Cross-posted at Project Vote's blog, Voting Matters

Weekly Voting Rights News Update

By Erin Ferns

In light of the U.S. Supreme Court's decision to uphold Indiana's voter ID law, the state-by-state battle to pass similar legislation has escalated with politicians seeking partisan gain furiously pushing laws that hinder access to the ballot. However, lawmakers seeking to dismantle barriers to electoral participation are just as committed to election integrity and protecting the voting rights of potentially millions of voters by calling out voter ID laws as "sheer political posturing." Meanwhile, positive measures to increase participation through Election Day Registration (EDR) are gaining ground in several states even as Iowa prepares to test-drive its new EDR law in the June 3 primary.

Cross-posted at Project Vote's blog, Voting Matters

Weekly Voting Rights News Update

By Erin Ferns

Requiring proof-of-citizenship in order to register to vote is the latest addition to voter suppression arsenal. Spurred by Arizona's 2004 implementation of proof of citizenship requirements and the recent U.S. Supreme Court decision to uphold Indiana's strict voter ID law, proof of citizenship bills - often coupled with voter ID - are gaining traction across the country. With more than 13 million Americans lacking ready access to citizenship documentation and scant evidence of voter registration fraud by non-citizens (or any voter for that matter) leading to illegal votes, proof of citizenship requirements could have a significant impact on the electorate. Wasting no time after the high court's decision, the neighboring states of Kansas and Missouri have swiftly moved forward with efforts to pass such legislation that could take effect in the November election.

The latest round of SUSA polls shows that Clinton has narrowed the electability gap overall. While she still lags slightly behind Barry, I've noted the following:

Cross-posted at Project Vote's blog, Voting Matters

Weekly Voting Rights News Updates

By Erin Ferns

In recent weeks, two Congressional hearings examined hot button voter suppression issues, voter fraud and voter caging, that have the potential to "taint the November election." These major voting rights issues have moved into broad public consciousness thanks to the 2007 exposure of the U.S. Attorney scandal in which nine federal prosecutors were fired for alleged lack of zeal in pursuing partisan accusations of widespread voter fraud. Now, two states with upcoming primary elections, Wisconsin and Pennsylvania, have made local headlines for voter registration discrepancies, creating openings for confusing and discouraging voters and possibly even allowing those with voter suppression agendas to make an impact.  

OHIO: (+ - 4.3%)

Clinton 52%
McCain 42%

Obama 47%
McCain 44%

MISSOURI:

Clinton 51%
McCain  44%

Obama 49%
McCain 43%

NEW MEXICO

Clinton 50%
McCain  45%

Obama 55%
McCain 40%

MINNESOTA:

Clinton 49%
McCain 45%

Obama 55%
McCain 40%

MASSACHUSETTS:

Clinton 52%
McCain  43%

Obama 48%
McCain 46%

CALIFORNIA:

Clinton 58%
McCain  35%

Obama 61%
McCain 34%

ALABAMA:

McCain 57%
Clinton 47%

McCain 58%
Obama 34%

What can we learn from the Massachusetts universal health care experiment?

Second in a series of long-winded diaries on health care policy by a non-expert. The first diary, on how well a plan without mandates might work, is here.

As everyone knows, Massachusetts is currently trying to implement a statewide universal health care plan that works partly by requiring state residents to buy health insurance (or obtain an exemption). Since there is fundamental disagreement between Barack Obama and Hillary Clinton over whether mandates are necessary to achieve universal health care, the Massachusetts example is often cited in policy arguments, usually by Obama supporters who claim that it is failing, and that mandates are therefore a bad policy idea.

Is that really the case? I wasn't well-informed about this, so I went to do some research about how the Massachusetts plan works, what its results are, and whether this has implications on how well a Clinton/Edwards style plan might fare in the real world.

What the Massachusetts plan does and does not do.

The Massachusetts health care plan was passed in April 2006 with overwhelming bipartisan support and the approval of then-Gov. Mitt Romney. Among other things, it provided for the following:

• An individual mandate. Massachusetts residents must show that they had health coverage as of Dec. 31, 2007, or lose a $219 exemption on their state tax returns.


• Subsidies for low-income residents. The state created Commonwealth Care to provide subsidized no-deductible insurance for those earning less that 300% of the poverty level who do not have access to health care through their employer or through MassHealth, the state's Medicaid program. Premiums are based on a sliding scale that reaches zero at 150% of the poverty level. This was accompanied by an expansion of MassHealth as well.


• Employer requirements.Employers with more than 11 employees must either offer health plans or pay the state a fee of up to $295 per employee per year.


• An insurance connector.The law established a Commonwealth Health Insurance Connector that connects individuals and small businesses with state-approved private insurance plans. This helps combine the buying power of the purchasers, and also allows people to keep their insurance even if their employment changes.

Thus, while the Massachusetts plan shares an individual mandate with the Clinton plan, it is more limited in several significant ways, most likely as a result of the huge disparity of power between federal and state governments. Among other things, the Massachusetts plan does not have the following items in the Clinton plan:

• A new public plan based on Medicare. Clinton's proposal would establish a new public health insurance program that would compete directly with private insurers.


• Strong new requirements for insurance companies. Insurance companies must accept any applicant who is able to pay their premiums, regardless of risk, and must renew coverage automatically for any patient. Premiums could vary based on age, gender, and occupation, but the amount of this variation will be regulated.
  
• Subsidies for low-income citizens. Through the use of a refundable tax credit, no person will have to spend more than a certain fraction of income on insurance.
  

The Clinton proposal also includes a wide range of other initiatives to reduce the cost of providing health care, such as the use of electronic medical records, that are not as directly relevant to this discussion.

To summarize, the Massachusetts plan combines an individual mandate with subsidies for the poor. It does not, however, create a generally available public insurance plan, nor does it do much to reform the insurance industry by requiring insurers to accept all new patients at fairly regulated premium prices, both of which are key components of the Clinton plan. More simplistically, the Massachusetts plan combined a stick with a few carrots. Clinton's plan adds more carrots.

How is the Massachusetts plan working?

Perhaps out of awareness of the size and complexity of its mission, the Massachusetts plan has a long ramp-up period and measured goals: the stated intention was to cover 95% of the uninsured within three years.

Despite being enacted in April 2006, it was not until Dec. 31, 2007 that state residents faced any penalty for not having insurance. Prior to enactment, it was estimated that Massachusetts had roughly 500,000 uninsured residents. Of these, 100,000 were eligible for MassHealth, but had not signed up. (To me, this is a good argument that not having a mandate is problematic--we have 100,000 people who could have had insurance who simply didn't.) Another 200,000 did not qualify for MassHealth, but were too poor to buy insurance. The Massachusetts plan covers them with subsidies; the Clinton plan would as well. This group of people is believed to make up most of the uninsured nationally. Finally, there were 200,000 people who could afford to buy insurance, but simply chose not to. These are the targets of the mandate. Under Clinton's program, they could but into either the public plan or any private plan.

As of this writing, it has been less than two months since the original deadline for buying health insurance in Massachusetts. The Commonwealth Connector estimates that some 300,000 people have become newly ensured since the passage of the law. A third of these acquired private insurance, while the remainder obtained subsidized coverage through MassHealth or Commonwealth Care. By most accounts, this appears to be a reasonable first step--already Massachusetts has halved the number of uninsured.

Criticism of the program has come for several reasons. From those opposed to mandates, there is the mention that some 60,000 people earning over 300% of the federal poverty level were exempted from buying insurance, since they couldn't find any affordable policies. I'm not clear on why this is--perhaps these people have pre-existing conditions that make their premiums too high? If this is the case, then Clinton's new insurance regulations will make plans affordable. In any case, this appears to be more of a problem with not having enough subsidies rather than the concept of mandates. Certainly removing the mandates would not help these people get insurance. There is also the criticism that the costs of the Massachusetts program have grown more than expected. As far as I can tell, this is because the program has been almost too successful in signing up residents for subsidized care.

Conclusions

The Massachusetts experiment is still in its infancy, and in any case is sufficiently different from the Clinton plan that it is hard to draw any firm conclusions from its experience. While apparently generally successful, there are some cautionary notes on applying this nationally. Massachusetts is a fairly wealthy state that began with a relatively small uninsured population (about 10% of the population, compared with 16% nationally). On the other hand, of the problems that Massachusetts is facing, I'm not certain that any of them are being caused by having mandates. The worst that one can say is that mandates have not completely solved the problem in their first few months of existence. It is also very possible that Clinton's proposal, with its strong new insurance regulations and the creation of a private plan, would go a long way towards reducing the number of people who have to be exempted from coverage.

Overall, then, my tentative conclusion is that the Massachusetts results in fact bode well for the idea of an Edwards/Clinton style shared responsibility program.

Sources
Springfield Republican: Report: New health care law is working
Hillary Clinton's health care plan
Business Week: In Massachusetts, Health Care for All?
NYT: Massachusetts Universal Care Plan Faces Hurdles
Massachusetts Health Connector
NPR: Romney's Mission: Massachusetts Health Care
Kaiser Family Foundation: Massachusetts Health Care Reform Plan - An Update

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Just in from MSNBC, Massachusetts has been projected for Hillary Clinton. More as we hear it...

Update [2008-2-5 21:1:19 by Jonathan Singer]: NBC News adds New York to the tally for Hillary Clinton.

Update [2008-2-5 21:4:28 by Jonathan Singer]: Obama gets his first win in a while, according to NBC News, by picking up Delaware.

Update [2008-2-5 21:18:21 by Jonathan Singer]: We're waiting to see if other networks join in, but Fox News (which I could only access by punching in my parental block code) has apparently projected New Jersey for Clinton. Update [2008-2-5 21:21:4 by Jonathan Singer]: NBC News joins in, calling New Jersey for Clinton.

The potential impact of Ted Kennedy's endorsement of Barack Obama is of course a question mark that looms over the campaign for the Democratic nomination for president. Personally, although the media is touting it as monumental, I'm not convinced it helps Obama much nationally unless Kennedy intends to stump for him in various February 5th states (that certainly helped John Kerry in Iowa four years ago.) It will be interesting to learn just how large a role Kennedy intends to play in Obama's campaign moving forward. Will he serve as an on-the-ground surrogate for Obama in key states as John Kerry and Janet Napolitano did in Las Vegas prior to the caucus there? The use of high profile surrogates will be key to the candidates' campaigning in February 5th states, as they try to campaign everywhere at once without actually being everywhere.

But there's one state where the impact of the Kennedy endorsement will undoubtedly shake the ground and that's in Massachusetts, where voters will be among the millions to go to the polls on February 5th. So far, Obama enjoys the support of the state's Governor Deval Patrick, Congressman William Delahunt and, as of tomorrow officially, both senators (not to mention, with Caroline's support, the appearance of the endorsement of the Kennedy family although RFK, Jr. has endorsed Hillary.) This is a huge base of institutional support for Obama in a state where, on paper anyway, he really shouldn't be competitive.

Survey USA's recent poll of the state (586 LVs, Jan 23-24, MOE +/-  4.1%) indicates just how steep an uphill climb Obama has ahead of him in Massachusetts.

Clinton 59
Obama 22
Edwards 11
Undecided 6

Consider this the baseline poll of the state, having been taken prior to his win in South Carolina and the Kennedy endorsements.

Clearly, this is one of the states Hillary Clinton was counting on not having to compete in. Something tells me it may not be as easy as she'd thought, although a friend of mine familiar with Massachusetts insists the state's demographics still favor Clinton.