health-care reform

Is Burwell v. Hobby Lobby about freedom of (corporate) conscience broadly, or is it just about a few specific contraceptives? It can’t really be both.

Ezra Klein’s work at the Washington Post is indispensable; he brings much insight to the task of making domestic policy accessible to those of us who only follow it part time. But I’m not buying this one:

There’s a tendency among some on the left and, with the “libertarian populists,” some on the right, to portray the interests of corporate American and the interests of low-income Americans as directly opposed to each other. That’s not true. They can conflict, of course — it’s easy enough to imagine a proposal to raise taxes on corporations in order to fund a low-income tax cut — but they’re not always in tension. Sometimes they’re even in concert.

Sometimes, sure.

Several GOP governors have made plans to go along with Obamacare's expansion of Medicaid. This is very good news.

Most people know only about the ACA's consumer-focused elements. Faith-based care providers are preparing for the law's other provisions as well.

With the Affordable Care Act upheld by the Supreme Court, Americans have yet another chance to learn about what the law actually contains.

The first is wonky fun; the second is just the regular kind.

Jonathan Chait is exactly right about the unspoken conservative position on health-care reform:

Opponents of the law have endlessly invoked “socialism.” Nothing in the Affordable Care Act or any part of President Obama’s challenges the basic dynamics of market capitalism. All sides accept that some of us should continue to enjoy vastly greater comforts and pleasures than others. If you don’t work as hard as Mitt Romney has, or were born less smart, or to worse parents, or enjoyed worse schools, or invested your skills in an industry that collapsed, or suffered any other misfortune, then you will be punished for this. Your television may be low-definition, or you might not be able to heat or cool your home as comfortably as you would like; you may clothe your children in discarded garments from the Salvation Army.

First the bishops sought an expanded exemption. Now they claim the contraception mandate itself violates religious liberty. It doesn't.

So, the Blunt amendment got killed in the Senate. And good riddance: you wouldn't know it from the L.A. Times's writeup, but the measure was a good bit broader than a reversal of the Obama administration's contraception mandate (which itself would have been nothing to celebrate). From the amendment text (pdf):

A health plan shall not be considered to have failed to provide the
essential health benefits package...on the basis that it declines to
provide coverage of specific items or services because...providing
coverage (or, in the case of a sponsor of a group health plan, paying
for coverage) of such specific items or services is contrary to the
religious beliefs or moral convictions of the sponsor, issuer, or other
entity offering the plan.

In other words, essentially a line-item veto of whatever the boss is morally opposed to, based on church teaching or otherwise.

The status quo on federal abortion funding leaves a lot to be desired, and not just for abortion-rights hardliners. Current law offers antiabortion citizens the peace of knowing that while abortion may be legal, at least their taxes aren't paying for it. In exchange for these clean hands, Americans get a system in which women who rely on the federal safety net for their health coverage don't have access to abortion, while women of greater means do. The Stupak Amendment to the House's health-insurance bill would make this inequality worse.

Longtime advocates of single-payer insurance like me are thrilled, anxious and deflated simultaneously by the state of the debate on health-care reform. The debate that we wanted has finally come, and it is coming with a legislative rush, but the plan that we wanted is being excluded from consideration. Should we hold out for the real thing, or get behind the best politically possible thing?

I am for doing both: Standing up for single-payer without holding out for it exclusively; supporting a public option without denying its limitations; and hoping that a good public plan will lead eventually to real national health insurance.