GOP Playbook Useless in Health Care Fight

David Weigel

Republicans gear up to counter Democrats' plans for health care reform.

Mitt Romney arrived at the House Republicans’ late-January retreat to a room that hardly needed a pep talk. Their vote against the Democrats’ Economic Recovery Act had revved them up; all Romney needed to tell them was that they “stood strong,” and that their fellow Republicans stood proud. Romney, who’d testified at the sole House Republican hearing on the stimulus, urged them to take one step further.

“We remain the confident voice of limited government and free enterprise,” said Romney. “These principles are going to face another test when it comes to health care. We should be first to propose a Republican plan to bring health insurance to all Americans, one based on market dynamics, free choice, and personal responsibility. Whatever direction we take, let’s not simply react to what the Democrats do.”

The House Republicans took Romney’s advice. Six days after his speech the party announced the formation of the House GOP Health Care Task Force, an ad hoc group of 16 members that would, in the words of Rep. Roy Blunt (R-Mo.) craft “real solutions to improve our health care system by putting patients before paperwork and frivolous lawsuits.”

As the stimulus debate winds to a close, it would appear that House Republicans are picking up their playbook and taking what they need for the coming battle over health care reform. But based on conversations with Republicans inside and outside of Congress, the right does not expect the strategy to work with health care, an issue that all consider strong Democratic turf. The Romney concept of “pre-empting” Democrats is a rearguard effort, something that will produce a list of Republican health care policies that the party can point to when Democrats charge them with obstruction, as they did with their for-show versions of a stimulus package. Republicans, who have developed a consensus about the virtues of tax cuts, have not done that same work on health care.

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“Republicans have been absolutely dreadful on health care,” said John Goodman, the president of the National Center for Policy Analysis, who devised the first Health Savings Accounts in the 1980s and who helped craft Sen. John McCain’s health care policy in the 2008 campaign. “They’re always on defense, they always let the Democrats take the initiative, then they scramble to come up with alternatives.”

While the Republicans’ stimulus working group came out of the gate with a media strategy, a public hearing (with guests Romney and former eBay CEO Meg Whitman) and an uncontroversial package of tax cuts, the health care group is operating below the radar and concentrating on message before policy. At their first meeting, Republicans did not meet with heads of the health care industry or with policy wonks, but with Dave Winston of the Winston Group, a polling firm that does the bulk of its work for the GOP. The second meeting brought in Steve Burd, the CEO of Safeway, the supermarket chain that has donated a total of $18,498 to members of the task force, according to Opensecrets.org.

Reached by TWI Thursday, Winston confirmed that he showed Republicans polling data on whether Americans favor “private” or “government” solutions for health care. “By an overwhelming margin, people prefer private over government-run health care,” said Winston, “but you have this big group who say [they] want some combination of private and public solutions. And of course, that’s what we have now.”

Winston recommended that Republicans pull their plans off the shelf and “modernize them,” while warning them that their disadvantage on the issue is steep—Americans trust Democrats over Republicans on health care by anywhere from 15 to 30 percentage points.

Some critics of the House Republicans speculated that the health care task force was a vehicle for spin, not a sweatshop where ideas would be hammered out. The fact that the effort is headed by Blunt, the former whip whose portfolio has shrunk since handing that job to Rep. Eric Cantor (R-Va.), perplexed some analysts who consider the less senior members of the task force, such as Rep. Ryan, more serious about health care.

“Paul Ryan is a real force in that conference,” said Len Nichols, the director of the Healthy Policy Program at the progressive New America Foundation, and the senior health care adviser for the Office of Management and Budget during President Clinton’s 1993-1994 push. “Ryan ought to be chairing this. But the Republicans don’t ask me what to do.”

Brendan Buck, a spokesman for task force member Rep. Tom Price (R-Ga.) disputed the idea that Republicans were “reactionary” on health care. “He has a comprehensive bill that’s he’s introduced every Congress,” said Buck. “That’s not reactive.”

Since the last significant health care reform, the 2003 passage of the Medicare Prescription Drug, Improvement and Modernization Act, other Republican members in the House—not just Price—have introduced health care bills that propose reforms such as a refundable tax credit for health insurance and letting consumers purchase health care plans across state lines. But According to Goodman and other free-market health care reform advocates, the party has never taken reform seriously enough to come up with an agenda that can compete with the Democratic agenda.

“I don’t like it,” said Robert Moffit, the director of the Center for Health Policy Studies at the conservative-leaning Heritage Foundation, “but there are people who mouth things about choice and free markets and don’t know what they’re saying.”

The Republicans’ stimulus playbook will be harder to apply to health care because the Senate, where Democrats had to work to broker a stimulus deal, is a softer sell on health care reform. Even after the losses of 2006 and 2008, the Senate includes several senior Republicans from safe seats who have been breaking bread with Democrats over health care. Sen. Ron Wyden (D-Oregon), a dark horse candidate for Secretary of Health and Human Services, has collected five Republican co-sponsors for his Healthy Americans Act, which would cover uninsured Americans through, among other policy changes, employer taxes. Sen. Bob Bennett (R-Utah), a veteran of the 1993-1994 health care battle who wanted to make a deal with Democrats, is Wyden’s chief co-sponsor.

“He’s smart as hell,” said Nichols of Bennett, “and he wants some sort of bi-partisan reform.”

In their battle against the stimulus, Republicans could count not just on party unity, but ideological unity—few members of either House agree with the Democrats’ Keynsian approach to the economic crisis. On health care, the GOP’s message is far from figured out. While January’s stimulus working group ran a tight press shop that connected reporters to its members, calls to several of the health care task force members went unreturned while Rep. Dave Camp (R-Mich.) postponed an interview.

David Weigel is a staff writer covering the conservative movement at the Washington Independent.

Analysis Economic Justice

New Pennsylvania Bill Is Just One Step Toward Helping Survivors of Economic Abuse

Annamarya Scaccia

The legislation would allow victims of domestic violence, sexual assault, and stalking to terminate their lease early or request locks be changed if they have "a reasonable fear" that they will continue to be harmed while living in their unit.

Domestic violence survivors often face a number of barriers that prevent them from leaving abusive situations. But a new bill awaiting action in the Pennsylvania legislature would let survivors in the state break their rental lease without financial repercussions—potentially allowing them to avoid penalties to their credit and rental history that could make getting back on their feet more challenging. Still, the bill is just one of several policy improvements necessary to help survivors escape abusive situations.

Right now in Pennsylvania, landlords can take action against survivors who break their lease as a means of escape. That could mean a lien against the survivor or an eviction on their credit report. The legislation, HB 1051, introduced by Rep. Madeleine Dean (D-Montgomery County), would allow victims of domestic violence, sexual assault, and stalking to terminate their lease early or request locks be changed if they have “a reasonable fear” that they will continue to be harmed while living in their unit. The bipartisan bill, which would amend the state’s Landlord and Tenant Act, requires survivors to give at least 30 days’ notice of their intent to be released from the lease.

Research shows survivors often return to or delay leaving abusive relationships because they either can’t afford to live independently or have little to no access to financial resources. In fact, a significant portion of homeless women have cited domestic violence as the leading cause of homelessness.

“As a society, we get mad at survivors when they don’t leave,” Kim Pentico, economic justice program director of the National Network to End Domestic Violence (NNEDV), told Rewire. “You know what, her name’s on this lease … That’s going to impact her ability to get and stay safe elsewhere.”

“This is one less thing that’s going to follow her in a negative way,” she added.

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Pennsylvania landlords have raised concerns about the law over liability and rights of other tenants, said Ellen Kramer, deputy director of program services at the Pennsylvania Coalition Against Domestic Violence, which submitted a letter in support of the bill to the state House of Representatives. Lawmakers have considered amendments to the bill—like requiring “proof of abuse” from the courts or a victim’s advocate—that would heed landlord demands while still attempting to protect survivors.

But when you ask a survivor to go to the police or hospital to obtain proof of abuse, “it may put her in a more dangerous position,” Kramer told Rewire, noting that concessions that benefit landlords shift the bill from being victim-centered.

“It’s a delicate balancing act,” she said.

The Urban Affairs Committee voted HB 1051 out of committee on May 17. The legislation was laid on the table on June 23, but has yet to come up for a floor vote. Whether the bill will move forward is uncertain, but proponents say that they have support at the highest levels of government in Pennsylvania.

“We have a strong advocate in Governor Wolf,” Kramer told Rewire.

Financial Abuse in Its Many Forms

Economic violence is a significant characteristic of domestic violence, advocates say. An abuser will often control finances in the home, forcing their victim to hand over their paycheck and not allow them access to bank accounts, credit cards, and other pecuniary resources. Many abusers will also forbid their partner from going to school or having a job. If the victim does work or is a student, the abuser may then harass them on campus or at their place of employment until they withdraw or quit—if they’re not fired.

Abusers may also rack up debt, ruin their partner’s credit score, and cancel lines of credit and insurance policies in order to exact power and control over their victim. Most offenders will also take money or property away from their partner without permission.

“Financial abuse is so multifaceted,” Pentico told Rewire.

Pentico relayed the story of one survivor whose abuser smashed her cell phone because it would put her in financial dire straits. As Pentico told it, the abuser stole her mobile phone, which was under a two-year contract, and broke it knowing that the victim could not afford a new handset. The survivor was then left with a choice of paying for a bill on a phone she could no longer use or not paying the bill at all and being turned into collections, which would jeopardize her ability to rent her own apartment or switch to a new carrier. “Things she can’t do because he smashed her smartphone,” Pentico said.

“Now the general public [could] see that as, ‘It’s a phone, get over it,'” she told Rewire. “Smashing that phone in a two-year contract has such ripple effects on her financial world and on her ability to get and stay safe.”

In fact, members of the public who have not experienced domestic abuse may overlook financial abuse or minimize it. A 2009 national poll from the Allstate Foundation—the philanthropic arm of the Illinois-based insurance company—revealed that nearly 70 percent of Americans do not associate financial abuse with domestic violence, even though it’s an all-too-common tactic among abusers: Economic violence happens in 98 percent of abusive relationships, according to the NNEDV.

Why people fail to make this connection can be attributed, in part, to the lack of legal remedy for financial abuse, said Carol Tracy, executive director of the Women’s Law Project, a public interest law center in Pennsylvania. A survivor can press criminal charges or seek a civil protection order when there’s physical abuse, but the country’s legal justice system has no equivalent for economic or emotional violence, whether the victim is married to their abuser or not, she said.

Some advocates, in lieu of recourse through the courts, have teamed up with foundations to give survivors individual tools to use in economically abusive situations. In 2005, the NNEDV partnered with the Allstate Foundation to develop a curriculum that would teach survivors about financial abuse and financial safety. Through the program, survivors are taught about financial safety planning including individual development accounts, IRA, microlending credit repair, and credit building services.

State coalitions can receive grant funding to develop or improve economic justice programs for survivors, as well as conduct economic empowerment and curriculum trainings with local domestic violence groups. In 2013—the most recent year for which data is available—the foundation awarded $1 million to state domestic violence coalitions in grants that ranged from $50,000 to $100,000 to help support their economic justice work.

So far, according to Pentico, the curriculum has performed “really great” among domestic violence coalitions and its clients. Survivors say they are better informed about economic justice and feel more empowered about their own skills and abilities, which has allowed them to make sounder financial decisions.

This, in turn, has allowed them to escape abuse and stay safe, she said.

“We for a long time chose to see money and finances as sort of this frivolous piece of the safety puzzle,” Pentico told Rewire. “It really is, for many, the piece of the puzzle.”

Public Policy as a Means of Economic Justice

Still, advocates say that public policy, particularly disparate workplace conditions, plays an enormous role in furthering financial abuse. The populations who are more likely to be victims of domestic violence—women, especially trans women and those of color—are also the groups more likely to be underemployed or unemployed. A 2015 LGBT Health & Human Services Network survey, for example, found that 28 percent of working-age transgender women were unemployed and out of school.

“That’s where [economic abuse] gets complicated,” Tracy told Rewire. “Some of it is the fault of the abuser, and some of it is the public policy failures that just don’t value women’s participation in the workforce.”

Victims working low-wage jobs often cannot save enough to leave an abusive situation, advocates say. What they do make goes toward paying bills, basic living needs, and their share of housing expenses—plus child-care costs if they have kids. In the end, they’re not left with much to live on—that is, if their abuser hasn’t taken away access to their own earnings.

“The ability to plan your future, the ability to get away from [abuse], that takes financial resources,” Tracy told Rewire. “It’s just so much harder when you don’t have them and when you’re frightened, and you’re frightened for yourself and your kids.”

Public labor policy can also inhibit a survivor’s ability to escape. This year, five states, Washington, D.C., and 24 jurisdictions will have passed or enacted paid sick leave legislation, according to A Better Balance, a family and work legal center in New York City. As of April, only one of those states—California—also passed a state paid family leave insurance law, which guarantees employees receive pay while on leave due to pregnancy, disability, or serious health issues. (New Jersey, Rhode Island, Washington, and New York have passed similar laws.) Without access to paid leave, Tracy said, survivors often cannot “exercise one’s rights” to file a civil protection order, attend court hearings, or access housing services or any other resource needed to escape violence.

Furthermore, only a handful of state laws protect workers from discrimination based on sex, sexual orientation, gender identity, and pregnancy or familial status (North Carolina, on the other hand, recently passed a draconian state law that permits wide-sweeping bias in public and the workplace). There is no specific federal law that protects LGBTQ workers, but the U.S. Employment Opportunity Commission has clarified that the Civil Rights Act of 1964 does prohibit discrimination based on gender identity and sexual orientation.

Still, that doesn’t necessarily translate into practice. For example, the National Center for Transgender Equality found that 26 percent of transgender people were let go or fired because of anti-trans bias, while 50 percent of transgender workers reported on-the-job harassment. Research shows transgender people are at a higher risk of being fired because of their trans identity, which would make it harder for them to leave an abusive relationship.

“When issues like that intersect with domestic violence, it’s devastating,” Tracy told Rewire. “Frequently it makes it harder, if not impossible, for [victims] to leave battering situations.”

For many survivors, their freedom from abuse also depends on access to public benefits. Programs like Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), the child and dependent care credit, and earned income tax credit give low-income survivors access to the money and resources needed to be on stable economic ground. One example: According to the Center on Budget and Policy Priorities, where a family of three has one full-time nonsalary worker earning $10 an hour, SNAP can increase their take-home income by up to 20 percent.

These programs are “hugely important” in helping lift survivors and their families out of poverty and offset the financial inequality they face, Pentico said.

“When we can put cash in their pocket, then they may have the ability to then put a deposit someplace or to buy a bus ticket to get to family,” she told Rewire.

But these programs are under constant attack by conservative lawmakers. In March, the House Republicans approved a 2017 budget plan that would all but gut SNAP by more than $150 million over the next ten years. (Steep cuts already imposed on the food assistance program have led to as many as one million unemployed adults losing their benefits over the course of this year.) The House GOP budget would also strip nearly $500 billion from other social safety net programs including TANF, child-care assistance, and the earned income tax credit.

By slashing spending and imposing severe restrictions on public benefits, politicians are guaranteeing domestic violence survivors will remain stuck in a cycle of poverty, advocates say. They will stay tethered to their abuser because they will be unable to have enough money to live independently.

“When women leave in the middle of the night with the clothes on their back, kids tucked under their arms, come into shelter, and have no access to finances or resources, I can almost guarantee you she’s going to return,” Pentico told Rewire. “She has to return because she can’t afford not to.”

By contrast, advocates say that improving a survivor’s economic security largely depends on a state’s willingness to remedy what they see as public policy failures. Raising the minimum wage, mandating equal pay, enacting paid leave laws, and prohibiting employment discrimination—laws that benefit the entire working class—will make it much less likely that a survivor will have to choose between homelessness and abuse.

States can also pass proactive policies like the bill proposed in Pennsylvania, to make it easier for survivors to leave abusive situations in the first place. Last year, California enacted a law that similarly allows abuse survivors to terminate their lease without getting a restraining order or filing a police report permanent. Virginia also put in place an early lease-termination law for domestic violence survivors in 2013.

A “more equitable distribution of wealth is what we need, what we’re talking about,” Tracy told Rewire.

As Pentico put it, “When we can give [a survivor] access to finances that help her get and stay safe for longer, her ability to protect herself and her children significantly increases.”

News Politics

Tim Kaine Changes Position on Federal Funding for Abortion Care

Ally Boguhn

The Obama administration, however, has not signaled support for rolling back the Hyde Amendment's ban on federal funding for abortion care.

Sen. Tim Kaine (D-VA), the Democratic Party’s vice presidential candidate, has promised to stand with nominee Hillary Clinton in opposing the Hyde Amendment, a ban on federal funding for abortion care.

Clinton’s campaign manager, Robby Mook, told CNN’s State of the Union Sunday that Kaine “has said that he will stand with Secretary Clinton to defend a woman’s right to choose, to repeal the Hyde amendment,” according to the network’s transcript.

“Voters can be 100 percent confident that Tim Kaine is going to fight to protect a woman’s right to choose,” Mook said.

The commitment to opposing Hyde was “made privately,” Clinton spokesperson Jesse Ferguson later clarified to CNN’s Edward Mejia Davis.

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Kaine’s stated support for ending the federal ban on abortion funding is a reversal on the issue for the Virginia senator. Kaine this month told the Weekly Standard  that he had not “been informed” that this year’s Democratic Party platform included a call for repealing the Hyde Amendment. He said he has “traditionally been a supporter of the Hyde amendment.”

Repealing the Hyde Amendment has been an issue for Democrats on the campaign trail this election cycle. Speaking at a campaign rally in New Hampshire in January, Clinton denounced Hyde, noting that it made it “harder for low-income women to exercise their full rights.”

Clinton called the federal ban on abortion funding “hard to justify” when asked about it later that month at the Brown and Black Presidential Forum, adding that “the full range of reproductive health rights that women should have includes access to safe and legal abortion.”

Clinton’s campaign told Rewire during her 2008 run for president that she “does not support the Hyde amendment.”

The Democratic Party on Monday codified its commitment to opposing Hyde, as well as the Helms Amendment’s ban on foreign assistance funds being used for abortion care. 

The Obama administration, however, has not signaled support for rolling back Hyde’s ban on federal funding for abortion care.

When asked about whether the president supported the repeal of Hyde during the White House press briefing Tuesday, Deputy Press Secretary Eric Schultz said he did not “believe we have changed our position on the Hyde Amendment.”

When pushed by a reporter to address if the administration is “not necessarily on board” with the Democratic platform’s call to repeal Hyde, Schultz said that the administration has “a longstanding view on this and I don’t have any changes in our position to announce today.”