In nearly a dozen Republican-dominated states, either the governor or conservative legislators are seeking to add work requirements to Obamacare Medicaid expansion, much like an earlier generation pushed for welfare to work.
The move presents a politically acceptable way for conservative states to accept the billions of federal dollars available under Obamacare, bringing health care coverage to millions of low-income people. But to the Obama administration, a work requirement is a non-starter, an unacceptable ideological shift in the 50-year-old Medicaid program and a break with the Affordable Care Act’s mission of expanding health care coverage to all Americans. The Health and Human Services Department has rejected all requests by states to tie Medicaid to work.
But the idea is catching fire among Republicans —and may well resonate on the presidential campaign trail in 2016.
In Indiana, Florida, Utah, and at least eight other GOP-dominated states, either the governor or state lawmakers have sought to tie Medicaid to work. Supporters see it as a way of taming a health care entitlement they regard as excessively costly and riddled with fraud and abuse.
Arkansas’ Asa Hutchison is one GOP governor who is striving to find a way to keep the millions of dollars flowing to his state under its version of expansion — now covering around 230,000 people — amid demands of conservatives. He’s open to a work requirement.
“This is supposed to be an incentive and encouragement for people to work versus an incentive for people to just receive the government benefit and not be part of a working culture of Arkansas,” Hutchison told POLITICO during a recent interview about Medicaid in the state Capitol.
His fellow Republican Gov. Gary Herbert of Utah put it this way: “I wanted to be able to say, ‘If you want the taxpayers to fund your health care, then you need to go out and be involved in a work program, no ifs, ands or buts.’ I’ve been accused by the Obama administration: ‘Well, you’re trying to turn this health care program into a work program.’ And I’ve said, ‘You’re right.’”
But the administration and its allies counter that Medicaid expansion is part of the Affordable Care Act, not the welfare system. Adding job requirements, time limits or other conditions subverts the health law’s goal of providing affordable and accessible care to the people who need it. It’s wrong, they say, to subsidize health insurance for middle-class people in the Obamacare exchanges while picking and choosing who among the poor deserves Medicaid assistance.
The administration “has proven its willingness to work with governors of both parties” to connect Medicaid expansion recipients to state-run employment programs on a voluntary basis, Obama’s Medicaid Director Vikki Wachino said in a statement to POLITICO. But she added, “Because Medicaid is a health coverage program, requiring employment may not be a condition of eligibility.”
That hasn’t stopped Republicans on Capitol Hill from considering ways to open the door to work rules.
Last year, a report by House Republicans’ budget guru Paul Ryan raised alarms about Medicaid’s potential to discourage employment. This year, Arkansas Rep. Bruce Westerman introduced a bill that would let states forge ahead with work incentives without federal permission. States are considering various kinds of work programs, including employment, job hunting, or job training.
Nearly 44 percent of Americans live in areas with dangerous levels of ozone or particle pollution, according to the American Lung Association’s annual “State of the Air” report, published yesterday.
The good news is that’s actually an improvement over last year’s report, which showed that 47 percent of the population lived in these highly polluted places. Overall, the air has been getting cleaner since Congress enacted stricter regulations in the 1970s, and the American Lung Association report, which looked at data from 2011 through 2013, showed a continuing drop in the air emissions that create the six most widespread pollutants.
But don’t pat yourself on the back just yet. Many cities experienced a record number of days with high levels of particle pollution, a mixture of solid and liquid droplets in the air that have been linked to serious health problems. Short-term particle pollution was especially bad in the West, in part due to the drought and heat, which may have increased the dust, grass fires and wildfires. Six cities—San Francisco; Phoenix; Visalia, California; Reno, Nevada.; Yakima, Washington; and Fairbanks, Alaska—recorded their highest weighted average number of unhealthy particle pollution days since the American Lung Association started covering this metric in 2004.
Los Angeles held its rank as the metropolitan area with the worst ozone pollution, even as it saw its best three-year period since the first report 16 years ago: the city experienced a one-third reduction in its average number of unhealthy ozone days since the late 1990s.
Meanwhile, states on the east coast showed the most headway in cleaning up their air, with major drops in year-round particle pollution. The American Lung Association attributed the improvement to a push for cleaner diesel fleets and cleaner fuels in power plants.
“The progress is exactly what we want to see, but to see some areas having some of their worst episodes was unusual,” said Janice Nolen, an air pollution expert with the association, referring to the record-breaking days of short-term particle pollution.
Data is missing for some of the dirtiest cities in the Midwest, including Chicago and St. Louis, due in part to problems at data labs in Illinois and Tennessee. Similar problems in Georgia also prevented researchers from assessing changes in Atlanta, another city notorious for air pollution.
Outdoor air pollution has been linked to about 3.7 million premature deaths worldwide, by causing or exacerbating lung cancer, chronic obstructive lung disease, acute lower respiratory infections, ischaemic heart disease, and strokes. And unfortunately, it seems people of color and with low incomes are often exposed to the dirtiest air.
Using data from the Environmental Protection Agency, the American Lung Association ranked cities around the country in terms of their year-round particle pollution, or the annual average level of fine particles in the air. These fine particles can come from many sources, including power plants, wildfires, and vehicle emissions, and breathing them in over such long periods of time have been linked to lung damage, increased hospitalizations for asthma attacks, increased risk for lower birth weight and infant mortality, and increased risk of death from cardiovascular disease.
Here are the 10 cities with the lowest levels of year-round particle pollution:
1. Prescott, Arizona
2. Farmington, New Mexico
3. Casper, Wyoming
3. Cheyenne, Wyoming
5. Flagstaff, Arizona
6. Duluth, Minnesota-Wisconsin
6. Palm Bay-Melbourne-Titusville, Florida
6. Salinas, California
10. Anchorage, Alaska
10. Bismarck, North Dakota
10. Rapid City-Spearfish, South Dakota
And the cities with the most year-round particle pollution:
California has stepped up its attempts to reduce greenhouse gas emissions by setting tough new targets for 2030.
Governor Jerry Brown issued an executive order to bring down emissions to 40% below 1990 levels, in the next 15 years.
The US state was already one of the most ambitious in its previous targets and has forced companies to pay for their carbon pollution.
Mr Brown said the new target must be met for the sake of future generations.
He called the plan “the most aggressive benchmark enacted by any government in North America to reduce dangerous carbon emissions”.
There were few details about how he intends to meet this target, but the governor has previously talked about increasing renewable electricity sources, reducing petrol use in vehicles and improving the energy efficiency of existing buildings.
Mr Brown mentioned by name some sectors that will have to reduce emissions – industry, agriculture and energy, plus state and local governments.
“With this order, California sets a very high bar for itself and other states and nations, but it’s one that must be reached – for this generation and generations to come,” he said in a statement.
California is the second-biggest producer of carbon dioxide through fossil fuels among US states.
A Senate committee has advanced legislation that would change how the Environmental Protection Agency uses science to craft regulations intended to protect the environment and public health, the Hill reported Tuesday.
On party line votes, the Senate Environment and Public Works Committee voted 11-9 to approve the “Secret Science Reform Act,” a bill to prohibit the EPA from using science that includes private data, or data that can’t be easily reproduced. The bill has been pushed strongly by House Republicans for the last two years, but this is the first time it has been advanced by the Senate. It is sponsored by Sen. John Barrasso (R-WY).
The purpose of the Secret Science bill, according to its House sponsor Rep. Lamar Smith (R-TX), is to stop “hidden and flawed” science from being the basis of EPA regulations. However, many scientific organizations have disagreed with this characterization.
For example, approximately 50 scientific societies and universities said the bill would prohibit the EPA from using many large-scale public health studies, because their data “could not realistically be reproduced.” In addition, many studies use private medical data, trade secrets, and industry data that cannot legally be made public.
“The legislation may sound reasonable, but it’s actually a cynical attack on the EPA’s ability to do its job,” said Andrew Rosenberg, the director of the Center for Science and Democracy at the Union of Concerned Scientists, in a statement. “This bill would make it impossible for the EPA to use many health studies, since they often contain private patient information that can’t and shouldn’t be revealed.”
On Saturday, April 25, a massive 7.8 magnitude earthquake hit Nepal, leveling historic sections of Kathmandu, killing more than 5,200 people, and leaving hundreds of thousands homeless.
Four days later, a protest erupted outside the main bus station in Kathmandu near the Nepalese parliament. People were reportedly told that the government planned to send a fleet of buses to take them out of the city, and they became irate when they were told there weren’t enough busses for everyone.
VICE News headed to the protest to speak with residents left stranded after the devastating earthquake.
On Monday, the media was quick to paint a single picture of Baltimore: a chaos scene of violence and mayhem filled with images of looting, rioting, the burning of a CVS and the torching of a police car.
Here are 10 powerful images images showing a very different side to Baltimore than the one you saw on television: