U.S. health care is in the midst of a major transformation. With the implementation of the Affordable Care Act, tens of millions of Americans are getting health insurance coverage for the first time. Expanded coverage will bring a tsunami of new demand, and current transformations underline the truth that insurance is not the same thing as access to appropriate health care. Across the nation, front-line providers of primary care – safety net providers – risk becoming overwhelmed by the arrival of millions of people newly insured or enrolled in Medicaid, including many vulnerable people with special needs. As happened after the start of Medicare in 1965, the United States faces the prospect of tremendous strain on the vital primary care infrastructure – with the risk that many people could still go without adequate care.
Bolstering safety net services will be essential to meet the needs of the newly insured – as well as the needs of millions who will still remain uninsured (either because Affordable Care does not include them or because they live in conservative states that refuse to expand Medicaid). (more…)
The debate over same-sex marriage – or “gay marriage” – has been contentious in national and state politics for nearly twenty years. After voters in many states rushed to ban same-sex unions, the tide turned. In recent years, sixteen states and the District of Columbia have legalized same-sex marriage and another three states have approved civil unions or domestic partnerships that include full spousal rights for lesbian, gay and bisexual couples. Despite this progress, as of the end of 2013, only 37% of Americans live in a state with marriage equality; and many lesbian, gay, and bisexual people still do not enjoy the full rights and benefits associated with marriage. This is unfortunate for moral and economic reasons. Equally important, a growing body of public health research documents the many health benefits associated with legal same-sex marriage. (more…)
As the new Affordable Care marketplaces get under way in each state, how many Americans without health insurance will learn about their new options – including the generous subsidies available to help people with low or moderate incomes afford premiums for health insurance plans? Public confusion has been widespread, but outreach experiences suggest that providing accurate information – especially face-to-face – makes people more positive toward the health reform law and increases their willingness to sign up.
In the words of outreach specialist Libby Cummings of the Community Health Center in Portland, Maine, “When we have a chance to explain it to people, it’s been very positive. People are excited about it and want to have health insurance. People see it as an opportunity to get coverage that was never open to them before.” (more…)
Charter schools operate in the public sector and are supported by taxpayers, but like private schools they grant considerable autonomy to principals and teachers and allow parents to make choices not constrained by zip codes or neighborhood boundaries. Boosters often make extravagant claims for charter schools, promising to fix deficits in American education and close achievement gaps between minority and white children and between students from richer and poorer backgrounds. Understandably, such glowing promises capture the imagination of public officials – and, above all, appeal to parents searching for quality schooling who are disillusioned with neighborhood public schools yet unable to afford tuition at Catholic or elite private schools.
But is the hype about charter schools backed up by the evidence? Is there solid research suggesting that charter schools are doing any better for students than traditional neighborhood or magnet schools? So far, the best objective research studies have arrived at mixed results, and there is a strong need to supplement existing approaches with a closer look at the on-the-ground experiences of teachers, principals, parents, and schoolchildren, comparing the daily operation of charter schools with other schools in their areas. Parents and citizens alike need to learn much more about how well charter schools actually are performing. (more…)
Stand Your Ground laws are suddenly in the spotlight, as Americans debate whether they counter violence or put more people in danger of death or injury by gunfire. It is a good time to look closely at what these laws do – and what we know, so far, about their effects. (more…)
Reelected to a second term, President Barack Obama is speaking with new force and clarity about the threat of climate change; and he is encouraging the Environmental Protection Agency to take bold steps to reduce dangerous greenhouse gas emissions. To make up for Congressional unwillingness to legislate, the Obama administration seems ready to do all it can through executive actions. Many professional environmentalists are delighted, and will rely on inside-the-beltway lobbying to urge regulators onward. That is fine for the short run, but it would be too bad if efforts to counter damage from global warming stopped at insider advocacy.
The new few years are exactly the right time to build a broad nationwide network of popularly rooted organizations committed to supporting carbon-capping as part of America’s transition to a green economy. To be prepared when the next opening arises in Congress, organizational efforts must reach far beyond the Beltway – to knit together alliances and inspire tens of millions of ordinary Americans to push for change. (more…)
All U.S. states provide tax credits and exemptions to older Americans, who clearly benefit and appreciate the help. Of course, people retired from the labor force do not owe payroll taxes, and their income tax rates may fall as well. Nevertheless, most citizens over age 65 must get by on relatively fixed budgets – and income for the typical older household is about half the level for all U.S. households. For many seniors, the cost of state and local taxes can loom large.
Not just older residents, but entire states may reap benefit from these tax breaks for seniors. Migrant retirees may move in, establishing new homes and spending pensions earned elsewhere. But there can also be disadvantages for localities and states that provide large and growing tax breaks to older residents. The pros and cons become evident when we look more closely at the various kinds of elder tax abatements and consider their consequences in the context of growing public budget pressures. (more…)
The Voting Rights Act of 1965 is a milestone in the long fight to ensure all Americans access to the ballot box. For nearly two centuries before President Lyndon Johnson signed this legislation, most African Americans were disenfranchised by law, force, or trickery. Starting in 1965, the U.S. Justice Department gained special authority to enforce minority voting rights, including the use of a Section 5 provision to review, in advance, any changes in election rules in states or districts with a proven history of discrimination. Where poll taxes, literacy tests and sheer terror once kept them from the polls, African Americans gained unprecedented citizen clout. Black interests and candidates gained new representation, and decades later high African American turnout helped elect and re-elect Barack Obama as the first black president of the United States. (more…)
Image by Ken Teegardin via Flickr
“Almost half of all Americans pay no taxes!” That’s the claim bandied about in elections and overheated television talk-fests. It refers only to federal income taxes, from which various groups are exempt. But many other taxes are also collected at the federal, state, and local levels. When all kinds of taxes are added up, almost all Americans pay substantial amounts. In fact, poor and middle-income people frequently fork over higher shares of their incomes than the very rich.
Federal Income and Payroll Taxes
The U.S. federal government relies on two big taxes collected from large numbers of Americans: the federal income tax and payroll taxes regularly deducted from wages and salaries to cover Social Security and Medicare benefits. Income and payroll taxes each contribute about 40% of federal revenues. Almost half of U.S. households currently do not owe federal income taxes, but over three-fifths of these “non-filers” are workers who contribute very substantial payroll taxes. For example, Americans making the lowest incomes pay nearly 9% of their wages in payroll taxes, about the same percentage as middle-income workers pay.
Only about 17% of American households pay neither income nor payroll taxes, because they are headed by people in special sub-groups:
- Elderly men and women, who previously contributed payroll taxes during their working lives, living on their Social Security benefits.
- Students or disabled individuals.
- Workers unable to find jobs. During the recent recession, the numbers of long-term unemployed people not filing income tax returns went up.
- Active-duty members of the U.S. military, who do not have to pay taxes on their combat pay and do not owe income tax after having been deployed. (more…)
Occupy Wall Street has put a public face on the backlash against growing inequality. As most Americans struggle to make ends meet, income and wealth at the very top continue to burgeon, in bad times as well as good. Although rag-tag protesters have been vilified, protests against the widest economic disparities in more than a century resonate with the wider public. For some time, the best research has documented shared American worries about inequality and broad support for steps to enhance opportunity. (more…)