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Posts published in December 2013

Health reform ahead

trahant MARK
TRAHANT

 
Austerity

The healthcare.gov web site is working. I spent some time on it this weekend and it was easy to navigate, pages popped up when they should, and I quickly found answers.

All of this is good news because it will make it easier for folks to fill out the forms and see what’s possible under the Affordable Care Act. If you want insurance to begin on January 1, 2014, then you need to fill these forms out this month. The deadline is December 23.

But for American Indians and Alaska Natives this process is both confusing and damning. It’s confusing because it’s a form that requires financial information, a lot like a tax return, so it means rounding up some documents. The damning part? I’ll get to that shortly. First let’s explore the healthcare.gov process.

For American Indians and Alaska Natives: The most important form is “Appendix B.” This is the paperwork that secures a lifetime exemption from the insurance mandate. Lifetime is a pretty good deal. So paperwork or not, this is worth doing this month (or you can also file this with your tax returns in April).

There is help to fill out these forms. Go to the Indian Health Service or a local urban or tribal clinic. Find someone there who has been trained. You should get answers, because, as IHS acting director Yvette Roubideaux wrote recently, “I don’t know is not an acceptable answer.”

One of the best things I read this weekend was an item in Montana’s Char-Koosta News with a schedule of community meetings on the Affordable Care Act. Yes! This should be happening across Indian Country.

There needs to be information, not just cheerleading, about what this law means and how it might change the Indian health system. (This is the main reason for my five-part video series with Vision Maker Media .) The law will shake up the Indian health system dramatically, opening up new funding sources, as well as presenting new challenges.

The problem is that so much of the discourse has been cast in absolute terms. Democrats need to recognize that this law, like the web site, is not perfect. It’s just one step -- and a complicated one at that. And Republicans would better serve the country if they would stop crying repeal and look for constructive additions or subtractions. (more…)

Thank you, Senator Fulcher

carlson CHRIS
CARLSON

 
Carlson
Chronicles

Majority Caucus chair, State Senator Russell Fulcher, is doing a favor for the voting public as well as the media by challenging incumbent Governor C. L. “Butch” Otter in a contest for the Republican nomination. He could also be doing Otter a favor.

For 104,000 Idahoans who would be eligible for an expanded Medicaid program, however, Fulcher is ensuring their needs will not be met. Real suffering even unnecessary deaths, will occur.

By challenging his party’s sitting governor what looked like a dull run-up to a third almost uncontested term suddenly has created the magic “buzz” candidates and their campaigns like to generate, but few do.

The Meridian senator has already generated extensive coverage by a media desperate for the good copy a hotly contested race between Tea Party conservatives and status quo regular Republicans will provide.

The media loves intra-party fights.

Now the perception (whether true or not) is a real horse race is shaping up. The result should be more scrutiny of the candidates, their issues and stances. An attentive voter can be the beneficiary if this translates into a more informed vote.

Many political pundits were surprised by the Otter campaign’s bland response to Fulcher’s announcement which more or less said “we’ll see you down the road.” If ever there is a good time for an incumbent to start defining his challenger its right at the get-go when they announce.

Governor Otter’s campaign manager, the normally competent Jayson Ronk, missed one of the best opportunities to frame what the race will be all about.

Fulcher will sound a familiar theme borrowed from Arizona Senator Barry Goldwater’s 1964 Presidential race: “a choice, not an echo!”

Like Tea Party candidate Bryan Smith, an Idaho Falls attorney challenging Rep. Mike Simpson in the second congressional district, he will claim he is the true conservative, not the incumbent.

The glib five-term State Senator from District 22 is counting on true blue Republicans (Only those previously registered as R’s will be able to vote in the May primary) responding to his message that the Governor sold the state down the river by registering Idaho’s insurance exchange with the hated ObamaCare program.

The real victims of Fulcher’s challenge, however, will be the estimated 104,000 Idahoans eligible for Medicaid under new rules being promulgated. In addition this expansion would greatly relieve most every county’s indigent fund that pays a large share of the cost for medical treatment that the poor cannot afford. For Fiscal Years 2014, 2015 and 2016 the Federal government would pay 100% of this expansion cost estimated to be $750 million each year. (more…)

Stressful oceanside living

rainey BARRETT
RAINEY

 
Second
Thoughts

Most of us move many times in our lives. For whatever reason exists at the moment. Life’s exigencies as it were. In the process, we’re deluged with changes in nearly everything. New environment – new and different shopping – new geography and place names to learn – sometimes different local customs or practices – new driver’s licenses or passports. Leaving friends. Meeting new people. The whole moving experience is often change top to bottom. We get used to it.

I’ve moved many times. Many and often. Across town, state-to-state, coast-to-coast and border-to-border. Life’s adjustments caused by relocating have been regular and varied. So often, in fact, I thought our most recent was just another “pack-‘em-up-and-move-‘em-out.” Wrong.

The first time we moved to the edge of the Pacific was a decade ago. We did it because we’d never lived there. Simple as that. Lots of exciting new things to experience and a very different living environment. My flat land artist wife has been ocean-smitten for years. So when the moving bug hit this time, like Brigham Young, she pointed westward and the family wagons moved. And we learned all over again.

Coastal living – Oregon coastal living – is a whole new deal. Take shopping, for instance. Most communities are small with limited store selection. If you want a Costco or Mode or Best Buy, you have to drive more than 50-75 miles inland. Then back. There may be an occasional Safeway or Fred Meyer but most grocery outlets are small, regional types like IGA or Ray’s or Grocery Outlet or Mom & Pop’s.

Prices for everything – everything – are higher. It’s a lifestyle premium you pay for rainfall that can exceed 90 inches a year. Yes, Virginia, 90! And there’s the fog and cold and other things that aggravate your arthritis and rheumatism. Lots of seniors try living near the ocean but find some of the frailties of age can make it a painful experience. So they either develop a tolerance or move inland again.

You can’t just go to a store near the ocean and buy anything you want or need at any time. One June, I was looking for a long-sleeved shirt at the largest chain store in Brookings and was told they only carried long-sleeved shirts between September and April. If I really wanted one in June, it would be a 180 mile drive. Until September, of course.

Medical care is most often sketchy. Hospitals – where they exist at all – are small and specialists are few. So major medical needs result in 100-200 mile drives inland or, in the case of a real emergency, air ambulance. Cost for that? Don’t even think about it. (more…)

Shaping the campaigns

idaho RANDY
STAPILUS
 
Idaho

Thanksgivings abound on the part of those who write about Idaho politics – directed at the political figure of the moment, Russ Fulcher. With his decision to run for governor against incumbent C.L “Butch” Otter, politics in Idaho took on some new coloration.

Maybe the challenges of the activist outsiders like Fulcher and (for the second district congressional seat) Bryan Smith will collapse by primary day. But as of late 2013, the raw materials are there for a really competitive showdown that could send Idaho politics, post-2014, sailing off in some new directions.

Caveats must be noted. Otter, who has won every primary and general election contest he has entered with one exception (for governor, in 1978) over four decades, is a strong campaigner. Fulcher is not nearly so experienced and may not be as strong on the stump (though we'll find out more about that). Otter will have a well-organized and well-funded campaign, likely better than Fulcher's on both counts. In 2012 organized cadres of activist candidates ran against incumbents for a number of legislative seats, and in Idaho's second U.S. House district, and they most failed, often without coming close to a win. There's a fair argument that 2014 could do the same.

And you can make the point that there's not much real policy difference between the two sides here. Fulcher is campaigning as a libertarian, small-budget critic of the federal government and President Obama; that is different from Otter, who has campaigned in the same essential ways (allowing for changes in the presidency) for 40 years, exactly how? (more…)