Reforming health care reform

megan.mullett

Women’s access to reproductive health care is currently under attack from both the left and the right.

President Obama has made health care reform a top priority,
which is welcome news to millions of un- or under-insured Americans.
Under the current system, women who purchase their own coverage already
pay more then men – sometimes up to 50% more.
As justification for the higher rates, insurers cite the fact that
women tend to use more heath care, especially during their childbearing
years. However, the rate disparity between women and men doesn’t
disappear in insurance plans which do not cover maternity care.
Healthcare reform holds the promise of more equitable pricing of
insurance for men and women.
 

 

Women
(both insured and uninsured) shouldn’t breathe a sigh of relief just
yet, however.  Women’s access to reproductive health care is currently
under attack from both the left and the right. Nineteen
House Democrats have said that they will not vote for healthcare
legislation unless it explicitly excludes abortion coverage
. The Republican leadership of the Senate Finance Committee is considering language in healthcare reform legislation that would eliminate coverage for abortion services. The exclusion of abortion services could result in women who currently have coverage losing that coverage, and prevent currently uninsured women from ever receiving coverage.
Health insurance is only as good as the services it covers, and having
health insurance that doesn’t cover the services you need is tantamount
to having no health insurance at all. 

 

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While healthcare reform is essential, reform at the expense of women’s health is too high a price to pay.  In
addition to expanding the number of people who have health insurance,
lawmakers should ensure that reform includes the healthcare services
Americans need. In the case of American women, that need is
comprehensive reproductive healthcare, including abortion coverage.
Comprehensive health care reform should be just that – comprehensive.

Analysis Politics

Experts: Trump’s Proposal on Child Care Is Not a ‘Solution That Deals With the Problem’

Ally Boguhn

“A simple tax deduction is not going to deal with the larger affordability problem in child care for low- and moderate-income individuals," Hunter Blair, a tax and budget analyst at the Economic Policy Institute told Rewire.

In a recent speech, GOP presidential nominee Donald Trump suggested he now supports policies to made child care more affordable, a policy position more regularly associated with the Democratic Party. The costs of child care, which have almost doubled in the last 25 years, are a growing burden on low- and middle-income families, and quality options are often scarce.

“No one will gain more from these proposals than low- and middle-income Americans,” claimed Trump in a speech outlining his economic platform before the Detroit Economic Club on Monday. He continued, “My plan will also help reduce the cost of childcare by allowing parents to fully deduct the average cost of childcare spending from their taxes.” But economic experts question whether Trump’s proposed solution would truly help alleviate the financial burdens faced by low- and middleincome earners.

Details of most of Trump’s plan are still unclear, but seemingly rest on addressing child care costs by allowing families to make a tax deduction based on the “average cost” of care. He failed to clarify further how this might work, simply asserting that his proposal would “reduce cost in child care” and offer “much-needed relief to American families,” vowing to tell the public more with time. “I will unveil my plan on this in the coming weeks that I have been working on with my daughter Ivanka … and an incredible team of experts,” promised Trump.

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An adviser to the Trump campaign noted during an interview with the Associated Press Monday that the candidate had yet to nail down the details of his proposal, such as what the income caps would be, but said that the deductions would only amount to the average cost of child care in the state a taxpayer resided in:

Stephen Moore, a conservative economist advising Trump, said the candidate is still working out specifics and hasn’t yet settled on the details of the plan. But he said households reporting between $30,000 and $100,000, or perhaps $150,000 a year in income, would qualify for the deduction.

“I don’t think that Britney Spears needs a child care credit,” Moore said. “What we want to do is to help financially stressed middle-class families have some relief from child-care expenses.”

The deduction would also likely apply to expensive care like live-in nannies. But exemptions would be limited to the average cost of child care in a taxpayer’s state, so parents wouldn’t be able to claim the full cost of such a high-price child care option.

Experts immediately pointed out that while the details of Trump’s plan are sparse, his promise to make average child care costs fully tax deductible wouldn’t do much for the people who need access to affordable child care most.

Trump’s plan “would actually be pretty poorly targeted for middle-class and low-income families,” Hunter Blair, a tax and budget analyst at the Economic Policy Institute (EPI), told Rewire on Monday.

That’s because his tax breaks would presumably not benefit those who don’t make enough money to owe the federal government income taxes—about 44 percent of households, according to Blair. “They won’t get any benefit from this.”

As the Associated Press further explained, for those who don’t owe taxes to the government, “No matter how much they reduce their income for tax purposes by deducting expenses, they still owe nothing.”

Many people still may not benefit from such a deduction because they file standard instead of itemized deductions—meaning they accept a fixed amount instead of listing out each qualifying deduction. “Most [lower-income households] don’t choose to file a tax return with itemized deductions,” Helen Blank, director of child care and early learning at the National Women’s Law Center (NWLC), told Rewire Tuesday. That means the deduction proposed by Trump “favors higher income families because it’s related to your tax bracket, so the higher your tax bracket the more you benefit from [it],” added Blank.

A 2014 analysis conducted by the Congressional Research Service confirms this. According to its study, just 32 percent of tax filers itemized their deductions instead of claiming the standard deduction in 2011. While 94 to 98 percent of those with incomes above $200,000 chose to itemize their deductions, just 6 percent of tax filers with an adjusted gross income below $20,000 per year did so.

“Trump’s plan is also not really a solution that deals with the problem,” said Blair. “A simple tax deduction is not going to deal with the larger affordability problem in child care for low- and moderate-income individuals.”

Those costs are increasingly an issue for many in the United States. A report released last year by Child Care Aware® of America, which advocates for “high quality, affordable child care,” found that child care for an infant can cost up to an average $17,062 annually, while care for a 4-year-old can cost up to an average of $12,781.

“The cost of child care is especially difficult for families living at or below the federal poverty level,” the organization explained in a press release announcing those findings. “For these families, full-time, center-based care for an infant ranges from 24 percent of family income in Mississippi, to 85 percent of family income in Massachusetts. For single parents the costs can be overwhelming—in every state annual costs of center-based infant care averaged over 40 percent of the state median income for single mothers.”

“Child care now costs more than college in most states in our nation, and it is an actual true national emergency,” Kristin Rowe-Finkbeiner, CEO and executive director of MomsRising, told Rewire in a Tuesday interview. “Donald Trump’s new proposed child care tax deduction plan falls far short of a solution because it’s great for the wealthy but it doesn’t fix the child care crisis for the majority of parents in America.”

Rowe-Finkbeiner, whose organization advocates for family economic security, said that in addition to the tax deduction being inaccessible to those who do not itemize their taxes and those with low incomes who may not pay federal income taxes, Trump’s proposal could also force those least able to afford it “to pay up-front child care costs beyond their family budget.”

“We have a crisis … and Donald Trump’s proposal doesn’t improve access, doesn’t improve quality, doesn’t lift child care workers, and only improves affordability for the wealthy,” she continued.

Trump’s campaign, however, further claimed in a statement to CNN Tuesday that “the plan also allows parents to exclude child care expenses from half of their payroll taxes—increasing their paycheck income each week.”

“The working poor do face payroll taxes for Social Security and Medicare, so a payroll tax break could help them out,” reported CNN. “But experts say it would be hard to administer.”

Meanwhile, Democratic presidential nominee Hillary Clinton released her own child care agenda in May, promising to use the federal government to cap child care costs at 10 percent of a family’s income. 

A cap like this, Blank said, “would provide more help to low- and middle-income families.” She continued, “For example, if you had a family with two children earning $70,000, if you capped child care at 10 percent they could probably save … $10,000 a year.”

Clinton’s plan includes a promise to implement a program to address the low wages many who work in the child care industry face, which she calls the “Respect And Increased Salaries for Early Childhood Educators” program, or the RAISE Initiative. The program would raise pay and provide training for child-care workers.

Such policies could make a major difference to child-care workers—the overwhelming majority of which are women and workers of color—who often make poverty-level wages. A 2015 study by the EPI found that the median wage for these workers is just $10.31 an hour, and few receive employer benefits. Those poor conditions make it difficult to attract and retain workers, and improve the quality of care for children around the country. 

Addressing the low wages of workers in the field may be expensive, but according to Rowe-Finkbeiner, it is an investment worth making. “Real investments in child care bring for an average child an eight-to-one return on investment,” she explained. “And that’s because when we invest in quality access and affordability, but particularly a focus on quality … which means paying child-care workers fairly and giving child-care workers professional development opportunities …. When that happens, then we have lower later grade repetition, we have less future interactions with the criminal justice system, and we also have a lower need for government programs in the future for those children and families.

Affordable child care has also been a component of other aspects of Clinton’s campaign platform. The “Military Families Agenda,” for example, released by the Clinton campaign in June to support military personnel and their families, also included a child care component. The former secretary of state’s plan proposed offering these services “both on- and off-base, including options for drop-in services, part-time child care, and the provision of extended-hours care, especially at Child Development Centers, while streamlining the process for re-registering children following a permanent change of station (PCS).” 

“Service members should be able to focus on critical jobs without worrying about the availability and cost of childcare,” said Clinton’s proposal.

Though it may be tempting to laud the simple fact that both major party candidates have proposed a child care plan at all, to Rowe-Finkbeiner, having both nominees take up the cause is a “no-brainer.”

“Any candidate who wants to win needs to take up family economic security policies, including child care,” she said. “Democrats and Republicans alike know that there is a child care crisis in America. Having a baby right now costs over $200,000 to raise from zero to age 18, not including college …. Parents of all political persuasions are talking about this.”

Coming up with the right way to address those issues, however, may take some work.

“We need a bold plan because child care is so important, because it helps families work, and it helps them support their children,” the NWLC’s Blank said. “We don’t have a safety net for families to fall back on anymore. It’s really critical to help families earn the income their children need and child care gives children a strong start.” She pointed to the need for programs that offer families aid “on a regular basis, not at the end of the year, because families don’t have the extra cash to pay for child care during the year,” as well as updates to the current child care tax credits offered by the government.

“There is absolutely a solution, but the comprehensive package needs to look at making sure that children have high-quality child care and early education, and that there’s also access to that high-quality care,” Rowe-Finkbeiner told Rewire. 

“It’s a complicated problem, but it’s not out of our grasp to fix,” she said. “It’s going to take an investment in order to make sure that our littlest learners can thrive and that parents can go to work.”

Analysis Politics

Reminder: Kasich Has Made Accessing Reproductive Health Care in Ohio More Difficult

Ally Boguhn

Republican presidential candidate John Kasich once again touted his record on reproductive health while speaking at a town hall event Monday, despite having made access to that care more difficult during his tenure as Ohio governor.

Republican presidential candidate John Kasich once again touted his record on reproductive health while speaking at a town hall event Monday, despite having made access to that care more difficult during his tenure as Ohio governor.

During an event at the Solvay-Geddes Community Youth Center in Solvay, New York, a woman in the audience asked Kasich why he had signed laws to defund Planned Parenthood in February when many rely on the provider for care.

“It’s a concern to a woman like myself who, when I was younger, I utilized Planned Parenthood for [gynecological] exams, for birth control pills, for a lot of things that as a young woman without insurance, it was an avenue for me to get female health care,” said the woman. “And it had absolutely nothing to do with abortion, you know, but they offer very good services to women who don’t have means to be able to … spend $30 a month on pills … So it is of concern to me when you talk about defunding programs like that.”

Kasich affirmed that he had acted to strip the organization of its funding, but justified the move by claiming money for women’s health was diverted to other care providers. “The money’s not going away. It’s just going to a another place. We’re not reducing one dime of funding for women’s health, because we think it’s critical,” said Kasich. “We’re not going to defund it. We’re just going to move the money someplace else,” he continued before touting his role in expanding Medicaid in the state.

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Though Kasich suggested that reproductive health funding in Ohio wouldn’t be affected by defunding Planned Parenthood because the funds would be diverted elsewhere, critics in Ohio and across the country say the community clinics and others receiving such money may not have capacity to take on the organization’s patients when the law goes into effect in May.

“If Planned Parenthood goes away as a provider, there will be a void of services in our community,” Kelli Arthur Hykes, the health policy director for the Columbus, Ohio health department, said in a statement when the measure was signed. “We don’t have the capacity to fill that void.”

The Republican presidential candidate made a nearly identical claim in March during a campaign stop in Wisconsin, where he suggested it was “absolutely unacceptable” for women to be unable to access reproductive health care. But as Rewire explained in fact-checking his claim, Kasich has used his “tenure as governor to relentlessly attack women’s health on multiple fronts”:

When Kasich signed a bill in February cutting $1.3 million in funding to Planned Parenthood, he did not cut funds for abortion care; those services are not covered by state money. Instead, he slashed funds for the organization’s sexually transmitted infection testing, mother and newborn care, and anti-domestic violence programs. As Rewire reported at the time, the cuts also targeted Planned Parenthood’s infant mortality program ….

In November, an Associated Press investigation discovered Kasich’s aides had played a critical role in drafting restrictive anti-abortion language, previously attributed solely to the state legislature, in Ohio’s 2013 budget requiring licensing regulations for clinics. This led to the closure of half of the state’s outpatient abortion clinics. The bill also contained provisions mandating ultrasounds for abortions, blocking funding for rape crisis centers that provide information about abortion, and “re-prioritiz[ing]” family planning funds away from Planned Parenthood to crisis pregnancy centers, which routinely lie to patients.

Since taking office in 2011, Kasich has signed at least 16 anti-choice measures, including a later abortion ban. He also endangered women’s health by appointing Ohio Right to Life President Michael Gonidakis to the state medical board in 2012.

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