Why ‘Ryancare’ Is Far More Hostile To States Rights Than ‘Obamacare’

By Ian Millhiser on Oct 7, 2011 at 2:20 pm

Yesterday, House Budget Committee Chair Paul Ryan (R-WI) predicted that the Supreme Court will embrace the meritless claim that the Affordable Care Act violates states rights and “knock down the individual mandate.” Yet, if there is one person who shouldn’t be hiding behind states rights arguments, it is Paul Ryan. The truth is that Ryan’s infamous health plan does far more than simply phase out Medicare, it outright declares war on the states’ ability to protect their citizens from insurance company abuses.
One of the centerpieces of Ryan’s plan is an element from the McCain/Palin presidential campaign’s plan that supposedly allows Americans to “purchase health insurance across state lines”:

Currently, individuals and families can purchase health insurance only in the States in which they live, because insurance companies are prohibited from selling polices outside their respective States. Thus the consumer is prevented from purchasing coverage from another State that might offer more suitable, or more affordable, coverage. [...]
Allowing consumers to shop across State lines will balance State regulation of health insurance. Individuals no longer will have to pay for health benefits mandated by their home States that they do not need; they will be able to choose policies from States whose mandates better fit their personal circumstances. States will then have an incentive to balance their insurance mandates against costs to remain competitive with other States.

This sure sounds great! Why shouldn’t you be able to buy a plan from an Arizona insurance company if you happen to live in Ohio? The truth, however, is that the McCain/Palin/Ryan plan’s promise to let people “shop across State lines” is nothing more than a code for completely immunizing the insurance industry from state laws that protect consumers.
As Sen. McCain explained during his failed campaign, the McCain/Palin/Ryan plan is modeled after the process banks used to systematically dismantle state laws protecting consumers from excessive interest rates. Once upon a time, banks were governed by something known as “usury laws,” state laws which prohibited lenders from charging excessive interest to homeowners and other borrowers. In 1978, however, the Supreme Court held that banks are only required to follow the usury laws of the state where they are “located,” effectively immunizing banks from the interest rate caps in each of the other 49 states.
The result was a race to the bottom where states competed to enact the least protective usury laws in order to coax the banking industry into relocating within their borders. Eventually, South Dakota “won” this race by repealing its usury laws altogether, and Citibank rewarded South Dakota by moving its lending offices to that state. The rest of the industry soon followed suit, immunizing itself from interest rate caps altogether by locating in places like South Dakota.
So the effect of this chain of events was to completely neutralize states’ ability to regulate interest rates — hardly the kind of states rights result that 10th Amendment absolutists pine for. And the McCain/Palin/Ryan plan would impose the banking model’s approach to state regulation on health insurance regulation. If the Ryan is successful in enacting this plan, a short list of laws that would effectively cease to exist includes:

Women’s Health: 49 states and the District of Columbia require health plans to cover reconstructive surgery after breast cancer, mammograms, and maternity stays;
Fair Appeals: 44 states and the District of Columbia allow patients to appeal denials of coverage to an external review board;
Preexisting Conditions: 38 states and the District of Columbia restrict how far into the past a insurance company can “look-back” to determine whether a patient is disqualified because of a preexisting condition;
Healthy Children: 31 states require health plans to cover well child care.

In other words, Ryan’s preeminence as the right’s leading health policymaker does nothing more than prove that they couldn’t care less about states rights and the 10th Amendment. They’re just happen to pretend to care in order to undermine President Obama’s signature accomplishment.

Decriminalizing Domestic Violence is Criminal

Topeka, Kansas City Council Considers Decriminalizing Domestic Violence To Save Money

By Marie Diamond on Oct 6, 2011 at 5:45 pm

Faced with their worst budget crises since the Great Depression, states and cities have resorted to increasingly desperate measures to cut costs. State and local governments have laid off teachers, slashed Medicaid funding, and even started unpaving roads and turning off streetlights.
But perhaps the most shocking idea to save money is being debated right now by the City Council of Topeka, Kansas. The city could repeal an ordinance banning domestic violence because some say the cost of prosecuting those cases is just too high:

Last night, in between approving city expenditures and other routine agenda items, the Topeka, Kansas City Council debated one rather controversial one: decriminalizing domestic violence.
Here’s what happened: Last month, the Shawnee County District Attorney’s office, facing a 10% budget cut, announced that the county would no longer be prosecuting misdemeanors, including domestic violence cases, at the county level. Finding those cases suddenly dumped on the city and lacking resources of their own, the Topeka City Council is now considering repealing the part of the city code that bans domestic battery. [...]
Since the county stopped prosecuting the crimes on September 8th, it has turned back 30 domestic violence cases. Sixteen people have been arrested for misdemeanor domestic battery and then released from the county jail after charges weren’t filed. “Letting abusive partners out of jail with no consequences puts victims in incredibly dangerous positions,” said Becky Dickinson of the YWCA. “The abuser will often become more violent in an attempt to regain control.”

The YMCA also said that some survivors were afraid for their safety if the dispute wasn’t resolved soon. Town leaders and the district attorney all agree that domestic abuse cases should be prosecuted — but no one would step up to foot the bill. The city council is expected to make its decision on decriminalizing domestic violence next week, but the back-and-forth over funding has already put battered women and their families at increased risk of harm.
Domestic violence is still at epidemic levels in the United States, and too few cases are prosecuted as it is. According to the National Coalition Against Domestic Violence, one in four women will be a victim of domestic violence. And domestic abuse is a crime that damages entire communities, not just women. Witnessing violence between one’s parents is the strongest risk factor of transmitting violent behavior from one generation to the next: boys who witness domestic violence are twice as likely to abuse their own partner when they grow up.
And while not prosecuting domestic violence cases may seem to save money in the short term, it actually has staggering financial consequences. The health-related costs of domestic violence exceeds $5.8 billion each year. Nearly $4.1 billion of that is for direct medical and mental health care services, and nearly $1.8 billion are for the indirect costs of lost productivity or wages. Victims lost almost 8 million days of paid work because of the violence.
It should go without saying, but apparently doesn’t, that preventing domestic abuse is essential to promoting communities’ economic and social well-being. That the Topeka City Council would even consider such action is a heartbreaking illustration of the consequences of austerity.