Further Away from Universal Health Insurance in Massachusetts

"We don't really care whether everybody gets insurance."

The Massachusetts Health Connector might as well emblazon that message on a banner and hang it the middle of Boston Common. It's what they're saying anyway by cutting the plan back 12%.

Already, as I have noted, many people in Massachusetts had coverage without care, because they couldn't afford to pay for the plan AND the deductible. Instead of paying the doctors, they paid the health insurers for plans that didn't give them anything.

Tuesday, the board of the Commonwealth Health Connector, which runs the mandatory insurance plan, dropped the last vestige of a pretense that everyone would even get insurance (useable or not). Are you a low-income resident, entitled by law to a full subsidy, but you forgot to sign up? Too late now. You and 18,000 people like you are out of luck. Even if you did what you were supposed to and enrolled, the Connector just snapped its collective fingers and took away your dental care. Or were you born in Ireland, or Greece, or Haiti, or El Salvador, and came to this country with full legal status? Tough. The feds aren't going to pay their share to insure you, so Massachusetts has decided you're just too expensive.

What makes it worse is that groups like Health Care for All, who should be marching in the streets, are busy making excuses for Massachusetts instead.

But the group said state officials appear to have made the best of a bad situation. “There’s no other place to go for money,’’ said Lindsey Tucker, the organization’s healthcare reform manager. “. . . My concern is people will not get the care that they need.’

Damn straight they won't! And it is not a health advocate's place to take the state off the hook. There are plenty of places to go for money. We just need politicians with backbones, and voters with consciences. We won't get either by dumping low-income and immigrant residents over the side of the leaky health insurance plan to lighten the load for the rich and powerful in this state.

Get Up, Stand Up After the Election

To keep the promises made by the Obama campaign, the Obama Administration will need all the help it can get.

Here is a very partial and incomplete list of campaign promises that I think Obama should keep:

Economy: Create a new "Making Work Pay" tax credit of up to $500 per person, or $1,000 per working family. Eliminate all capital gains taxes on start-ups and small businesses. Use trade agreements to spread good labor and environmental standards around the world. Ensure the freedom to unionize. Raise the minimum wage, index it to inflation and increase the Earned Income Tax Credit. Expand the Family and Medical Leave Act to cover businesses with 25 or more employees (instead of the 50+ employee businesses it currently covers).

Health Care: Require insurance companies to cover pre-existing conditions. Require coverage of preventive services, including cancer screenings, and increase state and local preparedness for terrorist attacks and natural disasters. Lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programs and taking on drug companies that block cheaper generic medicines from the market.

Foreign Policy: Secure all loose nuclear materials in the world within four years. End the war in Iraq and remove U.S. troops through a phased withdrawal. Emphasize diplomacy over military intervention. Focus America's attention on the challenges facing Africa. Cut extreme poverty in half by 2015.

Immigration: Increase the number of legal immigrants. Promote economic development in Mexico to decrease illegal immigration.

Poverty: Invest $1 billion over five years in transitional jobs and career pathway programs. Increase benefits for working parents, raise the minimum wage to $9.50 an hour by 2011, and provide tax relief to low- and middle-income workers. Create an Affordable Housing Trust Fund. Fully fund the Community Development Block Grant to aid cities, and invest in rural jobs, schools, and green industries.


Civil rights: Pass the Fair Pay Act to ensure that women receive equal pay for equal work and the Employment Non-Discrimination Act to prohibit discrimination based on sexual orientation or gender identity or expression. Pass the Matthew Shepard Act and strengthen federal hate crimes legislation. Enforce the laws we have.

Other women's issues (besides poverty, civil rights, etc.): Support research into women's health, help prevent unintended pregnancy (surely a men's issue too!), reduce domestic violence, preserve women's right to reproductive choice under Roe v. Wade.

Give Real Authority to the Privacy and Civil Liberties Board: Created by Congress and recommended by the 9/11 Commission, the Privacy and Civil Liberties Board needs to be substantially reformed and empowered to safeguard against an erosion in American civil liberties.

Reading this list after eight years of the Bush Administration is like taking a deep breath after eight years of chronic pneumonia! Still, just seeing the words is not enough. We must see action--and the President cannot do it by himself.

• Lots of these initiatives cost money. Obama will have Robert Rubin and other voices of Clintonomics whispering into his ear that we can't afford these big plans, that we should settle for small victories. It would be easy for him to listen, to cop out, saying he didn't realize how bad the economy would be. We need to stand instead with Representative Rangel. When they ask him where he'll get the money for social programs, he says, "The same place Paulson gets it for the bailout." The more people tell Obama that, the more room he'll have to carry out his plans.

• Some of Obama's promises will face corporate opposition. Raising the minimum wage and regulating the insurance industry are two proposals that every Chamber of Commerce across the country will scream about. We need to scream louder.

• Some of them will be derided as "favoring special interests." But the groups being advanced--women, people of color, gays, immigrants--are the majority in America! What's more, they are being advanced by measures that promote justice. We need to make it clear that there is a large, vocal, and persistent body of people who will hold the Administration's feet to the fire on this, to protect them from knee-jerk reactions by people who feel their own privileges are being taken away.

I hope it is clear that we cannot sit back and let Barack do it. Just to make his own promises into policy, he will need us to stand up.