Rockefeller And Wyden: Senate Finance Holdouts

Ezra Klein had two very good interviews today, with Sen. Jay Rockefeller and Sen. Ron Wyden, detailing their concerns with the Senate Finance bill and how they hope to change it. I know that people are getting bent out of shape about the emphasis on the Finance Committee bill when four other committees have jurisdiction, but right now, it's the only committee left to report something out, Wyden and Rockefeller sit on the committee so they represent the best hope for improving that version, and let's be honest, the White House is certainly using Baucus' bill as a framework, with the hope to at least just get it out of there. So it's important to take a look at their concerns.

Wyden, who like Rockefeller spent time at the White House this week, emphasized affordability concerns, like most other Democrats have. But Wyden also wants his proposal for Free Choice in the bill, allowing anyone to buy insurance off the exchange, not just those who don't get coverage through an employer. I thought he answered the concerns about the "end of the employer-based system" (you say that like it's a bad thing) pretty well:

Let me ask you about some of the concerns people have on this bill. One is that it will hasten the decline of the employer-based system. Young workers will leave quickly for cheap, catastrophic plans on the exchange. Workplaces will be left with older, sicker workers, and they won’t be able to continue offering health-care insurance.

That just doesn’t make sense, either from an economic standpoint or the nature of American life. First, companies will continue to see good benefits as a recruitment tool. It remains a primary way to attract young, talented workers. Second, as we look at this in terms of who would leave, I don’t get the sense that young, healthy workers will be the first to traipse off. Are they really going to be the ones to fill out the forms and contact the exchanges and all that? I think the most likely to go shopping are middle-class people who are pinched right now. We’ve also put into the bill safety valves for any worst-case scenario: after-the-fact risk adjustment that will review who stayed and who left and make adjustments based on that fact.

If what we’re saying is that we can’t find a sweet spot between blowing everything up in 15 minutes and telling people that you can’t improve your situation and have more choices, we’re not doing our job. And I think this is that sweet spot.

Wyden also spoke strongly against the "free rider" position, and said he is working with the Center for Budget and Policy Priorities to improve it.

Rockefeller, who has become the stand-in for liberals on health care in the Senate, has a whole different set of concerns, while still keying on affordability.

There are a number of big things. The Children's Health Insurance Program is put into the exchange. That's like putting it into a farmer's market. It loses its defined benefits. And children need defined benefits.

Obviously the public option. I feel very strongly about that as a discipline on the private health insurance market. The public health insurance option doesn't have to make a dime. It doesn't have to make Wall Street happy or shareholders happy. It just has to sell a product at cost. That will put pressure on private insurance companies to bring down their premiums. What's the alternative? My staff has done extensive research on co-ops and everyone says they can't do health insurance. The best health care co-op exists in the state of Washington, and both of Washington's senators are adamantly for a public option. That ought to tell you something.

Another issue is that 46 percent of the American people have health insurance from fairly large companies that self-insure. And they're not included in the regulations. They have to have protection from preexisting conditions and lifetime caps and rescissions too. People hear that the regulations in the bill don't apply to these companies and they think it's not possible. But it's true. And it's almost half of the insurance market!

Another piece is the MedPAC proposal. if you really want to be honest about it, eight to 10 percent of the members of Congress understand health care. At maximum. I chaired the intelligence committee, and health care makes it look like riding on a tricycle it's so complicated. So what you have is lobbyists picking on congressmen who don't know health-care reform, and they say, you know what, you could get a lot more jobs in your state if you only put more money into oxygen or a certain medical device. If you're going to do Medicare right, understanding that the trust fund is going to go downhill in 2016, you can't have Congress making these decisions. You need professionals.

My understanding is that MedPAC is in the Baucus bill, but I could be wrong. The self-insurance thing is something I discovered only recently. Large conglomerates like Disney and GE run their own insurance companies, essentially, contracting out to a health insurer to do the billing, at a fixed rate. So the profit that an insurance company could make off of insuring the employees of a large company is actually going to that large company themselves. They are running a small profit center off of their own employees. And that seems insane to me. So Rockefeller is right to bring this up.

Rockefeller did offer this bit of optimism, though.

What's the mood in the Democratic Caucus like right now?

There's very hot discussion. At the second-to-last meeting with Baucus, Democrats really let loose at Baucus. When you're getting close to the time you need to vote, public policy takes on a new type of intensity. Baucus, to his credit, had another meeting last night, and it was the best meeting we've ever had with the chairman. He told me they'd make sure CHIP is preserved. He knows he needs our votes. That's why I said I wouldn't vote for the bill. Democrats need leverage.

Rockefeller added that Olympia Snowe is getting hammered by Republican leadership for her dalliances with supporting the bill. Maybe that's why she laid down a subtle hint that "the party left me" and maybe she'd be better off elsewhere.

The fact that some Democrats are getting louder about what they would and would not accept is extremely healthy for this process. Maria Cantwell said yesterday that she wouldn't vote for a bill without a public option, and like Rockefeller and Wyden she's on the Finance Committee. Ultimately, progressives should encourage those who want to bring the bill back to the center of the Democratic caucus and away from being a Republican-lite bill.

Insurance Companies Make Out Like Bandits In CA Healthy Families Legislation

Last week I discussed the legislative fixes being made to save half a million kids from being dropped from the Healthy Families rolls. This fix would push more costs onto the families, making the program less affordable and the coverage stingier, and would extend a gross premiums tax on insurance companies, which was set to phase out in October, at a lower rate than they are now paying. Keeping that tax at the same rate would have spared families from increased premiums and co-pays.

But saving the program is saving the program, and yesterday the State Senate took the first step.

State lawmakers pushed forward Wednesday with a $196-million plan to keep nearly 700,000 children from being yanked off a government health insurance program for the working poor.

The state Senate passed a measure to create a new tax on insurance companies and bring in federal money to rescue the decade-old Healthy Families program, which had been cut deeply in recent months as lawmakers scrambled to balance the state budget.

Assembly officials expressed confidence that they would garner the needed two-thirds vote in the lower house, where the bill is expected to be taken up today. Administration officials said Gov. Arnold Schwarzenegger would sign the measure.

Again, not quite right. The "new tax" on insurance companies is an extension of an existing tax at a lower rate than before. This is why the insurance companies support the bill; they're getting taxed at a lower rate, keeping 600,000 kids on their insurance rolls, getting the families to pay more, and being credited with saving the system. It's a neat trick. Not only that:

The new tax would replace an existing 5.5% levy set to expire in October, prompting some lawmakers to quip that the new levy is actually a tax reduction. It would expire at the end of next year, and the insurers would be reimbursed for most of their cost.

"Of course the insurance companies want this -- it won't cost them a penny," Aanestad said.

Keeping the premiums tax in place does net $97 million in federal matching funds, which certainly helps matters. And keeping the program alive helps children in tangible ways. But this is a very strange conception of "shared responsibility," when the families participating in the program will have to pay more for premiums and co-pays, with less coverage overall, and the insurance companies get a lowered tax, which they will get reimbursement for down the road.

And the craziest part of all of this is that Sam Aanestad of the Yacht Party, while admitting this is a lowered tax and that insurers will not pay anything in the final analysis, voted against the bill because it "raises taxes on California business."

"Who pays is the bottom line here," said state Sen. Sam Aanestad (R-Grass Valley), who voted against the bill.

Sam Aanestad in this paragraph should read Sam Aanestad from the other paragraph.

Healthy Families Increases The Cost Of Coverage To Keep Children On The Rolls

Given the major hits that the Healthy Families program took in the last budget revision, it's sort of good news that the program is trying to find ways to keep almost half a million kids from being dropped from the insurance rolls. How did they manage to do that?

California legislators have apparently reached a bipartisan solution to prevent more than half a million children from being cut from the Healthy Families public health insurance program.

The Senate Appropriations Committee voted Thursday to send the proposal to the full Senate. All but two Republicans on the committee – one was absent – voted with Democrats to move it to the floor. Gov. Arnold Schwarzenegger also supports the measure, said spokeswoman Rachel Cameron.

The state board that manages the programs had planned to begin sending disenrollment notices next week to the first wave of children set to lose coverage but decided Thursday to delay the move for a month.

The bill, which surfaced this week, would raise money for Healthy Families by having participating families share more of the costs of coverage and extending a gross premiums tax on companies that manage Medi-Cal insurance plans.

What's this now? A tax? On corporations? Well, the tax already exists. It was due to end October 1, but this measure would extend the tax, and also LOWER it, from 5% down to 2%. The California Association of Health Plans (the state insurance lobby) supports the bill, and if my business' taxation were going down while I got credit for saving children's health care (a far higher sum of money to keep Healthy Families alive comes from the First Five Commission, not this lowered tax). Also, dental insurers got an exemption from this tax because Dave Cox wanted it. So anyone who thinks this vote, requiring 2/3 in both houses, will be smooth sailing, industry opposition or not, is dreaming.

As stated in the article, the bill would increase premiums and co-pays for participating families, who opt into the Healthy Families program because they cannot currently afford coverage. The Managed Risk Medical Insurance Board (MRMIB) set out cost-saving measures that would force higher costs on low-income Californians.

MRMIB also adopted four emergency regulations to trim program spending, three of which increase families’ out-of-pocket costs for Healthy Families services. Beginning November 1, families will pay higher copays for non-preventive health, dental, and vision services; prescription drugs; and emergency room visits that do not result in hospitalization. For example, families will pay $15 for using the emergency room, up from the current $5. A fourth emergency regulation requires families to enroll in the lowest-cost dental plans for their first two years on the program, at which point families could shift to a higher-cost plan. These four changes will generate net savings of $12 million in 2009-10, according to MRMIB estimates. MRMIB did not take action on a staff proposal to increase families’ premiums for savings of $5.5 million in 2009-10, because the increases are included in a bill currently moving through the Legislature (AB 1422, Bass).

I'm pleased action is being taken so that low-income kids in this state can have health insurance coverage; in the long run, we save money by allowing them consistent and preventive care instead of paying for it collectively through ER visits. But poor families may not be able to use the coverage they get through Healthy Families if the premiums go too high. And really, we're talking about $100 million dollars to cover kids when the state shoveled $1.5 billion annually to the largest corporations in America, none of whom are thinking of abandoning 38 million potential customers in the nation's largest state. It comes down to priorities.

P.S. The Legislature took action on some other health-related bills this week. Some decent bills may get to the Governor's desk, but others were killed. Cynthia Craft of Health Access has a roundup.

The Fate Of Healthy Families

One of the better tangible policy changes during the first 6 months of the Obama Administration is the expansion of SCHIP, the State Children's Health Insurance Program. Starting from the premise that all children deserve access to health insurance, SCHIP is a state/federal partnership that seeks to cover children who fall between the gaps, whose families make too much money to qualify for Medicaid, but not enough money to afford health insurance. The program has been wildly successful since its introduction under the Clinton Administration, and virtually every state has expanded their state-based SCHIP budgets to cover the maximum amounts of children.

Every state except California, that is. As part of the budget revision, the Legislature cut Healthy Families, causing between a $128 and $144 million shortfall in the program's current budget. With his veto pen, the Governor (illegally?) slashed $50 million more. The total, as much as a $194 million shortfall, is over 50% of its budget. This has led to the only waitlisting in the country for an SCHIP program.

The program already froze enrollment earlier this month, quickly amassing a waiting list of some 22,000 kids in need of health care, and swapped its application payment assistance program for $4.6 million in savings. Now, to cope with the cuts, it's expecting to disenroll hundreds of thousands of participants starting later this fall [...]

No talk of preserving a safety net for the neediest here. Disenrollment will be based on when participants entered the program. Children who hit their one-year coverage anniversary will not be eligible to renew their enrollment, and will instead be moved to that growing waiting list.

"At this point, it is strictly based on eligibility renewal dates," Puddefoot said. "Those children who were enrolled in July or August, and those children who were first enrolled in September will be the first to be disenrolled.

This could impact as many as 900,000 children.

Officials with the Managed Risk Medical Insurance Board met in Sacramento today to figure out the policy for waitlisting or disenrollment, and to explore additional avenues of support to fill the program gap. Many have speculated that First Five, the successful voter-approved program to support young children, could provide some funding, but they cannot cover a $194 million dollar hole, and their mandate allows them only to support children between 0-5. At the meeting, the board basically punted.

The task of shedding hundreds of thousands of children from the public Healthy Families health insurance program - or finding ways to keep some enrolled - was put off Thursday until Aug. 13 by the board managing the program.

The Managed Risk Medical Insurance Board must come up with a plan to respond to deep cuts in California's budget, including Healthy Families [...]

Disenrolling children from Healthy Families "is something we do not relish doing," said Cliff Allenby, the board's chairman, as members listened to a number of speakers anticipating harm that will come from cutting so many children from insurance. Allenby said the board "may have no choice," but is looking at ways to restructure the program to reduce costs and raise money for premiums from other sources.

Among the options under consideration: eliminating vision benefits, increasing co-pays and changing reimbursement schedules.

First Five committed to help with some money, but failed to delineate the amount.

I know one way to instantly restore $50 million in funding for poor children - by overriding Arnold's possibly illegal vetoes.

Enzi Invents New Six-Member Unicameral Parliament, Appoints Self Prime Minister

Steve Benen hit this yesterday, but I just noticed it. Mike Enzi, like most Senators, finds himself very, very important. So much so that he believes the November election leading to 60 Democratic Senators, 258 Democratic House members and a Democratic President sent the message that his word must be law.

With liberal Democrats on and off the Finance Committee already angling to pull the measure to the left when it is combined with a rival passed by the Health Committee, Enzi indicated his support is contingent on Democratic leaders leaving any Finance Committee agreement intact.

“I also need commitments from Sen. [Harry] Reid [D-Nev.] and Speaker Pelosi, as well as the administration, that the bipartisan agreements reached in the Finance Committee will survive in a final bill that goes to the president,” Enzi said.

There are six Senators involved in the Baucus caucus in the Senate Finance Committee. Together they represent about 2.8% of the total US population.

Let's add in some additional facts. Five Congressional Committees are working on health care legislation. The legislative process works like this: the bills coming out of the committees in the respective chambers are merged into single bills for a floor vote. Senators and House members have the opportunity to offer amendments. Those amendments are voted up or down, then there are final votes on passage of the bill in the House and the Senate. The bills coming out of the respective chambers go to a conference committee, where they are merged, with the details ironed out, and then returned to each chamber for a final vote.

That's how government works.

Mike Enzi's conception of government is this: Mike Enzi agrees to a compromise with 6% of the total Senate representing 2.8% of the population, and it becomes law.

I will say that his version has speed on its side.

The bill Enzi wants to fast track has a favorable CBO score going for it, reportedly costing under $1 trillion over 10 years and covering 95% of all Americans. But the only way to do that is to cut subsidies to the bone, making coverage unaffordable; or to phase in the program later in the ten-year budget window, maintaining the current broken, crappy system for as long as possible. It also apparently eliminates the successful Children's Health Insurance Program.

And by the way, they can't get it done until after the August recess.

Sen. Charles Grassley, R-Iowa, and Sen. Michael Enzi, R-Wyoming, dropped the bombshell news to CNN and two other reporters in Capitol hallways Wednesday night. They have spent weeks behind closed doors, trying to hammer out an agreement with their Democratic counterparts on the Senate Finance Committee but said too many issues remain unresolved, making it virtually impossible for them to sign on to a deal before the break.

“There are a lot of tough decisions to make and they aren’t going to be made real quickly,” Grassley said late Wednesday when asked whether negotiators should kick their talks over to September.

Senate Majority Leader Harry Reid, D-Nevada, had already postponed Senate floor action on health care legislation until the fall, but Democrats had hoped the Senate Finance Committee could finish its work before the summer break. In fact, one senior Democratic source said meeting that deadline was the central thrust of the president’s meeting with Reid and Finance Committee Chairman Max Baucus, D-Montana, last Friday [...]

Enzi, a soft-spoken conservative, was furious about headlines Wednesday morning that suggested he was close to reaching a deal with the Democrats.

“I felt my reputation was in danger,” he said.

In Enzi's world, signing on to a compromise with Democrats would ruin his reputation. So obviously we should just let him set the policy by himself. After all, 189,046 voted for him last year.

The silver lining here is that liberal Democrats in the House are resisting going along with this nonsense. From CongressDaily (sub. req.):

A trumpeted healthcare reform agreement with conservative House Democrats set off a firestorm of criticism from the party's liberal wing Wednesday, pushing back proceedings in a key committee and casting doubt on the strength of the leadership-backed accord.

Leaders and White House officials worked for days to reach an agreement with Blue Dogs, who had been holding up the legislation in the Energy and Commerce Committee because of concerns about cost, burdens on small business and a public insurance option [...]

"There's angst; there's questions; there's some anger," Rep. Eliot Engel, D-N.Y., a member of the Energy and Commerce Committee, said of the meetings with Waxman. "The question is, have we given up too much for the goals that we need?" he said of the agreement. "I don't want to see the insurance companies subsidized by middle-income taxpayers."

The Progressive Caucus called the Waxman/Blue Dog deal "unacceptable" and vowed to defeat such a compromise on the House floor.

Meanwhile, in the best news I've heard in years, Senate Democrats are making threats to Max Baucus' committee chair.

In an apparent warning to Senate Finance Committee Chairman Max Baucus (D-Mont.), some liberal Democrats have suggested a secret-ballot vote every two years on whether or not to strip committee chairmen of their gavels [...]

"Every two years the caucus could have a secret ballot on whether a chairman should continue, yes or no," said Sen. Tom Harkin (D-Iowa), the chairman of the Senate Agriculture Committee. "If the ‘no’s win, [the chairman’s] out [...]

Some senators suggest privately that Baucus might be more open to persuasion if his chairmanship is subject to regular votes.

Another senior Democratic senator endorsed Harkin’s suggestion but declined to speak on the record for fear of angering Baucus.

"Put me down as a yes, but if you use my name I’ll send a SWAT team after you," said the lawmaker when asked about a biennial referendum on chairmen.

Civil rights legislation in the 1960s didn't move forward until the House Rules Committee chair, a segregationist Southern Democrat, saw his power neutered by an expansion of the committee. Process changes often precede policy changes. Sen. Baucus, take note.

Governor Veto Pen

Brian and Robert have the rundown of what line-item veto cuts the Governor made today when signing the budget. The budget solution presented to him was about $1 billion short of the goal, so the Governor used his blue pencil to make unilateral cuts. I think I've said before that the good rule of thumb for these cuts, from the Governor's perspective, is to ask "Who doesn't vote?" and cut there. And for the most part, he did that. I guess he hopes that the AIDS patients who will no longer receive treatment due to cuts in the Office of AIDS Prevention and Treatment will succumb to the disease and therefore not vote. Cuts to child welfare and health care services fall on children who cannot vote. But since Schwarzenegger will never face voters again, he decided to even wield the blue pencil on actual voters. $6 million more got slashed from state parks, used by virtually everyone, and this could see as many as 100 state parks forced to close. All community health clinics get cut of their state funding, which may disproportionately affect rural areas, as will the elimination of funding for the Williamson Act, which gives farmers a subsidy to keep their parcels from falling into the hands of developers. In this budget, Schwarzenegger has assembled something for everyone to hate.

As Robert says, there's a way around this that the legislature probably won't take:

The state legislature could try and override these vetoes. But as we've seen time and again, this legislature appears to have forgotten that the override power actually exists. It would be a very good chance for Democrats to force Republicans to take a stand on these programs. Either they vote to restore the funding, or they vote to kick kids off of health care and close beaches and parks, giving Dems a set of issues to run on in 2010.

It seems doubtful that such an override will even be attempted. And so California slides deeper into ruin.

I'd have to look at the rules, and see if they've closed the extraordinary session and thus cannot override the blue-pencil vetoes. But basically this is correct. And some of those line-items, like the Williamson Act funding, would get a good deal of Republican support.

Needless to say, I agree that the line item veto, and the aggrandizement of executive power generally, should get ditched in a Constitutional convention. At the least, we could set up a mechanism where line items must be upheld by the Legislature.

...AP has a story up. Darrell Steinberg comes out with fighting words:

Senate President Pro Tem Darrell Steinberg, a Democrat who negotiated the original budget compromise with Schwarzenegger, immediately questioned the legality of many of the governor's line-item vetoes.

"We will fight to restore every dollar of additional cuts to health and human services," Steinberg said in a statement. "This is not the last word."

The last word, Senator, is override.

...also, fun fact: the budget is already around $8 billion short for 2010-2011. Surprise!

Blind To The Long Term

Robert Cruickshank pretty well covers the disaster that will be the upcoming budget "deal" between legislative Democrats and Arnold Schwarzenegger. By the way, this is BEFORE the Yacht Party tries to enact a few more goodies for the privilege of letting Democrats vote for $26 billion in cuts, gimmicks and raids on local government. We'll see a big sigh of relief from lawmakers over the next few days that will be wholly unwarranted.

In the coming days we will hear Democratic legislators claiming this is some sort of victory - that Cal-WORKS wasn't eliminated, that California can again pay its bills. These are hollow, pyrrhic victories. The raid on local government funds will ensure dozens of cities go bankrupt and will lead to reckless public safety cuts, especially to firefighters. Schools are going to get another hit without any firm guarantee that they will be repaid - we haven't seen details of the "agreement" to repay the $9.5 billion schools are owed, but Arnold seems to have won the battle to prevent repayment from becoming a constitutional mandate, meaning that repayment shouldn't be counted on until the checks are actually cut.

Still unclear is the fate of health care, IHSS, state parks, and other proposed cuts. But at this point it's not clear that their exact fate matters much. Democrats have signaled that they will abandon their half-hearted efforts to demand new revenues, to close corporate tax loopholes, and to have a more fairly balanced budget. When the next mid-year budget adjustment has to be done in 6 to 9 months from now, or in the battle over the 2010-11 budget a year from now, Arnold will have little incentive to listen to Democratic proposals, since he has proved once and for all that he can get Democrats to do his bidding by holding firm and demanding massive cuts.

Particularly galling is the targeting of city and county budgets to cover the state gap. By siphoning off almost $1 billion in gas tax funds slated for cities and counties, not one pothole in California will get filled this year. With the loss of $1.7 billion in redevlopment funds, not one project like affordable housing will get initiated. And by taking $1.3 billion in local property taxes, lots of city and county employees, particularly in public safety, will end up out of work. It's really robbery on a pretty grand scale, and it will offset any economic recovery through stimulus funding throughout the state.

One of the major consequences of this cuts-only budget will be, paradoxically, higher costs for individuals and the state. When you eliminate or severely restrict social services programs, those individuals who rely on them will have to go elsewhere for those services. The alternatives are more expensive for everyone.

Irene Steinlage has trouble walking, getting dressed, making her bed, taking a bath. She has stayed in her Folsom home with the help of a health aide, one that Gov. Arnold Schwarzenegger says the state can no longer afford.

The governor's plan to take away such care is meant to save money. But it could end up costing California more by forcing the 85-year-old, who has Parkinson's, osteoporosis and other ailments -- and thousands like her -- into nursing homes.

"I couldn't possibly afford a nursing home," Steinlage said. So the state could be saddled with a Medi-Cal tab that is triple the cost of her home care worker, who receives $10.40 an hour five days a week [...]

Others say the experience of governments that have closed gaping deficits with deep program cuts suggests that the price of doing so is hefty.

"It's pay now or pay later," said Nicholas Freudenberg, who co-wrote a study of the long-term effects of service reductions made in the aftermath of New York City's fiscal crisis of 1975.

His 2006 study, published in the American Journal of Public Health, found that less than $10 billion in cuts to healthcare, education and law enforcement in New York City over four years led to at least $54 billion in additional costs over a 20-year period, using 2004 dollars and adjusted for inflation. Consequences included higher rates of HIV, a worsened tuberculosis epidemic and a spike in homicides.

"Those potential epidemics that are being seeded by Gov. Schwarzenegger's cuts will not come in his term or the terms of people who are making these decisions," Freudenberg said. "It will be several years down the line."

The sick thing is that the Governor, and maybe even some in the Yacht Party, know this. The consequences of program cuts are easily seen. Eliminating the Poison Control System, for example, means that people calling the emergency number (many of whom don't need to see a doctor based on poison accidentally swallowed) will instead go to the ER, and many of those visits will be from people on Medi-Cal, leading to higher costs. Cutting adult day care will send many into nursing homes, at a higher cost to the state. Losing Cal Works welfare funding will send children into foster care, at a higher cost. Cutting the meager drug treatment and vocational training in prisons almost assures an even higher recidivism rate, at a higher cost.

This is not a difficult calculation to make. We fund social services programs not only because we have an obligation in a developed society not to see people dying on the street, but because we can create programs that get people back to self-sufficiency at a lower overall cost. There is only one reason not to fund such programs - because an arrogant and entitled right wing refuses to fund these government obligations in the short term, preferring apparently to pay more in the long term. There has been enough money in the last few budgets to produce massive corporate tax cuts, but not enough to get someone with a chemical dependency the treatment he or she needs. There's been enough money to protect California's unique status as the only oil-producing state not to charge corporations for taking our natural resources out of the ground, but not enough to provide long-term care services that relieve the burden of nursing home funding over the long term. There's enough money to keep in place useless enterprise zones that create nothing but tax giveaways, but not enough to keep the state from becoming the first in the nation to put poor kids on a waiting list for affordable health insurance.

We hear about the "generous social services programs" in California that simply had to be cut, but they've been reduced to the point where they are almost unanimously the worst in the nation. That depresses the business climate, that moves bodies out of the state, that alienates the public. And Arnold Schwarzenegger knows this, and he did it anyway, to keep a promise to what little of his base he has left.

Ultimately, this system isn't designed to produce good budgets. Without a media that cares, no amount of activism or public pressure can be brought to bear on a shameless and unaccountable minority. If you need proof of the need for a complete rethinking of how to structure government in California in the 21st century, look at the last seven months.

Successful Voter-Approved Program Steps In To Bail Out Failed State

On May 19, voters were asked to divert money from First Five programs to pay for General Fund expenditures. The argument was that First Five had a reserve that was just "sitting around" and they should give up some of that money, earmarked for children's programs, to pay for the budget. At Calitics, we called this the "if it ain't broke, break it" proposition. First Five, financed by a tax on cigarette sales, was well-funded and able to make multi-year program projections, so that the programs started up were not in perpetual fear of being dropped.

One of the values of First Five is that they can seek out other programs affecting children and contribute to them, in keeping with their mandate. And that is what they have voluntarily agreed to do with respect to the Healthy Families program, California's version of S-CHIP.

Meeting in Sacramento this afternoon, the First 5 California Children and Families Commission agreed to help the Healthy Families Program, which faces a $90 million General Fund shortfall in 2009-10. But the Commission declined to commit to a specific level of financial assistance. As a result, it appears all but certain that the enrollment freeze approved last month by the Managed Risk Medical Insurance Board, which oversees Healthy Families, will take effect on Friday, July 17.

In a resolution, the First 5 Commission committed “to join with like-minded public and private partners, including but not limited to health plans and philanthropic organizations, to provide financial assistance in Fiscal Year 2009-10 to the extent practicable and feasible…to ensure young children have access to affordable health insurance coverage.” This commitment, however, “is contingent upon the availability of funds in the applicable First 5 California accounts.”

I wish that First Five would have chosen a specific funding level, which could have rolled back the enrollment freeze. Still, they are making a commitment to help provide health insurance to needy children, one they couldn't have made if the state clawed back some of their money in the May 19 election. This way, First Five can target the money and keep in line with what the voters asked from them - to use their revenue to provide needed services for children. The state could have used that money for anything if they skimmed it off the top.

People often wail about ballot-box budgeting and the broken initiative process in the state, and to an extent I agree with them. But First Five is an example of GOOD ballot-box budgeting. It has a dedicated funding source, it's well-managed and well-capitalized, and it has the ability to make contingencies. If the structure of state government fails to allow increased revenue to pay for needed services, it's perfectly logical to go outside that process and produce dedicated sources of funding. It shows the virtue of a balanced approach. I don't necessarily want the ballot to do all of Sacramento's work for it, but the broken system of government sometimes leaves no choice.

Steinberg Looks To The 2010 Ballot To Restore Children's Health Care?

Looks like Darrell Steinberg is hedging his bets on fixing the broken political structure in Sacramento by going to the ballot to protect children's health coverage:

Days after Gov. Arnold Schwarzenegger proposed to abolish the Healthy Families Program (which would entail booting more than 900,000 California kids out of health insurance), Steinberg’s Committee for a New Economy on Monday made a $75,000 contribution to Californians for Children’s Health — a sizable cash infusion for a committee that previously had only about $20,000 in its coffers.

The statement of organization for Californians for Children’s Health says the group – for which a Web site is under construction – exists to support “expansion of children’s health coverage,” and its sponsoring organizations include the Children’s Defense Fund Action Council; the Children’s Partnership, a project of the Tides Center; Children Now; and PICO California. Its CFO is PICO California director Jim Keddy; its secretary is Kelly Hardy, Children Now’s associate director for health.

Hardy earlier today told me Californians for Children’s Health aims to develop a ballot measure for November 2010, and although today’s rapidly changing budget environment makes it hard to say exactly what that measure’s specifics will be, “we’re contemplating new revenue sources that would come in, not General Fund sources, that would support children’s coverage programs.”

Steinberg has a history of going outside General Fund revenues to pay for social services projects - see the millionaire's tax in Prop. 63, which funds mental health programs.

You need to play within the hand dealt, and voters have shown a willingness to use tax increases to fund specific programs. Losing the Healthy Families Program would mean 900,000 kids without health care in California, and we would be the only state in the country not accessing federal SCHIP funds. So obviously, you try to get that revenue absolutely any way you can.

At the same time, is this any way to run a government? Create a system where no revenues can be raised inside the legislature, forcing stakeholders and politicians to go to voters to look for a dedicated stream here and another dedicated stream there? This is unsustainable to the nth degree. We will not transform California one dedicated funding stream at a time. It just won't work, and we'll spend hundreds of millions of dollars on consultants in the process. Steinberg shouldn't foreclose the option, of course, but his money would be better spent on reform efforts so that he no longer needs to go to the voters for everything, and we can have a representative democracy such that has worked in America for over 220 years.

Moreover, I fear that Steinberg is setting this fallback plan up assuming that Healthy Families will be either eliminated or gutted in the next couple weeks. Perhaps the donation to a potential ballot committee is a threat to the Governor; but perhaps it's a signal that the cuts can come down. Let's be clear - in the meantime, while we wait for the results of that election, children will die from a lack of health care coverage. We have other options - Jean Ross describes some of them beautifully here - and the Democratic legislature should be drawing lines in the sand, not giving up on drastic cuts and making contingencies.

Governor Hoover's Plan To Weed Out The Sick

I just appeared on KPFA with Eric Klein to talk about the Governor's proposed budget cuts, along with several experts and stakeholders, including friend of Calitics Anthony Wright of Health Access California. I agree with him that it's almost hard to fathom the amount and severity of the cuts proposed for health care, especially at a time with the federal government is moving forward with a "do or die" plan to reform the health care market, increase access and lower costs. The proposed Governor Hoover cuts would have the exact opposite effect, and the people gravely impacted by this will not have the luxury of waiting around for the Feds to catch up and fill in the gaps.

Two recent CBP fact sheets help break down the Governor’s proposed cuts to Medi-Cal and Healthy Families, in numbers that are easier to grasp. These fact sheets show:

More than 940,000 California children would lose health coverage if the Healthy Families Program is eliminated as the Governor proposes. More than 240,000 children in Los Angeles county alone would be affected. Want to know how many children would be impacted in your county? Check out the fact sheet to see.

In total, more than 1.9 million Californians could lose access to health coverage within three years through proposed reductions to the Medi-Cal Program and elimination of Healthy Families.

As the Governor said himself today, “behind every one of those dollars that we cut there are real faces.”

Kudos to the LA Times, by the way, for allowing the great unmentionable to get printed on their pages - the decisions made in Sacramento will truly be the difference between life and death for many Californians.

Schwarzenegger argues that the state's declining economy and plummeting tax revenues have boxed California into a corner, forcing deep and historic cuts in the health and welfare programs that form the state's social safety net. Without those tough measures, he says, California will cartwheel toward insolvency.

But a 10-person legislative budget panel, which is reviewing the governor's proposals, listened during a long day in a crowded hearing room to scores of people who said their survival depends on programs set to be hit by the budget ax.

They heard from mothers of children with autism, representatives of people on dialysis, poor parents whose children see dentists on the government's dime, former drug abusers set straight by a state rehab program.

And they heard from a woman named Lynnea Garbutt who has lived with AIDS all of her 24 years.

She has survived with the help of a state program that provides the expensive antiviral drugs she takes. Now, with that program facing elimination, she pleaded with lawmakers to save it -- and her life.

"If these cuts take place, you're not just cutting money from the program -- you're cutting my life," she told the panel, her voice shaking and tears falling. "I choose to live. Please don't make me die. My choice is life."

This is how Yacht Partier Chuck DeVore responded - move out of the state. Love it or leave it!

The cuts made to programs like Healthy Families (California's SCHIP) would eliminate federal matching funds and double or triple the scope of the cuts. And it would be one thing, by the way, if the Yacht Party simply held the line and said "we can't afford it." But no, they want to spend billions of dollars, only on their own projects instead of saving human lives.

In this article in the San Diego Union Tribune, the same Republicans (and Republican governor) who would eliminate children's health care and basic services for the neediest Californians, actually want the state to pony up the money for a water bond.

Schwarzenegger, says the article, is still fixated on a whopping $10 billion bond. And Senate Republicans are right there with him:

"Sen. Dave Cogdill of Modesto, the lead Republican on water issues, agreed. “It's obviously a tough time to bring it forward, but we can't wait,” the article notes.

We can't wait? According to my calculator, If the entire $10 billion was sold together, the interest payment could be in the neighborhood of $660 million annually. That's $660 million more that would have to come out of schools, health care, and other items on the chopping block.

Similarly, the Yacht Party cried poor about programs that help people, but made room in the February budget for a huge corporate tax cut.

Everyone who has spent 10 seconds on this recognizes that there's no good way to use current revenues to provide the basic level of services Californians deserve. To the extent that I have hope that we will overcome the selfishness of the cruel and the impossibility of navigating a broken system, it comes from people, who are fed up and starving for leadership and change from a government that no longer serves their interests. To turn the figurative starvation literal, Los Angeles teachers are going on a hunger strike to protest budget cuts. We're all hungry, and we'll be a lot hungrier if Governor Hoover has his way.

The Good Shit

While today is in general a shitty day, it's not a total crapout. There have been a few victories of the "cleaning up Bush's mess" stripe.

First, Barack Obama signed an expansion of the State Children's Health Insurance Program, a fully paid-for bill that will cover an additional 4 million uninsured kids (11 million will be covered under the program in all). And importantly, he called it a first step to providing comprehensive health care reform.

"As I think everybody here will agree, this is only the first step," Obama said of the bill that reauthorizes the State Children's Health Insurance Program.

"Because the way I see it, providing coverage to 11 million children through CHIP is a down payment on my commitment to cover every single American," he said to applause before turning to the economic recovery bill.

"It won't be easy; it won't happen all at once," Obama said. "But this bill that I'm about to sign, that wasn't easy either."

Next, the Justice Department is righting the biggest wrong of the Monica Goodling era:

Remember Leslie Hagan, who last April was dismissed by Monica Goodling from the Justice Department's Executive Office for U.S. Attorneys because she was rumored to be gay?

Well, the Obama administration has righted that wrong, giving Hagen her job back, reports NPR, which broke the original story of her dismissal.

Hagen served as the liaison between DOJ and the U.S. Attorneys' committee on Native American affairs. In her performance evaluation, she received the highest possible ratings -- "outstanding" -- in each of five categories.

But Goodling, a Christian fundamentalist, heard a rumor that Hagen was gay. So it was curtains for her.

That's just the right thing to do as a matter of human decency. And the thing is, Hagen won the job on the merits, as part of a nationwide search and after several interviews. It's good to see "on the merits" in reference to a political job again.

Finally, Ken Salazar, showing an unusual partisan edge, is reversing oil and gas leases on federal land in Utah:

Interior Secretary Ken Salazar is canceling oil and gas leases on 77 parcels of federal land in Utah, according to sources familiar with the decision, ending a fierce battle over whether to allow energy exploration in the environmentally sensitive area.

The Bush administration conducted the lease sale in December, but environmental groups went to court to block the winning bids encompassing roughly 110,000 acres near pristine areas such as Nine Mile Canyon, Arches National Park and Dinosaur National Monument [...]

An Interior spokesman declined to comment on the matter, but several sources familiar with the decision said Salazar planned to announce it today, adding that he can reject the winning bids without a penalty because the transactions had not become final and the department has the discretion to accept or reject lease bids that prevail at a public auction.

This was the auction that environmentalist Tim DeChristopher tried to scuttle by buying up millions of dollars' worth of land without the ability to pay for it. Now he won't need to - Salazar cancelled the leases.

These are all all great accomplishments, but they are all backward-looking, fixing mistakes or realizing long-held goals. The forward-looking stuff is finding a much bumpier road.

Bredesen? End Of Health Care Reform As We Know It

Getting back into the talk about who will run HHS, the name Phil Bredesen has come up, which makes me stumble around as if I've been punched in the face.

As governor, Bredesen presided over some drastic cuts to TennCare, Tennessee's once innovative effort to reform Medicaid. I wrote about these in my book, Sick:

...it was a Democratic governor who would succeed in enacting the most sweeping cuts: Phil Bredesen of Tennessee. Bredesen knew a thing or two about health care: before getting into politics, he had made his fortune by founding a company called HealthAmerica—one of the fi rst commercial HMOs to cash in on managed care during the late 1980s. This experience, plus his confi dence in his own intellectual abilities (he had a physics degree from Harvard), convinced him that he could wring new efficiencies from Tennessee’s Medicaid system, just as his HMO had generated financial savings—and hefty profits—in the private market.

A lot of what Bredesen proposed to do—such as reducing fraud by providers and recipients, and improving the use of information technology—made sense. But when those quick fixes didn’t bring the TennCare budget under control, he unveiled a more straightforward plan: he would simply slash the program. More than 100,000 people who had qualified for TennCare because they were “medically needy” would lose their coverage altogether. Those allowed to remain in the program would have to make do with more limited benefi ts. The biggest change would be in the coverage of prescription drugs. “The sad reality is that we can’t afford TennCare in its current form,” Bredesen said. “It pains me to set this process in motion, but I won’t let TennCare bankrupt our state. This is the option of last resort.”

While Bredesen undoubtedly faced tough circumstances, he didn't exactly distinguish himself by coming up with creative solutions--or fighting for people who, after all, were among Tennessee's most vulnerable citizens. As liberal advocates protested planned cuts, he fought bitterly with them, threatening even more draconian measures if they wouldn't buy into his programme.

That's not the only reason Bredesen worries me, though. Another concern is characterological. He is typical of the top figures in the health industry I've met over the years: Self-made entrepreneurs a bit too convinced of their own brilliance, completely unaware that the strategies for making private insurers profitable don't help--and often hurt--the sicker, poorer people whom insurance should ideally protect. Their biggest fans are often people who know a ton about health care at the macro level, but haven't spent much time observing it on the ground--where reality is often messier than the statistics suggest.

Ezra Klein has more. I mean, Democrats are already telling America to forget about single payer (hopefully team single payer will have something to say about that), but under Bredesen, you'd basically have to forget about even decent incremental reform.

One bit of good news on that incremental front: the House passed SCHIP today for a second time, and as this bill is in line with the Senate version, it will in all likelihood be signed into law tonight. This is actually pretty good incremental reform, not the kind you'd get with Phil frackin' Bredesen.

...wait, I found somebody worse than Bredesen for HHS. Jim Cooper. The guy that killed the 1994 reform. Think "bigger giveaway to special interests".

Kids Getting Health Care, Republic Doomed

SCHIP expansion passed the Senate. I guess there were some slight differences in the bill, so the House will have to re-pass this version, which shouldn't be a problem.

The Democratic-controlled Congress moved a step closer to handing President Barack Obama an early health care victory Thursday as the Senate passed a bill extending government-sponsored health insurance coverage to about 4 million uninsured children.

The bill, which was approved 66-32, authorizes an additional $32.8 billion over the next 4 1/2 years for the State Children's Health Insurance Program.

This is a start on health care reform. It's still fulfilling only part of the promise of the 2004 Kerry campaign, but it's a start. Getting 4 million kids health insurance is not trivial. Hopefully we can build on this and get a comprehensive solution that is the only way to bring down costs. Henry Waxman is optimistic.

Barack Obama has said he wants to pursue major health care reform this year. Two key committee chairmen in the Senate, Max Baucus and Ted Kennedy, have said they want to pursue health care this year. But what about the House? [...]

A few minutes ago, Congressman Henry Waxman made his feelings known -- and did so with no ambiguity. Speaking at the annual Health Action conference, sponsored by the health care advocacy group FamiliesUSA, Waxman announced, "This is our time.... We need to get this job accomplished this year and get a bill to the president."

Waxman is not in the House leadership, of course. But he is very close with Speaker Pelosi and, no less important, he is chairman of the Energy and Commerce Committee -- the committee that will likely take the lead on writing and then pushing health reform legislation.

Let's see it, you mad munchkin, you.

Mint SCHIP

The House just passed an expansion of the State Children's Health Insurance Program (SCHIP) by a vote of 289-139, which is a very solid majority. I was wondering how it was funded, and I guess it's through that same sin tax.

SCHIP currently covers over six million children whose parents earn too much to qualify for Medicaid — the federal health insurance program for the poor — but who can't afford private insurance. The bill's supporters say the legislation would extend the program to an estimated four million additional children, paying for it with a 61-cent-per-pack increase in the federal tax on cigarettes.

Passing an expansion of SCHIP early in Obama's presidency, House Majority Leader Steny Hoyer said, would be "a very dramatic and important statement that change has come to America."

"Children are our treasure," said Rep. John Dingell, D-Michigan. "The (SCHIP) bill is only the beginning… We must not stop until all Americans qualify for quality, affordable health care."

I'd rather you taxed millionaires or financial transactions, but there's a certain logic to expanding health care by discouraging bad health outcomes. If less people abuse cigarettes in the process, you are saving health care money on the way in as well as raising revenue. Still, this is an incremental reform and only a gateway to the needed overhaul of the system.

Here's Obama's statement:

"In this moment of crisis, ensuring that every child in America has access to affordable health care is not just good economic policy, but a moral obligation we hold as parents and citizens. That is why I'm so pleased that Democrats and Republicans in the House of Representatives came together to provide health insurance to over ten million children whose families have been hurt most by this downturn. This coverage is critical, it is fully paid for, and I hope that the Senate acts with the same sense of urgency so that it can be one of the first measures I sign into law when I am President," said President-elect Obama.

The problem with this is that it didn't pass in 2007, when President Bush vetoed it twice. Because having that in place before the downturn would have meant that the programs would not have been cut to ribbons in the states:

Even as President-elect Barack Obama plans an ambitious push to expand health coverage nationwide, states are slashing health services to their poorest residents amid the economic downturn.

The unprecedented cuts in public assistance come as millions of Americans are losing their jobs and health insurance.

In many cases, the cuts are so deep that even the massive federal rescue package being assembled on Capitol Hill may not be enough to restore services being eliminated in the burgeoning crisis, health officials warn.

And the faltering economy has all but killed trailblazing state campaigns to expand coverage for the working poor -- once seen as hopeful signs for national healthcare reform.

This injection of money is going to help, but in many ways the damage has been done.

One additional point. The most controversial portion of the SCHIP debate is whether or not the children of immigrants should be covered. The xenophobic right thinks that "illegals" shouldn't reap the benefits of citizenship, even though we're talking in most cases about kids who were born here and are legal residents. In addition, having untreated kids running around could be a public health issue, and there's value (and even savings) in treating everyone with vaccinations for communicative diseases, for example. Simon Rosenberg says that this is a good reason to pass comprehensive immigration reform so we don't keep returning to these narrow debates:

"That the debate over SCHIP has immediately become a debate about immigration should be a clear warning to the Administration and Congress that progress on many important domestic priorities this year may get caught up in the debate on how to best fix our broken immigration system. It is our belief that rather than having a series of tough and contentious proxy fights on immigration, our leaders should recognize that passing comprehensive immigration reform this year will not only help fix our badly broken immigration system - a priority of many Americans - but may also be the key to unlocking bipartisan progress on a whole range of other domestic and security related issues."

I have to agree.

...roll call here. 40 Republicans joined every Democrat but 2.

(hint: if they can't vote for SCHIP, Bobby Bright and Jim Marshall aren't really Democrats.)

Fulfilling The Promise Of The Kerry '04 Campaign

The House is going to take up SCHIP again this week. Providing health care to all children is a noble goal, and I trust it will be enacted, but given how much further the plans and goals for universal health care went throughout the general election campaign, it's hard to work up much enthusiasm for it. John Kerry ran on covering all children and catastrophic health services, so in essence this bill catches up to him. Nevertheless, it ought to pass, because at $5 billion dollars, it's a very cost-effective way to expand health care coverage. Children are relatively cheap to cover, and a healthy childhood can lead to a healthy life. Christy Hardin Smith knocks down the objections:

Look for the usual screeching from "scary immigrant" wingnut corners. Fiscal responsibility may be the underpinning, but fiscal conservatism doesn't exactly tug at wingnutty heartstrings these days, or beat the shouting tom toms like scary brown people obviously do. Sad.

From a public health perspective, though, immunization for children entering the country seems logical to me: prevention of the spread of potentially virulent and communicable diseases brought into the country is just plain common sense. How about you?

SCHIP provides a safety net of health care for the most vulnerable in our society. Given the current economic climate, more and more families are going to fall into the cracks -- meaning children who could use health care now to correct a problem which may just get worse over time could use a hand.

Expanding the social safety net at this troubled time is a no-brainer. I look forward to passage of the SCHIP expansion, incremental though the progress may be.

The First 75 Days Before The First 100 Days

Obama's transition team is trying to manage expectations on what they will be able to attack immediately upon being sworn in. Rahm Emanuel makes it sound like the first order of business will be to un-veto the vetoes:

Asked what Barack Obama was elected to do, and what legislation he's likely to find on his Oval Office desk soonest, Mr. Emanuel didn't hesitate. "Bucket one would have children's health care, Schip," he said. "It has bipartisan agreement in the House and Senate. It's something President-elect Obama expects to see. Second would be [ending current restrictions on federally funded] stem-cell research. And third would be an economic recovery package focused on the two principles of job creation and tax relief for middle-class families."

SCHIP and stem cell research are leftover legislative priorities, and they won't cause much of a stir, but I wouldn't say they are anything Obama campaigned on. But it's good to rack up a couple quick victories. I imagine the Congress could pass those by January 20 and Obama could sign them January 21. Obviously the stimulus package was a major element of the campaign, so that will come next.

As for the inevitable center-left/center-right question, this isn't a horrible way of putting it:

So I asked Mr. Emanuel if the election of an unabashed liberal like Mr. Obama has made the New Democrat strategy obsolete. Perhaps what we witnessed on Tuesday means that liberalism is ascendant and the U.S. is no longer a center-right nation. "I think the country is incredibly pragmatic," he responded. "Pragmatic and progressive. But you still have to mix and match different approaches to reach your objectives. You have to be flexible."

He said the similarities between Barack Obama and the last Democratic president matter more than the differences. "Both Barack and Bill Clinton have an incredible connection to the public," he said. "Both ran on a message of hope. Both ran against failed policies that let the country down prior to them being elected. I don't think the country is yearning for an ideological answer. If anything it's the opposite. They want real solutions to real problems. And if we do an ideological test, we will fail. Our challenge is to work to solve the actual problems that the country is facing, not work to satisfy any constituency or ideological wing of the party."

I know a lot of people want to hear "progressive mandate" in there, but there is some work to be done with the public in proving that what is pragmatic is progressive, so I'm actually fairly OK with it. It's pretty close to the Wellstonian "politics is about improving people's lives."

If progressives want a dog whistle, here it is:

Transition advisers to President-elect Barack Obama have compiled a list of about 200 Bush administration actions and executive orders that could be swiftly undone to reverse White House policies on climate change, stem cell research, reproductive rights and other issues, according to congressional Democrats, campaign aides and experts working with the transition team.

A team of four dozen advisers, working for months in virtual solitude, set out to identify regulatory and policy changes Obama could implement soon after his inauguration. The team is now consulting with liberal advocacy groups, Capitol Hill staffers and potential agency chiefs to prioritize those they regard as the most onerous or ideologically offensive, said a top transition official who was not permitted to speak on the record about the inner workings of the transition.

In some instances, Obama would be quickly delivering on promises he made during his two-year campaign, while in others he would be embracing Clinton-era policies upended by President Bush during his eight years in office.

"The kind of regulations they are looking at" are those imposed by Bush for "overtly political" reasons, in pursuit of what Democrats say was a partisan Republican agenda, said Dan Mendelson, a former associate administrator for health in the Clinton administration's Office of Management and Budget. The list of executive orders targeted by Obama's team could well get longer in the coming days, as Bush's appointees rush to enact a number of last-minute policies in an effort to extend his legacy.

One of these is the "global gag rule."

The new president is also expected to lift a so-called global gag rule barring international family planning groups that receive U.S. aid from counseling women about the availability of abortion, even in countries where the procedure is legal, said Cecile Richards, the president of Planned Parenthood Federation of America. When Bill Clinton took office in 1993, he rescinded the Reagan-era regulation, known as the Mexico City policy, but Bush reimposed it.

"We have been communicating with his transition staff" almost daily, Richards said. "We expect to see a real change."

And another would allow California to regulate greenhouse gas emissions.

The president-elect has said, for example, that he intends to quickly reverse the Bush administration's decision last December to deny California the authority to regulate carbon dioxide emissions from automobiles. "Effectively tackling global warming demands bold and innovative solutions, and given the failure of this administration to act, California should be allowed to pioneer," Obama said in January.

California had sought permission from the Environmental Protection Agency to require that greenhouse gas emissions from vehicles be cut by 30 percent between 2009 and 2016, effectively mandating that cars achieve a fuel economy standard of at least 36 miles per gallon within eight years. Seventeen other states had promised to adopt California's rules, representing in total 45 percent of the nation's automobile market. Environmentalists cheered the California initiative because it would stoke innovation that would potentially benefit the entire country.

In a separate AP article, John Podesta basically confirms this imminent use of executive orders, in particular stopping the Bureau of Land Management from opening 360,000 of public land near Arches National Park in Utah for oil and gas drilling. Podesta noted, "They want to have oil and gas drilling in some of the most sensitive, fragile lands in Utah ... I think that's a mistake."

Well, it's hard not to smile at all of this. I believe the applicable term is "the adults are back in charge."

I understand that the new Administration is debating whether or not to go big and take on a variety of issues right away, but the above would reflect a pretty good deal of positive change. It's not enough, of course, and we're going to have to be there on the left flank pushing the Administration to keep moving forward and ignore the neo-Hooverists and the guardians of the status quo.

Ugh

Can everybody in the Democratic leadership in the Congress be required to take a political science class?

Congressional Democrats have scrapped plans for another vote on expansion of the Children’s Health Insurance Program, thus sparing Republicans from a politically difficult vote just weeks before elections this fall.

Before the summer recess, Democrats had vowed repeatedly to force another vote on the popular program. But Democrats say they have shifted course, after concluding that President Bush would not sign their legislation and that they could not override his likely veto.

Mr. Bush vetoed two earlier versions of the legislation, which he denounced as a dangerous step toward “government-run health care for every American,” and the House sustained those vetoes [...]

Representative Rahm Emanuel of Illinois, chairman of the House Democratic Caucus, said: “We are not going to change any votes on the children’s health insurance bill. We still don’t have enough to override a veto. Those who opposed this bill can face the voters and explain why they believe 10 million kids should not get health coverage.”

Yeah, no kidding, Rahm, and it'll be easier for Democratic challengers to draw this contrast if YOU PUT THE BILL UP FOR A VOTE AGAIN and showed yet again the callousness of the Republican caucus.

There were 2 SCHIP votes over a year ago. In news cycle time that might as well have been during the Eisenhower Administration. Everyone knows that SCHIP wouldn't pass - the point is to make the Republicans vote on it. It's part of the perks of being in the majority, forcing the opposition to make inconvenient votes in an election year. You might want to look up the vote for military force in Iraq (2002), the Homeland Security bill (2002), the Military Commissions Act (2006), and on and on...

Because there's no way the bill would pass, it's a free vote. You could tie the revenues to removing tax breaks for the oil companies and make the vote a two-fer. "Congressman X would rather give oil executives a new yacht than help sick children!" But alas, the leadership sees no reason why that would be a useful vote.

Thanks for making life harder for the dozens of challengers trying to unseat the bozos on the other side. Really nice work. Be sure to pass an offshore drilling bill while you're at it, because we should definitely play on Republican turf with our votes in an election year when we hold the majority. Great strategery.

SCHIP, Baby

Doesn't winning feel good?

After watching Republican opposition to a Medicare bill crumble in the Senate this week, emboldened Democrats are considering whether to force a new vote on expanding a children’s health insurance program.

Lawmakers, aides and lobbyists say House Democratic leaders may schedule a vote in September on an expansion of the State Children’s Health Insurance Program (SCHIP), a priority for Democrats since they took over Congress last year.

It's called "daring your opponent to make bad votes." SCHIP is a great political issue and an important policy, so having GOP lawmakers in threatened seats vote on it over and over again is a very good idea. And with the HCAN coalition and a possible jumping of the fence to Democrats by doctors, we have the outside muscle to get this done.

People don't really remember the SCHIP vote from last year. It's time to remind them.

(Unfortunately, eventually Democrats figure this stuff out on domestic policy; if it has to do with foreign policy they run scared. Which is completely sad, and harms their chances of taking back the White House.)

Republicans Using Cheney To Fix Cheney Problem

It's kind of a bad sign when you're trying to save a ridiculously Republican seat in a special election and your ace in the hole is Dick Cheney. Fourthbranch can still raise money, but it's not like he's ever been an enthusiastic campaigner - he's not much for, you know, people.

But this is of course where the GOP stands right now - in trouble of losing House races in the whitest areas of Mississippi - and starting to acknowledge their historically bad position.

The stakes in the 1st District special election couldn't be higher, strategically or symbolically. The loss of a traditionally GOP seat to a Democrat would be the third in a special election this spring and the second in the Deep South after the May 3 victory of Rep. Don Cazayoux (D-La.).

Rank-and-file Republicans say that would force a day of reckoning for their leadership.

"When you connect three dots in anything, that's a bad thing. This connects the dots. At that point, everybody's got to come together and have a come-to-Jesus meeting," said Rep. Tom Davis (R-Va.), a retiring centrist who will help form a new advisory panel at the National Republican Congressional Committee.

"It's a time of sober reflection and, to some extent, resolve. I hope these special elections are a wake-up call," said Rep. Jeb Hensarling (R-Tex.), the leader of the conservative Republican Study Committee.

The fact that Dick Friggin' Cheney is being sent on the campaign trail is a sign that the wake-up call is so far not being heard. Same with this little quip by Roy Blunt on one of the Sunday shows:

BLITZER: When it comes to domestic economic issues, what is the major difference between President Bush's policies, what he wants to do, and what John McCain would do if he were president?

BLUNT: Well, I think what John McCain wants to do is continue these pro-growth tax policies that our friends on the other side have been talking...

(CROSSTALK)

BLITZER: But that's what President Bush wants to do too.

BLUNT: And there is nothing wrong with that. There is nothing wrong with that.

BLITZER: So it would be in effect a third Bush term when it came to pro-growth tax policies?

BLUNT: It would be. I think it would be. And I think that's a good thing.

The same with the outside Republican allies, airing ads in Senate primaries attacking Republicans who favor SCHIP.

They don't seem to recognize that this is their entire PROBLEM with the electorate - Bush's failed economic plans, Cheney's imperialist neoconservatism, Republican obstruction on popular initiatives like children's health care. This is WHY they're in the hole they're in - it's unlikely employing the SAME methods will get them out of it. This is why practically no Republican is safe in November. This is why Republicans who look forthrightly at the situation will rally to the Democratic position. This is why there's the chance of a realignment election.

McCain's Terrible Economic Plans

(first in a two-parter!)

John McCain spent most of the Republican primary campaign tooling around on his wife's jet without paying much of the cost. At the same time, he was saying publicly that he was forced by his cash-poor campaign to fly coach and carry his own bags. It's a good metaphor for his economic plans, which offer a free ride for the wealthy and connected at the expense of the peons below the hard deck of 30,000 feet (or a million dollars, depending on the metaphor), while using double-talk to make them sound somehow populist. McCain wouldn't just make the Bush tax cuts permanent - he would add in a whole other round of new corporate tax breaks and eliminate the alternative minimum tax instead of recalibrating it to do the job it was meant for (ensuring that the wealthy pay some tax rather than use creative accounting to deduct their income completely away). Paul Krugman takes a look:

According to the nonpartisan Tax Policy Center, the overall effect of the McCain tax plan would be to reduce federal revenue by more than $5 trillion over 10 years. That’s a lot of revenue loss — enough to pose big problems for the government’s solvency.

But before I get to that, let’s look at what I found truly revealing: the McCain campaign’s response to the Tax Policy Center’s assessment. The response, written by Douglas Holtz-Eakin, the former head of the Congressional Budget Office, criticizes the center for adopting “unrealistic Congressional budgeting conventions.” What’s that about?

Well, Congress “scores” tax legislation by comparing estimates of the revenue that would be collected if the legislation passed with estimates of the revenue that would be collected under current law. In this case that means comparing the McCain plan with what would happen if the Bush tax cuts expired on schedule.

Mr. Holtz-Eakin wants the McCain plan compared, instead, with “current policy” — which he says means maintaining tax rates at today’s levels.

But here’s the thing: the reason the Bush tax cuts are set to expire is that the Bush administration engaged in a game of deception. It put an expiration date on the tax cuts, which it never intended to honor, as a way to hide those tax cuts’ true cost.

The McCain campaign wants us to accept the success of that deception as a fact of life. Mr. Holtz-Eakin is saying, in effect, “We’re not engaged in any new irresponsibility — we’re just perpetuating the Bush administration’s irresponsibility. That doesn’t count.”

Frequently the numbers in Presidential plans don't add up, but we're talking about $5 trillion dollars, which is far more fiscally irresponsible than the plans of both Democrats, despite the New York Times offering the pathetic lede in their story that all three "could significantly swell the budget deficit and increase the national debt by trillions of dollars." When the Democrats' plans are less than 1/3 in cost of McCain's, that shoudl kind of be noted up front, especially when every question directed at a Democrat about federal spending automatically includes "but how are you going to pay for that?" as a given. You'd think the fact that McCain really, really needs to figure out how he's going to pay for anything, like his own salary, under his budget plan, would merit a highlight.

And then there's the faux-populist, "I'm on your side" rhetoric that is at odds with virtually every policy he advocates. This happened all last week on his "Forgotten Places" tour, and now we see it's happened again - his advance people can't find a location for his speeches that isn't deeply embarrassing:

Kicking off his “Call to Action Tour” today, Sen. John McCain (R-AZ) toured Miami Children’s Hospital, where he “met and listened to some of its young patients and their parents.” In remarks delivered at the hospital, McCain pledged that he would “work to eliminate the worries over the availability and cost of health care” [...]

McCain’s use of the Florida children’s hospital to launch his health care-focused tour is ironic considering McCain’s recent vote against expanding the State Children’s Health Insurance Program. The expansion that McCain opposed would have extended coverage to a significant portion of Florida’s 658,000 uninsured children.

The expansion passed despite McCain’s protestations, but President Bush vetoed it in October, which McCain said was the “Right call by the president.”

There's literally nowhere McCain can visit without a call back to some horrible vote he made that's at odds with the majority of the public. SCHIP will be a major part of the 2008 election and he's on the wrong side of it.

Of course, he could just hold the rallies on the private jet at 30,000 feet...