Medicaid: Why It’s Important

by Brian Smedley, Ph.D.

During one of the first opportunities that I had to present testimony at a Congressional hearing, a member of the committee posed a challenging question to me and other witnesses at our panel:  Would you trade your current health insurance for Medicaid?

The Congressman’s intent was clear:  he and others who oppose expansions of public health insurance programs believe that Medicaid is worse than private insurance, and possibly even worse than no insurance at all.

I was the first witness seated on the right of the panel, so I was to respond first.  I hesitated.  I didn’t want to reinforce the idea that Medicaid was deeply flawed.  Sure, the program has problems, but it remains one of the most efficient health insurance programs in the country and has been a lifeline for millions of low-income and disabled Americans.  But trade the insurance I had at the time?  I caved and answered no.  Almost all of the witnesses at our panel did the same.  But I’ve regretted it since.

Yesterday a landmark new study was released that, for the first time, documents the many ways in which Medicaid improves the health and well-being of its beneficiaries.  Researchers found that “expanding low-income adults’ access to Medicaid substantially increases health care use, reduces financial strain on covered individuals, and improves their self-reported health and well-being.”  The study was remarkable because for the first time researchers were able to compare outcomes for people who were randomly assigned to Medicaid against those who sought Medicaid coverage but could not receive it due to budget constraints.  (http://www.hsph.harvard.edu/news/press-releases/2011-releases/medicaid-benefits-oregon-study.html)

The implications of the study are clear:  efforts to slash Medicaid, such as those being debated in Congress, would increase risks for poor health and financial ruin for millions of children, elderly, and/or disabled people.  These are the very folks who are struggling the most in the current economy.  And given the high cost of poor health for our nation as a whole, these cuts are not only morally wrong but also put our economic recovery at risk.

Medicaid works.  Let’s spread the word.  I wish I had when I was given the chance to correct the record.

Brian Smedley, Ph.D., is Vice President and Director of the Health Policy Institute at the Joint Center for Political and Economic Studies. To learn more about Dr. Smedley and the Health Policy Institute, visit the Joint Center website.

Video Games and Children of Color: There is More than One Compelling Interest at Stake

by Joseph Miller, Esq.

The Supreme Court’s recent decision to strike down a California law banning the sale of violent video games to children was not surprising in light of the Court’s First Amendment doctrine or the Roberts court’s business-friendly stance on corporate speech.  For children of color, the need for data establishing a nexus between violent video games and real-world violence is even more compelling as children of color spend more time playing video games than white children.  In addition to seeking to address the effect of video game violence on children’s psyches, state legislators should also seek to address the impact of popular video games on academic achievement.

At first glance, it is difficult to conclude that the Court’s decision was based on ideology rather than the letter of the law: While the Roberts court has demonstrated a proclivity for protecting corporate and business interests (see, e.g. Wal-Mart v. Dukes, Citizens United v. Federal Election Commission, and AT&T Mobility v. Concepcion), Justice Scalia’s majority opinion in yesterday’s Brown v. Entertainment Merchants Association decision was actually joined by the two justices widely considered to be the Court’s most liberal—Justices Ginsburg and Sotomayor. Nevertheless, Chief Justice Roberts and Justice Alito issued concurring opinions that can be read as a refinement of their doctrine protecting corporate speech.

The majority analyzed California’s state law from a strict scrutiny point of view.  To pass Constitutional muster, state laws abridging fundamental rights, such as the right to free speech and freedom of expression, must address a compelling governmental interest and must be narrowly tailored via the least restrictive means for achieving that interest.  In the context of free speech, this means that the state law in question must be designed to prevent speech that harms the compelling interest at stake.  Here, the interest advanced by the State of California was to protect minors from violent content in video games.  However, the majority reasoned that the scientific studies presented by the State of California to justify the statute did not prove a direct connection between violent video games and the asserted harmful effects on children.  Writing for the majority, Justice Scalia further stated that the California law was not the least restrictive means that could have been advanced because it was “under inclusive” — while the California law restricted the speech of game developers,  it did not restrict violence in other media targeting children, such as children’s books and television shows.

Chief Justice Roberts and Justice Alito deliberately avoided the “broader” issue of strict scrutiny, choosing to focus instead on whether the California statute provided adequate notice to game developers as to the standards that determine which content is too violent and which is not.  Thus, not only must a state law even remotely abridging corporate speech meet the strict scrutiny standard of review, such laws must be so specific as to require legislators to put themselves in the shoes of corporate speakers trying to determine what kinds of speech are prohibited.

Such was the disposition of the majority opinion and the concurrence, neither of which were particularly surprising or groundbreaking.  The strict scrutiny test itself remains largely unchanged, and the notion that legislators must consider the First Amendment from the point of view of speakers other than individuals is a bedrock principle, especially in light of Citizens United—this decision simply solidifies it.

Still, we are left with considerable uncertainty as to whether violent video games actually harm children, and clearly this is a matter that requires further research.  This issue is particularly important for children of color.  Last month, Northwestern University released a study that found that, on average, white children spend the least amount of time per day playing video games (:56), compared to blacks (1:25), Hispanics (1:35), and Asian Americans (1:37).  Not only could violent video games potentially lead to real violence, more time spent playing video games necessarily means less time studying.  Additional research and evidence is needed that firmly establishes these links, so that states can make the case for restricting the sale of video games to minors.

Joseph Miller, Esq. is Deputy Director and Senior Policy Director for the Media and Technology Institute for the Joint Center for Political and Economic Studies.

Health Costs of Air Pollution in California

RAND Briefing to California Delegation on Health Costs of Air Pollution,

As you may know, RAND recently published a study that estimates spending on hospital care in California due to the harmful health effects of air pollution. The lead author of the report, John Romley, will be in Washington, DC on Thursday, June 24, to brief findings from the research to California delegation staff. The briefing is  from 2:00 p.m. – 3:00 p.m. at 234 Cannon House Office Building. It is sponsored by Congresswoman Zoe Lofgren and Congressman David Dreier

The harmful health effects of air pollution are well understood. Less is known about the cost burden that these effects impose on the health care system. RAND researchers addressed these questions by estimating spending on hospital care in California due to the failure to meet federal and state standards for particulate matter and ozone emissions. More people in California live in areas that do not meet federal air quality standards than in any other state.

The analysis found that:

* Failing to meet federal air quality standards led to nearly 30,000 hospital admissions and emergency room visits in California from 2005 through 2007.
* The resulting spending was about $193 million over the three-year period.
* Public insurers Medicare and Medi-Cal spent the most-$104 million and $28 million, respectively-and private insurers spent $56 million.

The results suggest that publicly funded insurers as well as employers and private insurers would benefit financially from reductions in air pollution.

Please RSVP to kristy_anderson@rand.org or 703-413-1100 ext. 5196, if you would like to schedule a meeting with Mr. Romley for a separate meeting.

Speaker Series: Critical Issues in Climate Change

Critical Issues in Climate Change
The Green Economy and Clean Energy: Implications from the Gulf Oil Spill

-Thursday, June 17, 9:00 a.m., Columbus Room, Union Station-

Oil in the Gulf of Mexico (Photo: Reuters)

Over the past two months, millions of gallons of oil have flowed into the Gulf of Mexico – the most catastrophic oil spill ever. The extent of the damage it has created is still unclear, but a severe impact has already been seen in wildlife populations, polluted shorelines and illnesses experience by local residents and clean-up workers.

In light of this ongoing crisis, the Joint Center for Political and Economic Studies chose to focus the first Critical Issues in Climate Change Speaker Series around the oil spill and its implications to the growing green economy and movement toward clean energy.

According to the Joint Center’s official statement on the Gulf oil spill, “Without addressing energy sovereignty in the U.S., our coasts will continue to bear the brunt of our collective addiction to oil.” The move toward clean, renewable energy, and the subsequent development of a green economy, is a key to environmental and economic sustainability and success.

Joining host and Joint Center President and CEO Ralph B. Everett at the inaugural speaker series are:

• Leslie G. Fields, Esq., National Environmental Justice Director for the Sierra Club and member of the Commission to Engage African Americans on Climate Change;

• Dr. Arjun Makhijani, author and President of the Institute for Energy and Environmental Research;

• Dr. Michael K. Dorsey, assistant professor of environmental studies at Dartmouth College and visiting scholar at the Joint Center;

• Daniel J. Weiss, Senior Fellow and Director of Climate Strategy at the Center for American Progress.

See the full invitation after the jump.

Global Warming and Grim Atlantic Hurricane Season Bodes Hazardous for Communities of Color

Recent reports from the National Oceanic and Atmospheric Administration (NOAA) suggest that the ongoing oil spill may not be the only disaster the Gulf Coast has to face this year.

The decade from 2000 to 2009 marked the warmest global temperatures on record, and despite unexpectedly heavy snowfall in the U.S. at the beginning of this year, 2010 is predicted to follow suit. Based on monthly analysis conducted by NOAA’s National Climatic Data Center, the period from January to April produced the hottest combined global land and ocean surface temperature since formal measurements began in 1880. The combined average surface temperatures from January to April exceeded measurements taken in the 20thcentury by 1.24°F (0.69°C), reflecting global warming predictions. Similarly, global ocean surface temperatures in April marked the warmest for that month in over a century, with NOAA observing rising heat “most pronounced in the equatorial portions of the major oceans, especially the Atlantic.”

Comparison of 2010 Temperature to the Two Other Years with the Warmest Annual Means

[Extracted from NASA Goddard Institute for Space Studies “GISS Surface Temperature Analysis” Last Modified: 05-17-2010]

The Hidden Health Costs of Transportation

The American Public Health Association (APHA) recently released “The Hidden Health Costs of Transportation,” a report that addresses how our nation’s current transportation system contributes to today’s soaring health costs and impedes progress toward improving public health. The APHA also released a longer background document for more detail on the research.

According to the report, “Our dependence on automobiles and roadways has profound negative impacts on human health: decreased opportunities for physical activity, and increased exposure to air pollution, and the number of traffic crashes. The health costs associated with these impacts, including costs associated with loss of work days and wages, pain and suffering, and premature death, may be as high as several hundred billion dollars.”

Toxic Substances Control Act (TSCA) Briefing on Capitol Hill with Congressman Bobby Rush

Wednesday, May 19, 2010
10:00-11:30am
2322 Rayburn House Office Building

Sponsors: NAACP, BlueGreen Alliance and Safer Chemicals, Healthy Families

The NAACP, BlueGreen Alliance and the Safer Chemicals, Healthy Families Campaign are pleased to invite you to a briefing with leaders from the civil rights, religious and environmental communities about new legislation to reform the broken and outdated Toxics Substances Control Act (TSCA) of 1976, our country’s primary law to manage dangerous chemicals. Congressman Bobby Rush (D-1st IL) and Congressman Henry Waxman (D-30th CA) recently introduced a discussion draft in the U.S. House of Representatives reforming this statute. We are honored to have Congressman Rush scheduled to kick off the briefing on Wednesday at 10am.

The briefing will include a short tutorial on TSCA, an overview of the bills now moving through Congress to update TSCA and a presentation on the positive impact TSCA reform could have on the health and living conditions of people of color and low income communities across the United States.

If you have questions, please email Emily Enderle at Earthjustice: eenderle@earthjustice.org

Innovations in Sustainability: High Speed Rail in the U.S.

The Obama Administration has demonstrated its willingness to invest in clean technology through the High Speed Intercity Rail Program, which was launched nearly a year ago and aims to connect major cities through targeted investments in the existing railroad infrastructure. The initial phase of the project is currently underway in several locations, and the Federal Rail Administration (FRA) anticipates issuing a national rail plan by fall of this year.

The Environmental and Energy Study Institute and the American Public Transportation Association co-hosted a briefing last week on the “Benefits, Costs, and Challenges” of high speed rail development, at which participants discussed the topic in the context of growing domestic tourism, the threat of increasing oil prices, deregulation of the airline industry, and a crumbling, congested interstate system – and whether America’s so-called “love affair with the automobile” will continue to stand in the way of new approaches to investing in public transportation.

Map showing US high speed rail corridors as of July 9th, 2009.