Weekly Pulse: Mob Scene

Lindsay E. Beyerstein

Republicans and their allies are pressuring Democratic healthcare reformers at town hall meetings around the country -- but a network of corporate funders and lobbyists are behind the mobs.

This week’s edition of the Weekly Pulse is shorter than usual. Our team is getting ready for the fourth annual Netroots Nation blogger conference in Pittsburgh, PA. Esther Kaplan, editor of the Nation Investigative Fund,
and I are conducting an investigative reporting workshop on Saturday
from 1:30-4:15 p.m. Join us and help expose the corporate roots of the Teabagger/Town hall mob movement.

Here’s the latest news on the healthcare front: Republicans and
their allies are pressuring Democratic healthcare reformers at townhall
meetings around the country. Addie Stan has a blockbuster piece in
AlterNet that exposes the network of corporate funders and lobbyists behind the mobs.

The Progressive’s Ruth Conniff explains the mobs’ marching
orders, as spelled out in a memo by Bob MacGuffie, a volunteer for the
Tea Party Patriots, an anti-reform group with ties to former Republican
Rep. Dick Armey’s pressure group Freedom Works.
MacGuffie instructs town hall protesters to shout at lawmakers and
attempt to throw them off their game as they try to make the case for
health care reform. So much for reasoned discussion.

As I reported in In These Times, the teabaggers are trying to scapegoat organized labor
as the instigators of confrontations at town hall meetings. On August
6, a scuffle broke out in front of a town hall meeting in St. Louis.
The below video clip shows the last 10 seconds of a scuffle in which a
man in an SEIU t-shirt lies prostrate on the ground. A 38-year-old
conservative activist claims to have been severely beaten, but the
video shows him apparently uninjured, darting around to different cops
and trying to convince them that he was attacked. The man’s lawyer
claims that he saw his client get punched in the face and kicked in the
head by SEIU members.

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A spokesman for the St. Louis County police told me that the police
hadn’t reviewed the video because nobody had submitted it to them,
despite a call to the public to turn over evidence for the
investigation. The fact that the videographer hasn’t turned over the
video kind of makes you wonder if the teabaggers really take the
“evidence” as seriously as they claim.

How’s this for irony? According to Talking Points Memo, the activist was asking for money to pay his hospital bills because he’s uninsured.

Finally, Jodi Jacobson of Rewire reports that Kansas Now is calling upon AG Eric Holder to restore the Federal Marshall security detail
of prominent late-term abortion provider Dr. Leroy Carhart, a friend
and colleague of the late Dr. George Tiller. Carhart was placed under
protection after Tiller was shot. But the feds didn’t even wait for the
trial of Tiller’s alleged assassin to wrap before pulling Carhart’s
detail. Now he’s on his own, just as the alleged killer’s links to a
broader coalition of violent anti-choicers are coming to light.


News Law and Policy

Kentucky Governor Backtracks on Pledge to End Medicaid Expansion

Teddy Wilson

Republican Gov. Matt Bevin said last week that he would not eliminate the state’s expansion of Medicaid and the kynect health-care exchange.

Kentucky’s new Republican Gov. Matt Bevin had promised to dismantle the state’s effort to implement the Affordable Care Act (ACA), and his defeat of Democratic Attorney General Jack Conway in November appeared to be a death knell for low-income residents’ health-care coverage.

However, Bevin said last week that he would not eliminate the state’s expansion of Medicaid and the kynect health-care exchange, but rather reform how the state has implemented the programs.

Bevin repeatedly said during the 2015 campaign that he would eliminate Medicaid expansion in the state. Bevin proposed transitioning residents on Medicaid through kynect to the federal health insurance exchange by 2017, when the ACA’s federal health-care subsidies are reduced.

“Absolutely. No question about it. I would reverse that immediately,” Bevin told reporters during a February 2015 press conference, according to the Associated Press. “The fact that we have one out of four people in this state on Medicaid is unsustainable, it’s unaffordable and we need to create jobs in this state, not more government programs to cover people.”

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Bevin changed course and announced his plans for reforming the Medicaid expansion program during a December 30 press conference. “We are going to transform the way in which Medicaid is delivered in Kentucky, and this transformation, I think, will be a model for the nation,” Bevin said.

The details of Bevin’s plan will be hammered out over the next six months, after which people “will have a very clear understanding of whether this is going to work or no.” The governor said that the new system could be implemented by the beginning of 2017.

The Kentucky program has been widely praised as a success, and it has been credited with reducing the uninsured rate in the state from 20.4 percent in 2013 to 11.9 percent in mid-year 2014. Kentucky’s 8.5 percent drop in the uninsured rate over the past two years is higher than any other state with the exception of Arkansas.

Bevin was joined in December by Vickie Glisson, the secretary of the Cabinet for Health and Family Services, and Mark Birdwhistell, the former secretary of the Cabinet for Health and Family Services.

Birdwhistell said during the press conference that low-income residents needed a Medicaid system that was “affordable and sustainable,” and that other states have created programs that could be an example for the plan that may be proposed.

“We’ve looked at other models in other states,” Birdwhistell said. “One of the things we keep talking about is the Indiana model. My personal preference is that we need a Kentucky model: a model that meets the needs of Kentucky.”

Indiana Gov. Mike Pence announced in January 2015 that the state will expand Medicaid under the ACA, becoming one of many GOP governors to cede to some form of Medicaid expansion after opposing Obamacare since its passage through Congress. The expansion will cover 350,000 low-income Indiana residents, or about 46 percent of the state’s 765,600 uninsured residents.

Bevin said that the need to reform the Kentucky program was mostly about its cost.

“It comes down to several things,” Bevin said. “Cost is primary among them. Ultimately it does not matter what the solution is. If there is not a way to pay for it then it would not be an option for the long term.”

The federal government pays 100 percent of the cost of expanding Medicaid in the state, and beginning in 2017, federal funding will decrease to 90 percent. A 2013 analysis by the state health department projected that Kentucky’s expansion of Medicaid would create a $15.6 billion positive economic impact, as well as nearly 17,000 jobs across the state.

Bevin claimed in December that full Medicaid expansion under the ACA was unaffordable “despite all the happy talk that came out of the previous administration.”

Bevin’s proposal to reform Medicaid expansion due to the cost of the program was announced a week before the governor released a budget proposal that would slash the state’s revenue. Bevin has proposed eliminating the state’s inventory and inheritance taxes, which would cost the state an estimated $55 million per year, according to reporting by McClatchy.

Bevin dismissed a reporter’s question to respond to the concerns of the thousands of state residents who may lose their health insurance under the governor’s proposal. “I really hope you’ve been listening to what I’ve just said, and I’m not sure that you have in light of that question,” he said.  

Whatever plan Bevin proposes will need the approval of the federal government. The Centers for Medicare and Medicaid Services (CMS) must approve waivers from states seeking to implement plans that differ from full Medicaid expansion under the ACA.

“I had a very extensive and substantive conversation with Health and Human Services Secretary Sylvia Burwell,” Bevin said. “She and I had a good conversation about what solutions would look like for Kentucky. It is our intention to work with CMS as we have said we would.”  

CMS officials approved a waiver allowing Indiana to implement its plan after months of negotiations between Pence and the Obama administration.

Analysis Politics

Campaign Fact-Check: Rand Paul’s ‘HHS Investigation of Planned Parenthood’s Tissue Practices’

Ally Boguhn

Senator and presidential candidate Rand Paul (R-KY) announced Tuesday that the Department of Health and Human Services (HHS) would be launching an investigation into "Planned Parenthood’s unconscionable" fetal tissue donation practices.

Senator and presidential candidate Rand Paul (R-KY) announced Tuesday that the Department of Health and Human Services (HHS) would be launching an investigation into “Planned Parenthood’s unconscionable” fetal tissue donation practices.

The letter from HHS on which Paul based his comments makes no such promise.

On Tuesday, the senator released a statement touting a response from HHS Inspector General Daniel Levinson agreeing to an earlier request initiated by Paul and 49 other senators for the department to audit “all fetal tissue research support by HHS, specifically examining the Department’s oversight of contractor and grantee compliance with the laws governing fetal tissue research.”

Speaking of what he deemed to be an “HHS investigation of Planned Parenthood tissue practices,” Paul lauded the department for taking up his cause. “I am encouraged to see the Inspector General take action to investigate Planned Parenthood’s unconscionable practices,” the senator claimed, rehashing discredited claims about the organization.

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Rehashing discredited claims about the organization, Paul wrote that it “deserves not one penny more of our taxpayer dollars, and I am confident this investigation will give further proof of that.”

However, the actual response from Levinson on behalf of HHS did not promise to investigate Planned Parenthood or its practices specifically, instead affirming that the department would undertake an internal audit of all fetal tissue research supported by the department and the National Institutes of Health (NIH)—an agency of HHS—as Paul’s letter had originally requested.

Referring to a past discussion on the topic, Levinson explained that HHS would conduct an internal probe and “interview HHS and National Institutes of Health (NIH) officials” with a “focus on gathering relevant documentation related to policies and procedures for monitoring fetal tissue research activities.” 

“Our goal is to obtain information related to fetal tissue research grants, NIH’s monitoring procedures over third-party certifications and those related to the Department’s internal fetal tissue research, and any known violations of Federal requirements,” Levinson continued.

It appears Paul engaged in a bit of wordplay in his rush to promote HHS’ response, suggesting the investigation would be into Planned Parenthood by repeatedly asserting that the probe was into their “practices” and implying the organization was somehow tied to the review. But in truth, Paul’s initial letter simply asked the department for an internal probe of its fetal tissue policies and a review of whether the third-party entities it works with are in compliance with the law—not an inquiry specifically into Planned Parenthood.

Planned Parenthood, for its part, welcomed HHS’ probe of federal fetal tissue research oversight. “We applaud the HHS for this timely review of practices around fetal tissue donation,” Executive Vice President Dawn Laguens said in a statement on the matter. “This work is often critical to lifesaving medical research, and has helped with important breakthroughs, such as the polio vaccine and research into a cure for Alzheimer’s disease.”

The organization’s president, Cecile Richards, also noted the organization would only benefit from the “updated guidance” such a review would grant. “A new review by a blue ribbon panel could help ensure the entire medical community is meeting the highest possible standards for this practice,”  Richards said in a statement, according to the Washington Post. “In addition to Planned Parenthood, other health care providers that make tissue donations could benefit from updated guidance.”

Richards also noted that Planned Parenthood had formally asked NIH to conduct a similar review of their policies in June. Pointing to general public confusion over fetal tissue research in the wake of deceptively edited videos released by the anti-choice front group Center for Medical Progress (CMP), Richard’s letter on behalf of Planned Parenthood asked for a “review of the research and the procedures surrounding it by an independent expert panel.”

HHS has already told congressional Republicans, chomping at the bit to indict Planned Parenthood after the CMP’s video release, that the department has no evidence of any violations of fetal tissue laws.

An August letter from Jim Esquea, assistant secretary for legislation at HHS, to Sens. Joni Ernst (R-IA) and Roy Blunt (R-MO) explained that the department knew of no wrongdoing by Planned Parenthood in facilitating the donation of fetal tissue for patients who requested it. The senators had earlier co-sponsored a failed bid to defund Planned Parenthood over CMP’s videos.

“Currently, we know of no violation of these laws in connection with the research done at our agencies,” wrote Esquea to Ernst and Blunt, according to Politico. “Furthermore … we have confirmed that HHS researchers working with fetal tissue obtained the tissue from non-profit organizations that provided assurances to us that they are in compliance with all applicable legal requirements.”

As Politico further reported at the time, although HHS is involved with an extremely small share of fetal tissue research, all of it appears to be in accordance with federal law:

HHS has gotten re-affirmations from government researchers and government-funded researchers that their tissue procurement is done in accordance with the tissue laws. And it got assurances from the companies that provide that fetal tissue to researchers at NIH and FDA that they are obtaining the fetal tissue and organs in compliance with federal laws, the letter says.

HHS also said that research with fetal tissue conducted by NIH accounts for less than 0.1 percent of its total research budget. It didn’t provide whole numbers.

Other investigations led by states and Congress into alleged wrongdoing on behalf of Planned Parenthood and fetal tissue donations have consistently turned up no evidence that the reproductive health provider has broken any law.

Paul’s unwillingness to accept mounting evidence that fetal tissue laws are not being broken may be due in part to his relentless campaign to politicize CMP’s videos in order to push his stringently anti-choice agenda ahead of the 2016 presidential elections. In July, Paul vowed to use the discredited videos in order to defund Planned Parenthood, and in September he implied he would oppose any measure to fund the government that also funded Planned Parenthood.

“I don’t know about the rest of Congress, but I plan on taking a stand and saying, ‘Not one penny more for Planned Parenthood,’” Paul said at a September anti-abortion rally. “I have never voted for any funds for Planned Parenthood, and I never will.”

Planned Parenthood provides basic reproductive health services to an estimated 2.7 million people in the United States who may not otherwise have access to care. Despite making up just 10 percent of all publicly supported safety-net family planning centers, the organization provides contraception for 36 percent of all low-income women who seek these services at such centers, according to analysis from the Guttmacher Institute.

Although politicians often point to the presence of other health-care organizations and clinics to fill the gap should Planned Parenthood be defunded, the organization’s absence would be difficult to fill. Investigations conducted by Rewire revealed that many of the health-care centers conservatives claim could make up the difference are actually elementary, middle, and high schools; clinics that provide care for homeless people; nursing homes; and other locations ill-equipped to appropriately handle a sudden influx of patients seeking reproductive health services.