon dioxide, according to the Sierra Club. These changes are also likely to aggravate climate change.
5. Taking away medical care

Trump’s recently passed domestic policy law will leave 10 million Americans without health insurance, experts estimate. Another 4.2 million could lose health insurance if Republicans in Congress refuse to extend expanded tax credits under the Affordable Care Act. Together, these changes would undo about one-third of the coverage gains from that law.

Without health insurance, millions of Americans will not be able to get crucial medical care. A large recent study concluded that poor adults who received Medicaid were 21 percent less likely to die than those who were not enrolled. People with insurance are also more likely to be healthy enough to lead happy, productive lives than people without it. Among the biggest victims of the Medicaid cuts, as we recently explained, will be people addicted to opioids — a group Mr. Trump repeatedly promised to help.

The Medicaid cuts exist largely to finance tax cuts for affluent Americans. That same recent law also includes cuts to food stamps, which will leave poor Americans less able to feed their families and almost certainly less healthy. Wealthy Americans who do not need the money nonetheless receive more of it, while lower-income Americans lose food stamps and health coverage.

In each of these areas, it is easy to name ways that our health system has failed many Americans over the past few decades. Insurance is too expensive. Pollution is concentrated in lower-income communities. Cutting-edge medical treatments are sometimes available only to the affluent. Preventive care and chronic diseases receive too little attention from insurers, doctors, scientific researchers and government agencies. Ultraprocessed foods and “overmedicalization” have hurt children, as RFKjr (Kennedy) has noted.

All of which shows the need for a true Make America Healthy Again movement. Trump is not leading that movement, though. He is instead taking the country backward to a time when many health threats were much more ominous than they are today. Trump is surrendering America to curable diseases.

Donald Trump and maga Republicans attacking healthcare with Medicaid cuts devastating patient access to financially stressed hospitals

Donald Trump and maga Republican attacks on healthcare is expensive and dangerous:  Echo opinion letter published in the Ottowa News Network, in Michigan: ONN is a nonprofit newsroom that ensures all people in Ottawa County have access to trusted news.

All people have a fundamental right to healthcare, and, as a society, it benefits us to have people who are healthy in terms of people’s ability to work, the reduction of spreading illness, and curbing mental health crises.

A wrong minded, misleading and unsupported opinion in USA Today that claims Medicaid has been disconnected from helping its recipients to find work. It also claims that tens of millions of able-bodied adults are trapped in government dependency and not flourishing because they are not working.

The piece further purports that the cuts Donald Trump and Republicans made to Medicaid are not gutting Medicaid, but preserving the core of the safety net for the truly vulnerable and that he and his fellow Republicans are helping millions of able-bodied adults leave welfare and find work. He makes much the same claims for the SNAP program. This article completely ignores the facts.

The following statistics are from the Kaiser Family Foundation, an independent source for health policy research:

• 64% who receive Medicaid are already working either full- or part-time❗
• 12% are not working due to caregiving responsibilities.
• 10% are not working due to illness or disability.
• 7% are attending school to improve their ability to attain work.
• 8% are retired or unable to find work.

*Note: Total does not sum to 100%, due to rounding.

So, where are the tens of millions of able-bodied adults not working❓ The 64% who are working are in jobs that don’t offer healthcare to their employees, which is why they qualify for help. 

In addition, these people don’t earn enough to qualify for a premium subsidy under the Affordable Care Act, making the ACA policies unaffordable.

The cuts made to Medicaid and the changes made to the Affordable Care Act are going to increase hospital prices as they seek to cover the costs of people showing up to the ER with no health insurance. Hospitals with emergency departments are required to treat patients without insurance with emergencies. Premiums will increase as health insurance companies seek to cover the higher hospital prices. Hospitals that see a larger number of Medicaid patients, particularly inner city and rural hospitals, may well close because they can’t make it financially.
So, how are Republicans going to reduce waste and fraud❓ They are going to waste people's time and fraudulently cheat people out of benefits they qualify for by saddling them with onerous paperwork and red tape. Many low-income workers work odd hours, making it difficult to complete the requirements.

Both Arkansas and Georgia have tried or currently have work requirements for Medicaid. Both had serious issues with their websites not functioning correctly and people unable to submit their paperwork, resulting in the denial of benefits. The websites are closed at night and clients have difficulty getting an actual person to resolve issues. Georgia has spent more than $91 million in state and federal funds launching, building and operating its eligibility reporting system that still has major glitches two years on. In the meantime, qualified recipients go without the health insurance they need and deserve.

All people have a fundamental right to healthcare, and, as a society, it benefits us to have people who are healthy in terms of people’s ability to work, the reduction of spreading illness, and curbing mental health crises. Republican attacks on the U.S. health system are shortsighted, expensive and dangerous for us all.

From Beverley Rannow in Holland, a city in Michigan

Donald Trump and MAGA Republicans will deeply regret the immoral big bad ugly tax cuts for billionaires paid for by the working class

Donald Trump  bargained with Republicans in the middle of the night, to get what he wanted out of Congress; but it’s possible, in the coming years, that he is going to deeply regret and reject it.

Echo opinion published in New York Magazine "Intelligencer", by Ross Barkan, a political columnist for Intelligencer

This isn’t because Trump has any particular laments about the devastating policy in the reconciliation package, which will gut social safety-net programs and cut taxes, particularly on the rich. He won’t lament ballooning the deficit, either. He doesn’t think too hard about any of that.

Rather, the so-called One Big Beautiful "Bullshit" 💩❗ Bill is bound to be a tremendous albatross for the Republicans charged with shepherding his agenda through Congress. 

It may, too, prove especially damaging for his plausible successor, J.D. Vance, who is still somewhat likely to be the 2028, Republican nominee, despite Trump’s flirtations with seeking an unconstitutional third term.

That’s because, in the end, Trump and congressional Republicans didn’t pursue any great policy commitments consistent with the populist, MAGA-infused realignment that delivered him a slim victory in the 2024, election. They didn’t, like far-right populists across the world, marry social conservatism and immigration crackdowns with a charge to safeguard the welfare state. 

Gutting health care isn’t what the far right does outside the United States. Trump, at least, was wise enough to not campaign on it last year.

But you can’t spin Americans about their health care. Failed attempts to repeal the Affordable Care Act in 2017 fueled a Democratic midterm wave the following year. And these cuts, which are going into effect, will do a great deal of tangible damage: $1.1 trillion stripped from the health-care system, including nearly a trillion from Medicaid. Yes, the prototypical Republican politician cares almost nothing about health insurance for the working class and poor — this outpost of socialism in our capitalist economy — but they’ll understand very soon that insulating their constituents from these cuts will not be simple. They may fantasize about a world where Medicaid cuts merely torment Blue America, those big cities stuffed with the urban poor who generally don’t back their candidates. But Medicaid is what keeps rural America afloat, especially the underfunded hospital systems. There’s a reason Thom Tillis, the Republican senator from North Carolina, backed away from the reconciliation bill: He saw the suffering that was coming.

The irony of this legislation is that the movement of the working class and poor into the MAGA coalition did nothing to save them from the brunt of these cuts. This is a bill from the old-guard Republican Party, one forever partial to elites. That party won this fight. It’s a reminder that fealty to Trump extends far more to the person than to policy. Yes, Republicans will bend to Trump’s whims, but the cannier conservatives always understood what mattered to Trump was the spectacle of signing any legislation by July 4. Trump wants a win for the sake of a win. He doesn’t much care what’s in a Big Beautiful Bill as long as he can sign it and brag about it. He can preen. He can (lie 🤥 ....like he always does) feel he has done something.

This is a domestic-policy bill, ultimately, that could have been belched out by any generic GOP administration — and in that sense, it doesn’t veer very much from Trump’s first term, when he rhetorically moved his party leftward on questions of economics and foreign policy but largely governed like the men he vanquished in the 2016, primary. There are no great surprises here; it’s merely the tax cuts generations of Republicans have brayed about. Adding spending on “border security,” meanwhile, is no revolution. 

Little of it is a coherent outgrowth of what happened last year, when Trump made tremendous inroads with Black, Latino, and Asian voters, portending a realignment that he has done almost nothing since to secure. The reconciliation package, above anything else, may be remembered just for the trillions it added to the national debt with virtually nothing to show for it. No budget holes are being blown open to give Americans much of anything.

Americans, on the whole, will be worse off for what just transpired in Washington. And those beleaguered, feckless Democrats will be handed a road map back to the House majority. The Senate is still the far tougher fight, but whatever messaging problems the Democrats have now will be solved, to a great degree, by next year. 

Democrats know how to campaign on health care; they’ve done it for years, and usually with success. A strong defense of Medicare and Medicaid always polls well. They can blast away at the DOGE cuts to the federal government, which very few voters actually wanted. Republicans will have full control of Congress for at least one more year, and that may mean yet another reconciliation package that causes a great deal of chaos and benefits the vanishingly few. The only comfort the left can take is that MAGA will have no permanent, longstanding majority in this country. It’s only downhill from here.

Health care coverage is on the election ballot!

Remember that your vote can determine your health care! Echo opinion published in the Lansing State Journal, a Michigan newspaper.

For many Michiganders, the outcome of the upcoming November election could be a matter of life and death.

Depending on the outcome of the election, health care for millions of people could be in jeopardy. That’s why it’s crucial to know the facts when deciding who you’re going to vote for. Decisions about the health care that will be available to you and your families in the future will be made following the election.

It’s important to note that many Republicans have said they support Donald Trump’s lawsuit to repeal the Affordable Care Act. Others have not addressed their plans for health care. Both positions are dangerous for many people.

In Michigan, the repeal of the Affordable Care Act (ACA) means more than 720,000 people will lose their coverage, and the 4.1 million people in our state with pre-existing conditions will lose protections afforded to them under the Act.

In fact, the U.S. Supreme Court will hear arguments in the lawsuit to repeal the ACA. The administration has made clear it seeks the destruction of the ACA, including its protections for those with pre-existing conditions.

During a global pandemic that has killed more than 6,500 people in our state, this is an especially cruel time to be fighting to rip coverage away from people who desperately need it. The pandemic has put a spotlight on this issue and shown all of us how important it is for every American to have access to quality, affordable health care. The stakes have never been higher for many Americans

It’s unfortunate health care has become an increasingly partisan issue, as we should all understand it to be a right.

Republicans in leadership have put partisanship ahead of the interest and safety of their constituents for too long. To make matters worse, they have tried to repeal the ACA without any replacement. When that failed, their next move was to file the lawsuit that is now before the Supreme Court with oral arguments beginning one week after the presidential election.

If the ACA is repealed, seniors would have to pay more for prescription drugs, and many young adults would no longer be able to stay on their parents’ health insurance. The 4.1 million Michiganders with pre-existing conditions would lose their coverage, or be once again subjected to unaffordable premium costs or lifetime caps on their coverage. These are just some examples of the long list of benefits that would be eliminated if the ACA is overturned.

Democrats in leadership have consistently supported strengthening the ACA — including introducing and passing legislation to expand the ACA, reduce costs and provide better coverage for families and lower the costs of prescription drugs.

These comparisons are to point out that we know clearly where the parties stand on health care. The question is simple: Will any Republican candidates disavow the Trump administration’s continual attempts to sabotage the ACA? Will they oppose the Trump administration lawsuit to repeal the ACA?

If the answer is no, or if the response is continued silence, Republicans have made voters’ choices in November easier.

Dianne Byrum is state director for Protect Our Care Michigan.

Florida echo viewpoint - How they lead: Speaker Pelosi the most influential woman to hold national elective office

Nancy Pelosi v. Mitch McConnell: 

What a difference a leader makes | Editorial in the Florida Sun-Sentinel

The paradox stands out not simply in how differently the House and Senate vote, but in how they are led.
Rep. Nancy Pelosi of California, serving her third two-year term as Speaker of the House, has already taken her place alongside the late Sam Rayburn as one of its greatest leaders. In fact, Pelosi is the most influential woman ever to hold national elective office, as well as the first to lead either chamber and the first to serve as a minority leader.

She controls the House by force of personality, as well as the use of power. Having raised five children before she was elected to Congress in 1987, she perfected a steely glance — “that look,” some call it — that speaks louder than words. She used it to good effect to silence applause after the vote to impeach President Trump Wednesday night.

She didn’t need the impeachment to achieve historic stature, although it is certainly an accomplishment.

Without her, the Affordable Care Act probably would not have been enacted nine years ago, during her previous term as speaker. Given what has been happening in the courts, she might have to do it again next year.

In this term, the House has passed more than 400 bills, some of such extreme importance as restoring vital parts of the Voting Rights Act that the Supreme Court had overturned, protecting the 2020 election from renewed Russian interference, raising the minimum wage, and reauthorizing the Violence Against Women Act.

Despite today’s hyper-partisan climate, the Democratic speaker produced a bipartisan budget agreement and a new North American trade bill, one of the president’s highest priorities, which he will owe to her.

Only five bills, not counting resolutions, remain to be voted on in the House.

Pelosi represents the best of times.

But more than 300 of these bills are languishing in the Senate, including some 275 that passed the House with bipartisan support.

That brings us to Senate Majority Leader Mitch McConnell of Kentucky. He personifies the worst of times.

There is no valid reason for him to prevent the Senate from voting on any of the House bills other than his contempt of Democrats and his desperation to keep Trump in power, for the sake of the Republican Party, even if it leaves the nation vulnerable to foreign meddling in our elections.

McConnell’s abuse of power is second only to Trump’s. He plumbed the depths of partisan irresponsibility when he stole a Supreme Court appointment from President Barack Obama on the spurious and historically inaccurate pretext that a president shouldn’t be allowed to make such an appointment during his last year in office.

Pelosi’s leadership is a case study in the wise use of power. McConnell’s is quite the reverse.

Only a year ago, however, some younger House Democrats were agitating for her and other veteran Democratic leaders to step aside. Despite their having shattered Republican control in the 2018 mid-term elections, there were even hints that some might throw in with Republicans to deny her a majority when it came time in January for the official vote.

Pelosi is 79. Her two top aides, Majority Leader Steny Hoyer of Maryland and Majority Whip James Clyburn of South Carolina are 80 and 79 respectively.

The insurgents should be glad they didn’t get what they wished for. Most seem to be.

“I thought it was time for new leadership, and I’ve got to tell you: Thank goodness, thank goodness that we have Nancy Pelosi speaking for the House of Representatives,” said Rep. Dean Phillips, D-Minn.

Pelosi won the decisive caucus vote with 124 votes to 63 for Rep. Tim Ryan, 46, of Ohio, who mounted a short-lived campaign for president this year.

But the confrontation prompted her to promise to abdicate the speakership after one more term, assuming the Democrats hold the House in 2020. The policy she proposed would have her and the other top leaders serve only three two-year terms in those capacities, with a fourth depending on the support of two-thirds of the party caucus.

She said she sees herself “as a bridge to the next generation of leaders,” with a “continuing responsibility to mentor and advance new members into positions of power and responsibility in the House Democratic caucus.”

Hoyer said he wouldn’t be bound by that. There was discussion of the caucus making it a party rule, but nothing has been heard of it since.

Term limits for leadership positions would be a plausible check on abuse of power, such as McConnell has demonstrated. But while Senate Republicans term-limit their committee chairs, no Republican there has cared or dared to challenge McConnell’s dictatorship.

On the other hand, there’s nothing right and much wrong in term limits for individual members of Congress, the nostrum touted by presidential candidate Tom Steyer. Term limits ruined the Florida Legislature and would leave U.S. representatives and senators even more dependent than now on keeping in good graces with whomever happen to be Speaker and Senate majority leader. Worse, term limits would make the presidency even stronger at the expense of Congress.

It’s not by coincidence that the Founders devoted the first article of the Constitution to the Congress and only the second to the executive branch.

“In republican government, the legislative authority necessarily predominates,” wrote the anonymous author of The Federalist 51, who was either James Madison or Alexander Hamilton.

The three branches of our government were meant to be co-equal. Power is dispersed among 535 people in the Congress and among nine at the Supreme Court, but in the executive branch it is concentrated in one person, the president, which makes it easier to abuse.

The Founders left each house to make its own rules, allowing them to give as much or as little power to their presiding officers as it suits the members from time to time. The caucuses, not the presiding officer, determine who lead committees and who serve on them. That still leaves enormous power to the House Speaker and Senate Majority leader to decide what will or won’t become law.

But the last word isn’t theirs. This is still a democracy.

In next year’s elections, the voters will pass judgment not only on Trump but, indirectly, on the respective leadership of Nancy Pelosi and Mitch McConnell.

Their own voters may or may not return them to Washington. Pelosi’s surely will and McConnell’s shouldn’t. But it’s Americans across the nation who’ll determine control of the House and Senate.

Thanks to Pelosi, House Democrats have a strong case for retaining the majority. McConnell’s drones do not.

Editorials are the opinion of the Sun Sentinel Editorial Board and written by one of its members or a designee. The Editorial Board consists of Editorial Page Editor Rosemary O’Hara, Sergio Bustos, Steve Bousquet and Editor-in-Chief Julie Anderson.

Racism and Antiracism - echo excerpt

As a professional nurse, I believe this excerpt from the book "How To Be An Antiracist" matches with my understanding about the sociology of medicine, and how racism is a public heath risk for poor health and early death. 

This blog is an echo excerpt from the book by Author Ibram X. Kendi.  His concept of antiracism reenergizes and reshapes the conversation about racial justice in America--but even more fundamentally, points us toward liberating new ways of thinking about ourselves and each other. Instead of working with the policies and system we have in place, Kendi asks us to think about what an antiracist society might look like, and how we can play an active role in building it.

In his memoir, Kendi weaves together an electrifying combination of ethics, history, law, and science--including the story of his own awakening to antiracism--bringing it all together in a cogent, accessible form. He begins by helping us rethink our most deeply held, if implicit, beliefs and our most intimate personal relationships (including beliefs about race and IQ and interracial social relations) and reexamines the policies and larger social arrangements we support. How to Be an Antiracist promises to become an essential book for anyone who wants to go beyond an awareness of racism to the next step of contributing to the formation of a truly just and equitable society.

Kendi wrote (p. 21-22) this autobiographical segue to the data he presents that correlates race with poor health and life expectancy:

I am one generation removed from picking cotton for pocket change under the warming climate in Guyton, outside of Savannah, GA.  That's where we buried my grandmother in 1993. Memories of her comforting calmness, her dark green thrum, and her large trash bags filled with Christmas gifts lived on as we drove back to New York from her funeral.  The next day, my father ventured up to Flushng, Queens, to see his single mother, also named Mary Ann. She had the clearest dark-brown skin, a smile that hugged you and a wit that smacked you.

When my father opened the door of her apartment, he smelled the fumes coming from the stove she'd left on, and some other fumes.  His mother was nowhere in sight, he rushed down the hallway and into her back bedroom. That's where he found his mother, as if sleeping, but dead.  Her struggle with Alzheimer's, a disease more prevalent among African Americans, was over.

There may be no more consequential White privilege than life itself. White lives matter to the tune of 3.5 additional years over Black lives in the United States, which is just the most glaring of a host of health disparities starting from infancy, where Black infants die at twice the rate of White infants. But, at least my grandmother and I met, we shared, we loved. I never met my paternal grandfather. I never met my maternal grandfather, Alvin, killed by cancer three years before my birth. In the United States, African Americans are 25 percent more likely to die of cancer than Whites. My father survived prostate cancer, which kills twice as many Black men as it does White men. Breast cancer disproportionately kills Black women.

Three million African Americans and four million Latinx, secured health insurance through the Affordable Care Act (ACA), dropping the uninsured rates for both groups to around 11 percent before President Barack Obama left office. But, a staggering 28.5 million Americans remained uninsured, a number primed for growth after the Republican Congress repealed the individual mandate in 2017. And, it is becoming harder for people of color to vote out of office the politicians crafting these policies designed to shorten their lives.  Racist voting policy has evolved from disenfranchising by Jim Crow voting laws to disenfranchising by mass incarceration and voter-ID laws. Sometimes these efforts are so blatant that they are struck down: North Carolina enacted one of these targeted voter-ID laws, but in July 2017, the Court of Appeals for the Fourth Circuit struck it down ruling that its various provision "target African Americans with almost surgical precision." 

Nevertheless, others have remained and been successful. In fact, Wisconsin's strict voter-ID law suppressed approximately two hundred thousand votes- again primarily targeting voters of color, in the 2016 election. Donald Trump won that critical swing state by 22,748 votes.  

In Maine Writer's  summary about the above excerpt: Race and politics and health share a negative correlation for people of color. Data demonstrates how people of color are obstructed from voting for the people who could improve their human condition.  

Las Vegas Sun editorial - Joe Biden and the middle class

Joe Biden vows to rebuild middle class, lead with morality- an editorial echo, published in the Las Vegas Sun

Former Vice President Joe Biden said the economic playing field in the U.S. has been tilted in favor of corporate CEOs and shareholders and vowed to “rebuild the middle class” if he makes it back to the White House as president.

“There used to be a basic bargain in the country ... If you contributed to the success — the economic success of the enterprise you worked with — you got to share the benefits,” Biden, a Democratic candidate for president, said Tuesday in Henderson.

“I think the moral obligation of our time is to rebuild the middle class, and when we rebuild it this time, bring everybody along,” Biden said, addressing members of the International Painters and Allied Trades Union.

Former Vice-President Joe Biden will revitalize the American Middle Class

Biden, visiting Nevada for the first time since announcing his candidacy, said he would raise the minimum wage and roll back President Donald Trump’s 2017 tax cuts, which critics charge have largely benefited the wealthy instead of working people.

Biden, who spoke for about a half hour, also promised to restore a sense of morality to the White House, saying four years of Trump may be a historical aberration but eight years could be disastrous for the country.

“I really believe in my whole heart and soul the values of this country — the decency, honor, leaving no one behind, who we are, we the people — is really ... at stake,” Biden said.

Biden said he would reverse what Trump has done to undermine the Affordable Care Act and threw his support behind a government-run public health insurance option to compete with private insurers.

The issue of Medicare for All has been a dividing line in the 2020 campaign, with Democratic candidates further to the left, such as Sen. Kamala Harris of California and Sen. Elizabeth Warren of Massachusetts, supporting it and more centrist candidates, like Biden and former U.S. Rep. Beto O’Rourke, supporting a public option.

Marcy Ramirez, a retired Biden supporter, said she agrees with Biden’s stance on health care and is confident he will win the Democratic nomination and unseat Trump. “I told him I’d see him at his inauguration,” she said.

Jason Lamberth, the union’s regional manager, introduced Biden as a pro-labor candidate and “someone who knows that when you give ordinary Americans a chance, they can do extraordinary things.”

Biden ended his speech the same way it began, with a call for unity. “If we just remember who we are, nobody can tear America apart but America,” he said.

Holding the Republicans accountable for pre-existing conditions insurance coverage

Bangor Daily News editorial:

Republicans suffer from pre-existing positions

In 2017, Republican conventional wisdom was that repealing the Affordable Care Act was their ticket to re-election. 

Insurance beneficiaries want their health coverage to include care for pre-existing conditions

But, it turns out, Americans appreciate the protections included in the landmark law, which Republicans nearly repealed last year.

This is especially true of protections for those with pre-existing conditions, which could include half the non-elderly U.S. population.

So, now, Republicans are turning themselves into pretzels to profess their longstanding support for protections for American with pre-existing conditions, which range from acne to diabetes to cancer to depression.

This is a difficult contortion for Republican House members, including 2nd District Rep. Bruce Poliquin who voted in May 2017 to repeal the ACA and replace it with the American Health Care Act. That inferior plan had weaker protections for those with pre-existing conditions (under the guises of greater flexibility for states) — and allowed insurers to charge these people much more than their healthier counterparts — that would have led to more than 23 million Americans losing their health insurance by 2026, according to the nonpartisan Congressional Budget Office. It also would have done away with the requirement that plans cover “ essential health benefits” such as prescription drugs, emergency services and maternity care.

Republicans now argue that their efforts to undo the ACA aren’t so bad because Maine law protects those with pre-existing conditions. State law includes some protections for people with pre-existing conditions, but they are weaker than those in the ACA, they could change and Mainers aren’t so self-centered that we don’t care about people in other states who don’t have such provisions.

Nearly half the state’s population — 590,000 Mainers — has pre-existing conditions, according to Sen. Susan Collins’ office.

She was the first Republican senator to say she would vote against a repeal and replace bill in the Senate. That bill, which was to be meshed with the House-passed bill, was rejected by the Senate in July 2017, thanks to the opposition from Collins and fellow Republicans Lisa Murkowski and John McCain.

“It could lead to insurance plans that, really, are barely insurance at all,” Collins told ABC News. “It would cause premiums to increase for some very vulnerable individuals, including those with pre-existing conditions.”

Health care is the top concern of voters nationally and in Maine. Digging deeper, continuing protections for those with pre-existing conditions was the top health concern, according to a Kaiser Health poll.

That’s why many Republican have had to change their tune.

President Donald Trump has also joined the charade. He has been touring the country telling people that his administration will always protect people with pre-existing conditions. This is absurd because his administration is now part of a Texas lawsuit arguing that the mandates to cover pre-existing conditions are unconstitutional. Collins had urged the Department of Justice to do the opposite — to defend protections for people with pre-existing conditions. LePage joined the lawsuit in February, as an individual, not as the chief executive of Maine because he can’t do so without the approval of the state’s attorney general.

In February, the Trump administration issued rules allowing an expansion of the sale of short-term health plans. These plans can be denied to people because of the health history and higher premiums can be charged to those with pre-existing conditions. Plans can be structured to appeal to only young and healthy buyers.

Just days ago, the Trump administration approved ACA subsidies for skimpy health insurance plans that don’t offer a full range of benefits. These plans don’t cover essential health benefits and can be denied to people with pre-existing conditions.

In the case of Republicans and pre-existing conditions, actions speak much louder than words. Their actions show that their new-found affection for protecting people with pre-existing conditions is shallow and simply meant to help them win elections. But when insurance company lobbyists start paying them through their political action committees, they will find ways to renege on their shallow support.

Meanwhile, (MaineWriter note) virtually all of Congress and White House staffs have pre-existing conditions coverage in their government plans.

Rising health care costs and shopping for sales under Donald Trump's administration

MaineWriter: Donald Trump and the rising costs of health care.  In 2017, the Republicans passed a tax cut for the rich while middle class and working poor are forced to pay higher health care costs.

This opinion echo is factually cynical and fun to read.

An echo opinion written by Michael S. Robinson, Sr., was published in the Utah newspaper The Salt Lake City Weekly.

From Salt Lake City, Utah: Owing largely to big pharma's predatory gouging and the exorbitant charges of doctors and hospitals, U.S. health care costs have soared into the stratosphere. 

Donald Trump, the Rabid Orange Raccoon, hasn't improved the situation. His wrong minded policies have partially dismantled Obamacare, the Affordable Care Act. In fact, President Trump's self-avowed destructive agenda has escalated health care pricing, fueled in part by the added burden of millions of citizens who've elected not to buy insurance and have instead become charity cases.

In an effort to take control of the ever-worsening situation, many Americans have chosen non-domestic medical providers as a money-saving alternative. For prescription drugs, they've tapped into the discounts of India and Canada. And for medical and surgical procedures, thousands have flocked to other countries in search of better prices—discovering that some of the best surgical care in the world is not necessarily statewide. The price difference is really a jaw-dropper; surgical candidates are often so shocked at the disparity that their own friends confuse them with Jay Leno.

Take, for instance, the cost of an aortic valve replacement. In the U.S., you'll pay around $170K, including surgeon, anesthesiologist and hospitalization. But wait a minute. You could book reservations for you and your spouse and take a medical vacation instead. In India, you can have the same procedure, done by U.S.-trained heart surgeons, for a mere $9,500, and it's only $5,300 if you decide to go to Warsaw instead. Think about the fun you can have with the leftover money. It's mind blowing, and a sad indictment of American health care. Medical tourism has brought the reality poignantly home: It's not about the cost of medical services; it's about the price.

As a service to supporters of our Clown President, I've compiled a list of useful medical procedures and pricing for the adventurous medical tourist.

•Corrective rhinoplasty for Republicans: U.S. price is $6,500, but it's only $3,600 in Singapore. Expect remarkable results: The olfactory-impaired will suddenly be able to smell a rat.

•Lasik eye correction special for Trump lovers: U.S. price is $4,000, but it's only $1,000 in Delhi, India. Anticipated benefit: The refraction-created illusion of Trump's wings will disappear and his halo will sink to his midriff. As an added bonus, Biblical text regarding the treatment of others will become clear and crisp.

•Knee replacement special for the Christian right: U.S. price is $35,000, but only $7,700 in Kuala Lumpur, Malaysia. Anticipated benefit: "Get down on your knees and pray" will suddenly be a viable option.

•Anal sphincter repair: U.S. price is $13,500, but it's only $2,500 in Mexico. Anticipated benefit: The accompanying brown trails that occur simultaneously with the "OMG" and "WTF" responses to Trump's frequent verbal abortions will abruptly cease. (Sadly, carpet sales are likely to decline.) Note: All ASRs will include a complimentary rectocephalectomy if required.

•Fusion of lumbar vertebrae (Republican Congressional special fall sale): U.S price is $110,000, but in Amman, Jordan, you can have it done for $10,000. Anticipated benefit: Senators and representatives will be able to stand and be counted, thus ending their existence as spineless invertebrates.

•Lingual nerve repair: Here, it costs $8,700, but you can have it done in Pyongyang, North Korea, for only $57.95. Benefit: Relief from epidemic tongue-biting and the joy of finally having your voice heard. "If you can't say anything nice," as Thumper entreated us in Bambi, "shout it."

So go ahead, my friends. If this list of discounted medical procedures has reminded you of what's wrong, launch yourself into the real world and get yourself fixed at a bargain price. It's a chance to cure America, one procedure at a time, and restore the health of an ailing democracy, Trump be damned.

Author Michael S. Robinson Sr. is a former Vietnam-era Army assistant public information officer. 

Governor LePage is wrong to obstruct Medicaid expansion

Maine- LePage’s obstruction continues as thousands of Mainers await access to health insurance

http://bangordailynews.com/2018/09/08/opinion/editorials/lepages-obstruction-continues-as-thousands-of-mainers-await-access-to-health-insurance/
Bangor Daily News echo opinion

Gov. Paul LePage has finally, as required by federal law, filed a plan to implement Medicaid expansion. The governor, however, asked the federal government to reject Maine’s plan because, he says, it isn’t paid for.

Funding for the initial implementation, which was, by law, supposed to begin in July, is not in the state budget because LePage vetoed a plan to pay for it. He did not offer an alternative funding source.

LePage’s intransigence is preventing thousands of low-income Mainers from accessing health insurance that they are entitled to under state and federal law. Without insurance, many forgo needed medical care, substance abuse treatment and other health services, which can harm their employment and quality of life.

From the first time it was approved by the Legislature, LePage has sought to thwart an expansion of Medicaid as allowed under the Affordable Care Act. After LePage vetoed expansion bills five times, voters last year resoundingly approved an expansion that will extend health insurance to at least 70,000 Mainers, most of whom are working but don’t currently have access to insurance.

Despite this mandate from voters and court orders to begin the implementation process, LePage has continued to fight. His main argument is that the state cannot afford it. This is not true.

Maine ended the fiscal year with a “record” surplus of more than $175 million, the LePage administration bragged in July. Some of that money could be used to cover the cost of the first phase of expansion.

That was the intent of a bill lawmakers approved this summer that would have allocated $3.8 million in state funds to hire new employees to begin the expansion. The funding sources in LD 837, the surplus and state tobacco settlement fund, were not the best solution, but the legislation would have funded expansion for a year, long enough to get it up and running. The state funds would have been matched by $6.4 million in federal funds.

Even in the face of a court order requiring the state to file a plan to implement Medicaid expansion, LePage vetoed the funding measure and House Republicans banded together to sustain the veto in July.

In August, the Maine Supreme Judicial Court reaffirmed that the state was required to file an implementation plan.

Now, LePage has finally submitted the implementation plan that was due in April. But it is not a serious effort to comply with the law. The plan should be rejected, he wrote to the Centers for Medicare and Medicaid Services in an Aug. 31 letter, because it is not paid for.

“I strongly encourage CMS to reject the State Plan Amendment,” LePage wrote.

“ … not one dime of the hundreds of million of dollars that will be needed to pay for the state’s share of the expansion has been appropriated,” he added.

Again, none of the money has been appropriated because he rejected the Legislature funding plan without offering an alternative.

In addition, LePage’s cost projections have long been overinflated. Under the Affordable Care Act, the federal government covers 90 percent of the cost. Maine is estimated to receive more than $525 million per year for a state investment of about $55 million annually, beginning in 2021, the first full year of implementation.

LePage’s refusal to follow the law won’t make its requirements go away. Instead, it needlessly delays access to health care for thousands of deserving Mainers while wasting taxpayer money on legal fees.

(Sadly), No one wins in the scenario.

Republicans and poverty

Maine Equal Justice Partners published this disturbing report about how Maine is not sharing in American prosperity.  After reading and now blogging this narrative, it makes even less sense for Senator Susan Collins to have wrongly supported the Republican bill to give tax cuts to the rich.  Nothing in the Republican tax cuts for the rich will improve the quality of life for the people who are described in this report:  

Maine is not sharing in the prosperity being experienced by rising socio-economic data, reported in other US states. 

Yet, Maine's Republican Governor Paul LePage, the Second District Congressman, and Republican Bruce Poliquin and Senator Susan Collins, a Republican from Caribou, Maine, are not responding to the state's poverty problem. 

Instead, they supported the Republican plan to provide tax cuts for the rich, the people who are already prospering in the US economy, rather than invest in programs to improve Maine's economy to the level of prosperity, like what's happening in other states.

This report from Maine Equal Justice Partners:

Maine is not sharing in the progress being made in other parts of the country; in fact, it has been heading in the wrong direction for the past several years. 

Significant cuts to Maine services have left thousands of Mainers behind. And actions of the Republicans in Congress and the Trump administration threaten to push even more Maine people into poverty. Data released in September by the Census Bureau show that the national poverty rate declined from 2015 to 2016. 

Additional data from the Census Bureau and other sources show the ways the U.S. is making progress in the fight against poverty. We are seeing relief for families who have been lifted out of poverty by an increase in incomes and the number of jobs brought on by a stronger economy as well as by federal programs and policies that lift them up. 

In fact, the new Census Bureau data also shows that effective anti-poverty programs like housing assistance, Temporary Assistance for Needy Families (TANF), the Supplemental Nutrition Assistance Program, (SNAP, formerly known as food stamps), low income tax credits, and assistance for people with disabilities have lifted millions out of poverty. Yet, while the nation is making progress in poverty reduction, that same progress is not being shared in Maine, where poverty rates remained flat from 2015 to 2016. 

Through so-called “welfare reforms,” Maine’s Governor LePage and other policy makers have significantly diminished the state’s anti-poverty programs in recent years thus, they are not working as well as they could to deliver opportunities and lift families out of poverty. Compared to 2011, an estimated 100,000 fewer people receive assistance for food, shelter, or medical care here in Maine.

And proposals from Congress and the Trump administration to cut programs that have lifted millions out of poverty threaten even more vulnerable people. Proposed budgets and spending bills from leadership in the House, Senate, and White House would slash billions from the very programs that are designed to support low-income Mainers. Such cuts would surely cause more Americans and more Mainers to suffer in poverty and near poverty. 

The State of Poverty in Maine 

Roughly 161,750 Mainers (12.5 percent) are suffering under poverty’s weight. Approximately 59,000 Mainers (4.5 percent) live in deep poverty – less than $800 a month for a family of three. 3 This includes nearly 16,400 Maine children. 

Tragically, children remain more likely to be poor in America than any other age group, with nearly one in five in poverty nationwide. 

Although there has been some progress in reducing both child poverty and deep child poverty in the U.S. – this progress is not shared by Maine kids. In fact, since 2011, the proportion of U.S. children living in deep poverty decreased by 4.2 percent, while it increased in Maine by 13.6 percent.  The rate of child poverty nationally has dropped in the last year, while it remains stagnant in Maine, standing at 17.2 percent in 2016, showing no improvement

from 2015 levels.

Communities of color in Maine saw a lack of progress in poverty reduction as well: 42.7 percent of African Americans and 17.9 percent of Latinos were poor in 2016, percentages comparable to those in 2015 and 2007. 

In contrast, the poverty rate among non-Hispanic whites in Maine in 2016 was 11.5 percent. In Maine and in the nation as a whole, communities of color still remain disproportionately affected by poverty. The number of American households that are food insecure has continued a downward trend nationwide, but here too, progress eludes Maine families. The proportion of American households that weren’t always able to provide enough food for all family members in 2016 is down 12 percent from 2014 and down 17 percent from a high in 2011.5 

Hunger has decreased in the region and the rest of the nation, but not so in Maine. Here, on average 16.4 percent of households were food insecure between 2014 and 2016,—26 percent higher than the national average. This is statistically flat from 2011-2013 and remains 3.5 percentage points higher than pre-recession levels. 

Due to program changes such as an ineffective work requirement and a burdensome new asset limit, roughly 42,600 Mainers lost food assistance from 2011-2016,6 and Maine has the third highest rate of very low food security in the nation. 

Mainers in rural areas face particularly high barriers to getting the food they need. 

Across the country, progress has been made in increasing the number of Americans with health insurance, thanks to health insurance subsidies available under the Affordable Care Act and the states’ option under the law to use federal dollars available to them to expand Medicaid coverage to low income adults. 

Nationwide uninsured rates fell 41 percent from 2013 to 2016. But in Maine, which had not yet expanded Medicaid coverage, uninsured rates were flat from 2015 to 2016, and declined only 29 percent from 2013 to 2016. 

In other words, Maine saw some gains as individuals gained access to subsidized insurance on the Marketplace, but did not benefit as did other states from Medicaid expansion. Even more troubling, due to so-called “welfare reforms” championed by Maine’s Governor, Paul LePage, between 2011 and 2016, more than 40,000 Mainers lost their health insurance through MaineCare and the Elderly Drug Program including seniors, children, working parents, adults under the 3 poverty level, and immigrants. 

Maine’s overall health ranking during that period fell from 10th best in the nation to 22nd , showing that Maine has been heading in the wrong direction. In November 2017, however, Maine voters chose by ballot initiative to expand the state’s Medicaid program, making Maine the first state in the nation to make that decision through an election measure. The impetus for voters to do this came about after Maine’s legislature passed Medicaid expansion five times, only in each case to be met by a veto from Governor LePage. Now, with over 59 percent of voters approving the measure at the ballot this November, an estimated 70,000-80,000 people will begin to finally receive the coverage that they need.

Effective Programs Reduce Poverty and Speed Up Progress 

The Census Bureau’s Supplemental Poverty Measure (SPM) is a more accurate measure of poverty and its changes over time than the official poverty rate noted above. This is so because, unlike the official poverty rate, the SPM counts income sources such as federal tax credits and food and housing assistance as well as expenses like out-of-pocket medical costs. The SPM shows that federal programs increase incomes for millions of Americans, lifting them out of poverty and reducing the burdens of poverty for millions more. After accounting for under-reporting of benefits, safety net programs were shown to have lifted 46 million Americans, including 12 million children, out of poverty each year between 2009 and 2012, on average. 

In Maine, (a) 240,000 people, including 42,000 children, were lifted out of poverty by basic living standard programs each year between 2009 and 2012, on average (b) Supplemental Security Income (SSI), federal support for people with very limited resources who are elderly or with disabilities, or families caring for children with severe disabilities, lifted 24,000 out of poverty (c) 16,000 fewer people were poor because of housing subsidies; (d) 47,000 fewer people were poor because of SNAP (Food Stamps) (e) Low-income tax credits lifted 28,000 out of poverty each year between 2011-2013, on average (f) Nationally, more than 8.1 million people were lifted out of poverty by low-income refundable tax credits in 2016; (g) 3.1 million fewer were poor because of housing subsidies and (h) 3.6 million fewer people were poor because of the Supplemental Nutrition Assistance Program (i) SSI lifted 3.4 million people out of poverty, and (j) the school lunch program did the same for 1.3 million people. 

The Census data shows that 10.5 million more people would be in poverty if out-of-pocket medical costs were taken into account, showing the importance of quality, affordable health insurance.

In fact, programs that help provide basic living standards play a major – and increasingly important – role in the reduction of poverty that has occurred since the 1960s. 

Researchers using the Supplemental Poverty Measure and other data, including adjusting poverty thresholds for costs of living and different housing situations, found that poverty has actually decreased by more than one-third since 1967. According to this analysis, 13 government programs reduced the national poverty rate by 12.0 percentage points in 2014 and lifted more than 50 million people above the SPM poverty line that year. In Maine, the poverty rate would have been 14.6 percentage points, higher in 2014, without government programs; child poverty would have been 12.5 percentage points higher, and poverty among the elderly would have been 42.2 percentage points higher in 2014, without these programs.

Programs that help Maine people to achieve basic living standards do more than lift people out of poverty. Medicaid allows low-income individuals to address health issues and live healthier and more productive lives, even improving health outcomes across generations. A recent study found that the grown children of women who had received Medicaid during their pregnancies were more likely to have healthier babies. 

Housing vouchers sharply reduce housing instability and homelessness, as well as other hardships like food insecurity, domestic violence and child separation, for recipients, 68 percent of whom are seniors, children, or people with disabilities. SNAP is our nation’s largest child nutrition program – one in four children in the U.S. lives in families that receive SNAP benefits. SNAP improves the health and educational outcomes of children in the near- and long-term and improves the health of their parents. 

Families participating in SNAP are also 28 percent more likely to be able to pay for medical expenses without forgoing basic necessities like food, rent and utilities. In addition, SNAP is an economy booster: economists estimate that in a weak economy, $1 in SNAP benefits expands the economy by about $1.70.18 In a recent survey in Maine, nearly half of respondents said they would go hungry without SNAP.19 Federal and state assistance programs also help people get and keep good jobs. 

Child care subsidies, for example, allow parents to go to work or school and provide children with quality educational experiences in the critical early years. Single mothers were more likely to be employed, more likely to be employed full time, and more likely to have stable employment when receiving child care subsidies.

Unfortunately, many of these effective anti-poverty programs do not reach enough of the people they are designed to help. The Temporary Assistance for Needy Families program was designed to help families meet their most basic needs and provide employment, education and training services for low-income parents. But the number of Maine families receiving cash benefits through TANF has dropped 66 percent since May 2012, when a state-imposed five-year lifetime cap on benefits took effect.

Two-thirds of people in Maine who lost benefits as a result of the cap still didn’t have work four years after the cap took effect, leaving most families without cash assistance or earnings from employment. And the third who did work were not earning enough to make ends meet.

All told, roughly 9,000 Maine families, including 16,000 children, lost help from the TANF program between 2011-2016.23 More than 28 million Americans, including 106,000 Mainers, remain uninsured. Low-income adults in the states that refused to expand access to Medicaid to their low-income residents are uninsured at nearly twice the rates of those in states that have taken this step to expand coverage, leaving them at even greater risk for overwhelming medical costs and, too often, forcing them to forgo necessary medical treatments. 

The lack of child care holds back working parents. Only one out of seven children eligible to receive federal child care assistance is getting any help, and more than 373,000 children in need have lost access to child care since 2006, including 2,600 children in Maine, leaving families to struggle to pay for care or forgo jobs to stay home and provide care. 

Nationally, only one in four qualifying renters receives rental assistance because Congress has not provided enough funding.

Between 2004 and 2015, the number of families with children receiving rental vouchers dropped by 250,000 – a 13 percent decline. This is despite the fact that the Census 5 data show that 45 percent of Maine households with income less than $20,000 a year spend more than half of their income on housing. The Earned Income Tax Credit (EITC), an extremely effective anti-poverty and pro-work tax credit, provides far less help to low-income workers who aren’t raising children. This group has an unenviable distinction as the only group of Americans who are taxed into poverty. 

Expanding the EITC to these workers would benefit up to 16.2 million people.

Similarly, families with children earning less than $3,000 a year are excluded from claiming the Child Tax Credit (CTC), denying help to children because their parents, despite working, are too poor. Expanding the CTC to these poorest children and families would benefit millions every year. As noted above, Maine’s Governor and policy makers have instituted changes in recent years that have further limited access to anti-poverty programs in our state. We know that there are approximately 100,000 fewer people receiving help from assistance programs in our state than did in 2011, when most of these policy changes began. This could include tens of thousands who would have been lifted out of poverty had those changes not been made. The Trump Administration and Congress Would Make Maine Poorer Proposals from President Trump and leadership in Congress to cut successful anti-poverty programs like Medicaid, SNAP, housing assistance, and others would harm individuals and families and would turn back the progress we’ve made in reducing poverty. 

For example, the House and Senate passed a joint FY 2018 Budget Resolution that calls for about $5 trillion dollars in cuts through 2027 to the full range of services the federal government provides, except for allowing increases in military spending. It would cut Medicaid, the Affordable Care Act (ACA), and other health programs by $1.3 trillion over that ten-year period. Medicare would be cut by $473 billion. Programs in the “income security” category (which includes SNAP/food stamps, Supplemental Security Income for poor seniors and people with disabilities, Temporary Assistance for Needy Families, unemployment insurance and low-income tax credits) would drop by $653 billion. The Senate plan calls for $800 billion in cuts to domestic appropriations, threatening further cuts to housing, education, and substance abuse treatment, to name just a few. By 2027, the Senate budget would slash these programs to 29 percent below their levels in FY 2010, taking inflation into account. 

If these cuts are made proportionally, by 2027, 900,000 low-income households would lose their rent subsidies,  despite their success in lifting millions of families out of poverty. 

Even with the ACA remaining in place, the Trump administration has announced it will allow inadequate insurance plans that do not assure protections for people with pre-existing conditions or expensive medical needs. The administration will stop making payments to insurance companies for low-income policy-holders, all aimed at further weakening the law. In addition, the Trump administration has been undermining the ACA by refusing to advertise open enrollment or to approve requests by states to improve their programs. 

These actions, plus unspecified Medicaid and ACA cuts in the budget, can significantly undo the progress made in reducing the number of uninsured Mainers by 41,000 since 2013 and threaten the impact of Maine’s newly voter-enacted Medicaid expansion law. While not all of the cuts in the budget are expected to become law, they show the vision of the House and Senate leadership – to drastically reduce critical programs for low-income families. 

Cuts in President Trump’s budget are extremely harsh, including $4.3 trillion in cuts to Social Security, Medicare, Medicaid, education, and other programs and services that help working families get by and get ahead. 

If just three of President Trump’s proposed budget cuts had been in effect in 2015, an additional 2.3 million Americans would have been in poverty that year. 

In addition to these threats, passage of the budget resolution will allow Congress to use special rules known as reconciliation to fast-track huge tax cuts for the wealthy and corporations, and perhaps to expedite cuts to safety net programs as well, and to do so with only a simple majority in the Senate.

The budget will allow Congress to increase the deficit by $1.5 trillion over 10 years to give tax cuts to those with the highest incomes. The loss of this revenue will inevitably hurt low- and middle-income Americans, both because services they need are slated for cuts at the outset, and because a ballooning debt will eventually increase pressure to cut programs people rely on. Spending bills passed by the House in July and September for Fiscal Year 2018 would also continue and worsen years of cuts, totaling more than $8 billion to non-defense programs. This includes slashing or eliminating multiple education programs, apprenticeship and employment services, low-income housing, community development programs, mental health and substance abuse treatment, programs to remove lead and other harmful toxins from homes, and other programs vital to low-income communities. The House spending package fails to renew nearly 140,000 housing vouchers in use this year, including 744 vouchers in Maine, increasing homelessness and housing instability. 

In total, the House spending package cuts critical non-defense programs $5 billion below the already austere sequestration-level spending caps for FY18. 

As the House and Senate have not yet actually agreed upon detailed spending bills for FY18, which began October 1, (this date has now been extended into January 2018) most government programs are operating with funding levels that are flat from 2017. 

While this avoids disastrous cuts to critical low-income programs in the short term, inflation continues to erode them, and it also denies them the additional investments they need to be able to expand to help more people. Before the current stop-gap spending bill expires in December, Congress needs to agree on a bipartisan deal to lift the harmful sequester spending limits on domestic discretionary (annually-appropriated) programs for FY18 and future years that will allow for these necessary investments. As mentioned above, Congressional leadership and President Trump are proposing devastating cuts to human needs programs while also trying to fast-track massive tax cuts for the rich and for corporations. 

Tax cut bills passed by the House and Senate benefit those at the top by, for example, repealing or reducing taxes that only affect taxpayers with the highest incomes. 

Moreover, the Republican tax plan will also slash the corporate tax rate. The bills would not only reduce federal coffers by trillions of dollars over a decade, taking away money that could instead be invested in improving the lives of low- and middle-income Americans, they would starve local and state governments, too, affecting education, public safety, and other services they provide. Taxpayers in the top 1 percent would receive 31 percent of the plan’s net tax cuts in 2018, and 48 percent of the cuts in 2027.

Numerous studies have shown that tax cuts for the wealthy and corporations create few jobs or economic growth, despite the fact that these claims are often used as excuses for such cuts.

President Trump’s decision to end the Deferred Action for Childhood Arrivals (DACA) program threatens to strip from 800,000 young adults – including roughly 40 in Maine – the ability to work legally and, in some states, the ability to drive legally and attend college to better their lives. 

Forcing these individuals, more than 90 percent of whom have jobs, and who are more likely than the general population to start their own businesses,36 to again live in the shadows or be deported will surely not decrease poverty in our nation. 

In fact, a prominent economist has estimated that five years after a repeal of DACA, the nation’s gross domestic product would be $105 billion less than it would be if the program stays in place.37 Additional proposals in Congress that would add work requirements to SNAP or Medicaid would hurt individuals and our nation, not help them. 

Studies have shown that work requirements – including those instituted here in Maine – don’t have a significant effect on work efforts or the well-being of those subjected to them, don’t cut poverty, and in some cases actually increase poverty. 

In October 2014, Maine reinstated statewide time limits for SNAP recipients who weren’t employed at least half-time or in a qualifying work or training program, even if they were searching diligently for a job or working less than 20 hours a week. 

This caused thousands of the state’s poorest residents to lose essential SNAP benefits; participation in SNAP among childless adults subjected to the time limit fell 70-80 percent after the time limit returned. 

At the same time, Maine work rates were nearly the same before and after the time limit. A proposal to add work requirements to MaineCare is also misguided and harmful. More than 30,000 Mainers with low income, and some with chronic conditions, would be subject to a work requirement, premium payments, and asset tests under a proposed waiver. Thousands will likely lose access to affordable health care and have no other means of obtaining it, leaving their medical conditions to worsen and leaving them less able to get and maintain employment. 

This proposal would not only hurt those Mainers directly affected by it, but it would hurt Maine’s economy as well.

Similarly, national proposals to tie work requirements to Medicaid would likely increase the number of uninsured and leave without coverage individuals who can’t work because they are caring for a family member, have a mental health issue, are without access to child care or transportation, or are working but do not have enough hours. Adding work requirements to SNAP nationwide is also misguided, as the vast majority of SNAP recipients are either already working, are looking for work, are unable to work, or are not expected to work (children or the elderly). 

More than 50 percent of households with at least one working-age, non-disabled adult worked while receiving SNAP, with more than 80 percent working in the year prior to or after receiving SNAP. 

In families with children, more than 60 percent of recipients work while receiving SNAP, with almost 90 percent working in the year prior to or after receiving benefits.

The Census Bureau data also shows that in nearly two-thirds of poor families in Maine, at least one person worked at least part time or part of the year. 

In addition to the human toll poverty takes, it is also expensive for our nation. Child poverty alone has been estimated to cost the U.S. economy 3.8 percent of our gross domestic product (GDP), or $672 billion in 2015.  Child poverty results in a less-educated workforce, which reduces productivity and economic output years later, and higher physical and mental health costs. 

Unstable housing among families with children will cost the nation as estimated $111 billion in health and education expenditures over the next ten years.

If our elected leaders really want to boost our economy, and create jobs and a highly-skilled labor force, they would invest in programs that lift millions of children out of poverty, not cut them. 

Rather than cut, Americans should invest in programs that allow parents to find and keep good paying jobs, like training programs, scheduling and paid leave protections, and child care. And they would require the wealthy and big corporations to pay their fair share, so we can increase these investments. 

We Can – and must – continue to make progress for the millions still struggling. We can – and should – do more to further reduce poverty for the millions of Americans still struggling. 

To achieve this goal, Maine Equal Justice Partners and the Coalition on Human Needs recommend the following actions for Congress and President Trump: 

 Reject cuts to proven anti-poverty programs; instead protect and expand funding for programs including SNAP, Medicaid, housing subsidies and others. 

 Reject tax cuts for the wealthy and corporations that will lead to further cuts in domestic programs. Paying for tax cuts for the rich while cutting programs for the poor, infrastructure investments and public health protections is simply wrong. Corporations and the wealthy need to pay their fair share. 

 Lift sequester caps for domestic discretionary programs to boost investments in education and many other programs. A bipartisan deal, similar to those reached in past years, is needed to lift the austere sequester-level spending caps for FY18 and beyond. 

 Increase federal funding for housing subsidies and child care subsidies. As Congress continues its FY18 appropriations process, it should increase funding to provide millions more low-income Americans in need with access to safe, stable housing and quality, affordable child care. 

 Expand the Earned Income Tax Credit to workers not raising children and expand the Child Tax Credit to families making less than $3,000 a year. A bipartisan group of members of Congress have previously shown support for expanding the EITC, so helping workers without dependent children should be a top priority for Congress. Congress should also act to ensure all low-income children benefit from the CTC. 

 Reject harsh time limits and work requirements for SNAP, Medicaid, and subsidized housing recipients. Congress should end the harsh time limits on SNAP benefits for certain jobless adults willing to work. 

 Congress should once and for all abandon efforts to repeal the Affordable Care Act and instead stabilize the law’s insurance markets. Maine should promptly implement the vote of the people to provide Medicaid to all under 138 percent of the federal poverty level. 

Other states should follow. 

States that haven’t yet expanded health coverage to low-income Americans by drawing down federal Medicaid dollars should do so. Governors of states that have continued to deny health coverage to low-income residents should end this costly failure 9 to take advantage of federal dollars on the table to provide necessary health care to those who can least afford it. 

 Congress should enact the Dream Act, providing legal status and a path to citizenship for the young people brought to this country as children. America is the only home many of them have ever known. They are Americans and should be regarded as such. 

Dreamers deserve freedom to work, learn, and serve in the armed services, where they contribute to economic growth. 

Reducing poverty clearly should be a top priority for our nation. The evidence shows that proven antipoverty programs like SNAP, housing assistance, and low-income tax credits are effective at lifting millions of people out of poverty and building family economic security. As a whole, the U.S. has made progress in reducing poverty and now is not the time to turn back this progress. 

Maine, which has not shared in that progress in recent years, serves as a cautionary tale. Harmful cuts to Maine’s anti-poverty programs have coincided with shameful outcomes related to hunger, health care and child poverty. 

Frankly, the last thing we should be doing as a nation is cutting programs for those who need help the most to give giant tax cuts to those who most certainly do not need it. 

Instead, Congress and the Trump administration must invest more in proven anti-poverty programs to speed up this progress and extend it to more of our neighbors in Maine. 

This report was prepared by Maine Equal Justice Partners and the Coalition on Human