Daily Pulse: Public Option Is Alive and Kicking

Lindsay Beyerstein

Reports of the death of the public option were greatly exaggerated. In fact, Democrats now have a chance to move further to the left. Also, can reproductive choice help reverse climate change?

Reports of the death of the public option were greatly exaggerated. According to Steve Benen of the Washington Monthly, liberals are once again optimistic
that health care reform will include a publicly-run insurance option to
compete with private insurance companies. The main excuse to drop the
public option was that Republicans wouldn’t go for it. As Benen
explains, now that a bipartisan bill is out of reach, Democrats can
move further to the left. Progressive Democrats have convincingly
argued that the public option would save money, which undermines the
Blue Dogs’ opposition for the sake of fiscal conservatism.

The Senate Finance Committee will tackle the public option
tomorrow. Meanwhile, the House Democratic caucus is wrestling over what
kind of public option to support. Speaker Nancy Pelosi publicly
rejected a so-called “trigger” which would activate a public option
only if private insurers failed to control costs. “A trigger is an
excuse for not doing anything,” she said.
By contrast, Senate Majority Leader Harry Reid supports a trigger. The
views of the Speaker and the Majority Leader are important because they
will lead negotiations to merge the House and Senate versions of the
bill, creating the final text that both houses will vote on.

Meanwhile, in international news, scholars at the London School of
Economics released new research last week showing that reproductive
choice is the most powerful tool in the fight against climate change.
The news broke as nearly a hundred heads of state gathered in New York
for the UN Summit on Climate Change. As Amanda Marcotte notes in RH
Reality Check, the report’s recommendations are sure to spark controversy from both the right and the left:

It’s easy enough to assume that the Obama administration and the Sierra Club are shying away from the issue
because reproductive rights are such an explosive topic, and even
touching it brings a hail of crazy from the anti-sex nuts down on your
head. But I can honestly say that I don’t think it’s the fear of the Anti-Sex Mafia that causes this sort of allergy. It’s
the history of the fear of overpopulation being used as an excuse to
coerce childbirth choices, and the fact that as soon as the potential
for coercion is introduced, you suddenly attract a sea of racists who
love to pontificate about eugenics all day, and would love to be able
to influence policy to reduce the number of non-white people in
relation to the number of white people.

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At Feministing, Ann Friedman argues that the rubric of population control
is irrevocably tainted by its historical links to eugenics and other
forms of racism. She argues that international development should focus
on empowering women for their own sake, not because we hope that they
will have fewer babies.

I agree that the phrase “population control” is a misleading frame.
You could just as easily call it “helping women have as many children
as they want.” The key is that virtually all women want fewer children
than they will bear if nature takes its course. And the more
opportunities women have for education, paid work, and healthy
children, the fewer kids they tend to want. The phrase “population
control” should be scrapped, but the effort to put women in charge of
their own fertility must continue, for the good of humanity and the
planet.

This post features links to the best independent, progressive reporting about health care and is free to reprint. Visit Healthcare.newsladder.net
for a complete list of articles on health care affordability, health
care laws, and health care controversy. For the best progressive
reporting on the Economy, and Immigration, check out Economy.Newsladder.net and Immigration.Newsladder.net. This is a project of The Media Consortium, a network of 50 leading independent media outlets, and created by NewsLadder.

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 Human Rights

For Undocumented Women in Texas, HB 2 Is ‘Life or Death’

Tina Vasquez

A lot has been written about how Texas' reproductive health-care restrictions codified into law in 2013 disproportionately hit low-income women of color and Latinas in particular. What's not been covered by the media, or covered enough, is how HB 2 affects undocumented people.

Read more of our coverage of Whole Woman’s Health v. Hellerstedt here.

It has been almost three years since abortion providers filed their first challenge to Texas’ omnibus anti-abortion law. As we approach March 2, the day the Supreme Court will begin hearing oral arguments for and against Whole Woman’s Health v. Hellerstedt, a lot has been written about how the reproductive health-care restrictions codified into law in 2013 disproportionately hit low-income women of color and Latinas in particular. What’s not been covered by the media, or covered enough, is how HB 2 affects undocumented people.

HB 2 contains multiple abortion restrictions, including a 20-week abortion ban, but on Wednesday the Supreme Court will specifically hear arguments on the regulations requiring abortion providers to be affiliated with nearby hospitals and limiting abortion care to ambulatory surgical centers. The implications of the case are much larger, however. As Rewire has reported, what’s at stake in the case is not just the future of abortion access in Texas, but the impact the Court’s decision will have on clinic shutdown restrictions in states nationwide.

While a person’s citizenship status affects her ability to access health care throughout the United States, this is especially true in Texas, which has the second-highest undocumented population in the country and some of the nation’s harshest anti-immigrant laws.

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There are roughly 1.5 million undocumented residents in the state of Texas, 78 percent of whom emigrated from Mexico. Despite concerns from politicians that the undocumented population is growing in the state, as the Texas Tribune reported, the Migration Policy Institute found that it has remained relatively unchanged in recent years, with more than half of the state’s undocumented immigrants having lived in Texas for more than a decade.

As Texas’ undocumented population remains fixed in place, the state legislature has fought to deny this group basic human rights, whether it’s by challenging an Obama administration executive action designed to expand temporary protection from deportation for millions of undocumented immigrants—effectively stopping Deferred Action for Parents of Americans and Lawful Permanent Residents (DAPA) in its tracks—or pushing to have the state’s family detention centers licensed as child-care facilities with reduced standards. The state’s enactment of HB 2 is yet another example of the way it has targeted one of the country’s most vulnerable communities.

As the Center for Reproductive Rights reported, it is the 2.5 million Latinas of reproductive age in Texas that are disproportionately affected by HB 2, which has closed more than half of the state’s clinics, most of them in predominately Latino areas. Though it’s unclear what percentage of those Latinas are undocumented, what is known is that immigrant women already experience significant barriers when trying to access sexual and reproductive health care and HB 2 only made things worse.

Ana Rodriguez DeFrates is on the front lines of the reproductive rights battle as the Texas Latina Advocacy Network state policy and advocacy director for the National Latina Institute for Reproductive Health (NLIRH), one of more than 40 organizations that filed an amicus brief in Whole Woman’s Health. DeFrates says that “without question,” those most affected by HB 2 are the people already adversely affected by current health-care practices and immigration laws.

“We’re a reproductive [justice] organization in Texas and we see every day that it’s the same population of people most impacted that are not invited to the conversation about the policies that impact them,” DeFrates told Rewire. “I can say that ignoring the implications of immigration status [whether a person is a citizen or undocumented] when it comes to accessing health care—especially sexual and reproductive health care—would be to paint a very inaccurate and incomplete picture of what is happening in Texas.”

Since HB 2 went into effect, the southernmost region of Texas—the Rio Grande Valley—has lost all but one abortion clinic, Whole Woman’s Health of McAllen. If the remaining clinic in the Rio Grande Valley were to shut down, the only option would be driving north to San Antonio to the nearest abortion provider, but that’s not really an option if you’re undocumented. Transportation and immigration checkpoints are just two of the hurdles undocumented people must clear under HB 2.

“There are internal immigration checkpoints that exist upwards of 100 miles north of the actual Texas/Mexico border,” DeFrates told Rewire. “If you’re undocumented, you simply couldn’t get to the heart of the state where abortion access is available. And even then, we’re assuming you can take the time off work it would require for the multiple days it now requires because of increased restrictions that now mandate increased office visits and increased wait times.”

“We’re also assuming … that you have the money and means available to travel that distance and that you have child care available to you. It assumes a lot. You cannot separate immigration from HB 2 or bigger conversations surrounding health care. They are operating together and impacting lives together,” DeFrates said.

Advocates in Texas working for organizations like NLIRH are doing more than fighting for access to abortion; they are fighting strong anti-immigrant sentiments. In the state, unions representing Border Patrol and Immigration and Customs Enforcement (ICE) work with anti-immigrant groups to undermine immigration policies and promote anti-immigrant views. As the Texas Medical Association reported, legislation from 1986 to 2013 has made it increasingly difficult for undocumented people with chronic illnesses to receive safe and affordable care, forcing them to rely on costly emergency rooms, often after their condition has worsened. Whether Texas legislators set out to target low-income people of color cannot be confirmed, but advocates say intent hardly matters when vulnerable people are suffering.

A few months ago, organizers at NLIRH met a woman who would have to walk 45 minutes from her colonia to the nearest bus stop.

“That is a long walk and she is scared to make that walk because of the increasing number of law enforcement she encounters,” DeFrates said. “She’s scared because she’s undocumented, but she needs to get to that bus because that’s her only way to her health-care appointment.”

The woman told NLIRH organizers that she would rather live with the pain in her abdomen than risk deportation or separation from her family. The woman’s circumstances and concerns call to mind Blanca Borrego, the undocumented mother of three arrested this past September when seeking treatment for a cyst that was causing abdominal pain at Texas’ Memorial Hermann Medical Group Northeast Women’s Healthcare clinic.

The staff member who called the authorities on Borrego because she provided the staff with a fake driver’s license said they were simply “enforcing the law,” the Los Angeles Times reported. Situations like this could be avoided if, like the State of California for example, Texas issued driver’s licenses to undocumented immigrants. Instead, Texas is arguing that President Obama’s deferred action executive order would cause the state to “incur significant costs in issuing driver’s licenses to DAPA beneficiaries.” If an injunction had not been placed on DAPA, Borrego would have been eligible for deferred action.

According to Texas’ attorneys, subsidizing licenses for DAPA beneficiaries would cause the state to lose a minimum of $130.89 on each license issued. But a report from the Institute on Taxation and Economic Policy found that with full implementation of DAPA and Obama’s other executive actions, Texas could see returns of nearly $59 million.

Even before HB 2, things were bad for Latinas and undocumented women, who had few places to turn for contraception and other preventive reproductive health services after 2011 when Texas gutted the public family planning program. Texas invested $50 million in a new program that combines family planning with other health services, like diabetes screening; Planned Parenthood, however, was not allowed to participate. The Center for Reproductive Justice reports that Latinas have far fewer options for controlling their reproduction and are two times more likely to have an unintended pregnancy than their white counterparts.

“At best, these policies are ignorant. At worst, they are attacks on our communities,” DeFrates said. “When you look at how many Latinas are dying of cervical cancer, when you look at how many clinic closures occurred as a result of the 2011 budget cuts in Texas where two-thirds of family planning was slashed, when you look at where these communities are and who inhabits them, when it seems no one is considering the needs of low-income people of color, one has to question whether these policies are rooted in racism.”

The majority of cervical cancers are preventable, yet Latinas continue to die without adequate testing and care; they have the highest incidence of cervical cancer among all ethnic or racial groups and the second highest mortality rate. As NBC Latino reported, the situation is even worse for Latinas in Texas, whose rates are 19 percent higher than the national average and 11 percent higher than the national average for Latinas.

“There is no reason in this day and age why you should be dying from this, yet Latinas in Texas are dying at a higher rate than other people. What did the Texas legislature do in response? Instead of ensuring that not one more woman died from this very preventable disease, it cut the number of providers that can participate in the cervical cancer screening program. That directly impacts Latinas and makes it harder for undocumented women to access preventive care, and we told them that. We told them that through organizing, through public testimony at the capitol, yet they moved forward with it,” DeFrates said.

As March 2 approaches, advocates like DeFrates are trying to remain hopeful that the Court will recognize the overarching implications of HB 2 and the ways in which the law puts already vulnerable communities at greater risk. The recent normalizing of anti-immigrant sentiments espoused by those seeking the highest public office—the presidency—can understandably make it hard to remain positive, but DeFrates says it’s imperative to continue fighting.

“For us in Texas, this isn’t a short-term issue. It’s not about one case or an election or whether or not we’re in legislative session,” DeFrates said. “It’s a long-term fight. We’re going to continue centering the lives of those directly impacted because bad things happen when the voices of those most impacted aren’t heard. In Texas, this is really life or death.”

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