Little Evidence that Undocumented People Get Medicaid

Many posts have discussed federal deficits and the federal debt. Americans vastly overestimate the amount of waste in the budget

Phil Galewitz at KFF:

Last August, as part of the federal government’s crackdown on people in the country illegally, the Trump administration sent states the names of hundreds of thousands of Medicaid enrollees with orders to determine whether they were ineligible based on immigration status.

But seven months later, findings from five states shared with KFF Health News show that the reviews have uncovered little evidence of a widespread problem.

Only U.S. citizens and some lawfully present immigrants are eligible for Medicaid, which covers health care costs for people with low incomes and disabilities, and the closely related Children’s Health Insurance Program. Both programs are administered by states.

Spokespeople from Pennsylvania’s and Colorado’s Medicaid agencies said, as of March, the states had found no one who needed to be terminated from Medicaid. That was after checking a combined 79,000 names.

Texas has reviewed records of more than 28,000 Medicaid enrollees at the Trump administration’s request and terminated coverage for 77 of them, according to Jennifer Ruffcorn, a spokesperson for the Texas Department of Human Services.

Ohio has checked 65,000 Medicaid enrollees, of which 260 people were disenrolled from the program, said Stephanie O’Grady, a spokesperson for the Ohio Department of Medicaid.

In Utah, 42 of the 8,000 enrollees identified by the Trump administration had their Medicaid coverage terminated, said Becky Wickstrom, a spokesperson for the state’s Department of Workforce Services.

Article II and State Constitutions

Many posts have discussed the presidency.

At AEI: 

Reading the First State Constitutions on Executive Power: A Window into Article II Joseph M. Bessette, Alice Tweed Tuohy Professor (Emeritus) of Government and Ethics at Claremont McKenna College Joseph.Bessette@claremontmckenna.edu & Gary J. Schmitt, Senior Fellow, American Enterprise Institute Gschmitt@aei.org

 Turning next to the opening words of Article II—“The executive Power shall be vested in a President of the United States of America”—the question arises whether those words were meant to grant substantive power or were merely meant to designate the office of the chief executive. First, as our review of the state constitutions showed, the executive vesting clause was not an invention crafted by the delegates to the Constitutional Convention. Virtually every state constitution included a general grant of executive authority, with the constitutions of three states—South Carolina, Pennsylvania, and New York—offering clear textual antecedents to the vesting formula found in Article II. In each of the three, there is evidence that the executive vesting provision was read, or assumed to be, a substantive grant of power. When that fact is combined with the most obvious reading of the text itself,78 it seems reasonable to conclude that the opening line of Article II was intended to give the president an actual power. And the fact that the power vested is “the executive power” implies that it was a power that was understood to have a distinct and discernable character.

Also worth noting is how Article II of the U.S. Constitution mirrors much of the structure of the New York constitution. As in the case of New York, Article II’s first section 57 vests the executive power and also spells out how the chief executive is selected. Then, in the following section in both constitutions, the executive is given a set of powers, such as being commander-in-chief and having the authority to grant pardons. And finally, Article II, sec. 3 of the Constitution, echoing Article XIX of the New York Constitution, states: 

[The President] shall from time to time give to the Congress Information of the State of the Union, and recommend to their Consideration such Measures as he shall judge necessary and expedient; he may, on extraordinary Occasions, convene both Houses, or either of them, and in Case of Disagreement between them, with Respect to the Time of Adjournment, he may adjourn them to such Time as he shall think proper; he shall receive Ambassadors and other public Ministers; he shall take Care that the Laws be faithfully executed, and shall Commission all the Officers of the United States.

The section appears as a mix of authorities—some significant, others less so; one seemingly discretionary, the others not (“shall”). What appears to tie them together is that each has in some way a role in keeping the government moving forward. This is both broad, such as in putting forward ideas for legislative consideration and ensuring the nation’s laws are properly administered, and, more mundanely, in formally accepting the credentials of foreign emissaries and ensuring civilian and military officials are properly authorized to carry out their duties. Given this list of responsibilities, it was perhaps one reason the nation’s chief executive was designated as “President,” presiding not over another branch of government or even a single chamber of the legislature but, rather, acting as a steward for government functions most aptly suited to the institution of the presidency. 

Finally, with the exception of Pennsylvania’s constitution, the U.S. Constitution is the only constitution in the founding period in which the executive is given both a list of 58 duties and an oath of office. And, with the exception of Georgia’s constitution, the Constitution is the only American governing charter of the period that had an oath specifically tailored for the chief executive. (“I do solemnly swear (or affirm) that I will faithfully execute the Office of President of the United States, and will to the best of my Ability, preserve, protect and defend the Constitution of the United States.”) It’s an oath that points toward the president’s official responsibilities being broader than being a mere executive—with the duty to faithfully execute the laws being just one of several responsibilities listed in Section 3 of Article II—while, at the same time, circumscribing their execution to supporting the political order itself. 

Pennsylvania Polarization

 

Many posts have discussed partisan polarization and aversive or negative partisanship.

According to a Rose Institute survey, 87% of Pennsylvania Democrats see Trump as a threat to democracy, and 80% of Democrats say the same of Biden.

Many voters believe that the very fate of the nation’s system of government is at stake in this year’s midterm elections. To examine these beliefs, we asked voters in Pennsylvania: “Which of the following political figures represents a threat to American democracy?”

As with the poll’s other questions, partisanship emerged as a major factor: Democrats overwhelmingly selected Republicans Trump, Mastriano, and Oz as threats while Republicans selected Democrats Biden and Fetterman. Interestingly, 56% of Republican respondents selected Republican Representative Liz Cheney (R-WY), a Trump critic, as a threat to democracy. Overall, Republicans were least likely to select Josh Shapiro among the Democrats on the list. In fact, Republican respondents viewed Shapiro as less of a threat than Liz Cheney. Meanwhile, Cheney was the Republican who drew the least concern among Democrats.

In a negatively polarized environment where 87% of Democrats view Donald Trump—still the top-polling Republican candidate—as a threat to democracy and 80% of Republicans similarly view Joe Biden, many voters clearly believe the other party is unacceptable. Under these circumstances, it is difficult to convince voters to consider voting across party lines and campaigns can make only a limited difference. If Fetterman wins the Pennsylvania Senate race despite his poor debate performance, he likely can thank this feature of contemporary American politics.

Violent Campaign Video

The most elitist threat I've ever heard: "I'm going to stomp all over your face with golf spikes." https://t.co/PgiXx4hPoP

— Chris Young (@ByChrisYoung) October 12, 2018

Overdoses and Life Expectancy

The Centers for Disase Control reports that life expectancy dipped slightly in 2016

• Life expectancy for the U.S. population in 2016 was 78.6 years, a decrease of 0.1 year from 2015.
• The age-adjusted death rate decreased by 0.6% from 733.1 deaths per 100,000 standard population in 2015 to 728.8 in 2016. Age-specific death rates between 2015 and 2016 increased for younger age groups and decreased for older age groups.
• The 10 leading causes of death in 2016 remained the same as in 2015, although unintentional injuries became the third leading cause, while chronic lower respiratory diseases became the fourth.

Another CDC report suggests that drug overdoses were the cause. 

• In 2016, there were more than 63,600 drug overdose deaths in the United States.
  The age-adjusted rate of drug overdose deaths in 2016 (19.8 per 100,000) was 21% higher than the rate in 2015 (16.3).
• Among persons aged 15 and over, adults aged 25–34, 35–44, and 45–54 had the highest rates of drug overdose deaths in 2016 at around 35 per 100,000.
• West Virginia (52.0 per 100,000), Ohio (39.1), New Hampshire (39.0), the District of Columbia (38.8), and Pennsylvania (37.9) had the highest observed age-adjusted drug overdose death rates in 2016.
• The age-adjusted rate of drug overdose deaths involving synthetic opioids other than methadone (drugs such as fentanyl, fentanyl analogs, and tramadol) doubled between 2015 and 2016, from 3.1 to 6.2 per 100,000.

Pennsylvania, Texas and Special Education

Reposted from Autism Policy and Politics:

In The Politics of Autism, I discuss special education.  Some states do a reasonably good job, but Texas is not one of them.

At The Houston Chronicle, Susan Carroll and Brian M. Rosenthal report on a girl with Asperger's who made great progress after her dad moved from Texas to Pennsylvania. (h/t FRL)

Pennsylvania does not have a special education enrollment target — no state does, other than Texas — but it does fund special ed in an unusual way.

The state assumes that roughly 16 percent of students need special ed and funds all school districts at that rate, regardless of how many special ed kids they actually have.

The state's rationale for choosing that number was simple — it was the state average at the time, according to Casey Smith, an education department spokesman. But before implementing the system, officials also called in experts and hosted public forums across the state, Smith said.

That approach is far different than what took place in Texas, when a small group of officials set a benchmark well below the state average without consulting the public, the federal government or any researchers.

The Pennsylvania system is good because it does not incentivize either under-identification or over-identification, several experts said.

Pennsylvania law also is praised for requiring schools to respond to verbal requests from parents for special education evaluations, instead of only written requests.

As a result, about 17 percent of students receive special education,  a 1.5 percentage point increase from 2004, according to the latest federal data.

Rejecting a Nominee

Byron York reports at The Washington Examiner:

Senate Democrats killed the filibuster for nominations because they wanted to be able to confirm the president's choices for top administration positions even if Republicans were united in opposition. From now on, Democrats ruled, nominations would be confirmed by a simple majority vote. With 55 Democrats in the Senate, and as few as 51 required for confirmation, the change virtually guaranteed success for the president's nominees.

But even a rule change was not enough to save the nomination of Debo Adegbile, the former NAACP Legal Defense Fund official who was the president's choice to head the Justice Department's Civil Rights Division. Seven Democrats -- Bob Casey, Joe Donnelly, Heidi Heitkamp, Chris Coons, Joe Manchin, Mark Pryor, and John Walsh -- abandoned Abegdile Wednesday in a vote to move forward with the nomination. (Majority Leader Harry Reid switched his vote to 'no' at the end, but that was just a procedural maneuver to allow for possible future reconsideration of the matter.) The final vote on Adegbile, including Reid's switch, was 52-47.

Five of the seven Democrats -- Donnelly (Indiana), Manchin (West Virginia), Pryor (Arkansas), Heitkamp (North Dakota), and Walsh (Montana) come from states that Mitt Romney carried.  

Casey represents Pennsylvania, an Obama state. But it was also the state of Philadelphia police officer Daniel Faulkner, who died at the hands of Mumia Abu-Jamal.  Adegbile worked on a legal brief in Abu-Jamal's defense.  Delaware is in the Philadelphia media market, which may also explain Coons's vote.

State Legislatures Matter

Our chapter on federalism discusses the importance of state legislatures.  At the Washington Post, Chris Cillizza addresses this point, likening them to baseball's minor leagues:

But, like the minor leagues — where potential stars hone their craft — the state legislatures matter more than most people realize. Not only are they an incubator for young political talent but they also produce tons of legislation that draws national attention.

A few examples:

* The Arizona legislature’s controversial immigration bill, the most stringent in the country.
* The Virginia legislature’s bill regarding mandatory ultrasounds — transvaginal and otherwise.
* The photo identification law in Pennsylvania that has become a touchpoint in the broader voter ID fight nationally.
* The North Carolina House and Senate agreed to put Amendment One, affirming that marriage is between a man and a woman, on the ballot earlier this year.

There are lots (and lots) of other. But they all point to the same thing: State legislatures matter — big time. 

Registered Independents

A new report from Third Way examines voter registration data, showing an increase in the the number of voters not formally affiliated with either party.

The number of registered Independents has increased since 2008 in many of the battleground states that will decide the 2012 election. Among 12 likely battleground states, 8 have partisan voter registration—Colorado, Florida, Iowa, Nevada, New Hampshire, New Mexico, North Carolina, and Pennsylvania. In 7 of these 8 battleground states (all but Iowa), Independent registration gained ground relative to both parties in terms of voter registration between 2008 and 2011.

In each battleground state, Democratic registration fared worse relative to both Republican and Independent registration between 2008 and 2011. In all eight states, Republican registration gained relative to Democratic registration between 2008 and 2011.

The importance of Independents has grown over time as voters are increasingly leaving the traditional two-party system. Based on the combination of this general trend and the rise in both registration and self-identification of Independents since 2008, the most likely scenario for 2012 is that Independents will make up a bigger portion of the electorate next year than in any election since 1976, based on national exit polls.

Open publication - Free publishing

The Nomination Calendar

As we discuss in our chapter on political parties, the presidential nomination calendar puts some states at an advantage and others at a disadvantage. In Wilkes-Barre, Pennsylvania, The Times Leader reports that the GOP field may shrink by the time of the Pennsylvania primary on April 24.

“If they’re lucky, there might be two choices,” opined Tom Baldino, a political science professor at Wilkes University.

Dave Sosar, a political science professor at King’s College, agreed, saying that unless former House Speaker Newt Gingrich can pull off some surprise victories over the next two months, Pennsylvania voters will realistically be choosing between front-runner Mitt Romney and a group of candidates who’ve already either removed their names from consideration or have no mathematical chance at securing the nomination.

The historic order of things, or as Keystone College political science professor Jeff Brauer calls it “political tradition,” is why states go the polls in the order they do in presidential election years.

...

“Basically, states are expected to keep their order and respect the political traditions of the primaries. Switching the order means major unexpected shifts in strategy for the candidates and the political parties which they are not interested in doing,” Brauer said.

...
Baldino said Pennsylvania can still be a viable player in the nominating process if Romney makes some missteps or Gingrich builds on his momentum after winning South Carolina and continues to capture some states to remain within reach of Romney.

“It’s an optimistic scenario,” Baldino said, noting that he doesn’t believe Gingrich can win Florida’s primary on Tuesday, and it could spell the end for his chance. But a surprise victory would certainly shuffle things significantly and make the odds much better that Pennsylvania could still be in play.

Obama in Pennsylvania

Our chapter on elections and campaigns discusses the battleground states of the electoral college. Pennsylvania is one such state, which may help explain the president's visit this week. The Scranton Times-Tribune reports:

"This part of the state is a swinging part of the state," said Jean W. Harris, Ph.D., chairwoman of the University of Scranton political science department.

So swing-area Scranton could be a perfect place to start rebuilding his support with a visit billed as "official," focused on passing a key part of his jobs plan and in a place at the heart of a metro area whose unemployment rate has been the state's highest for 18 months.

To Dr. Harris, Mr. Obama's re-election is the only reason to use Scranton as a backdrop now.

"I don't think there's any other reason for him to be coming to Scranton in late November 2011," Dr. Harris said. "At this point, you know it's a campaign visit."

The Case Against a District System

An earlier post looked at a Pennsylvania proposal to adopt the district system for allocating electoral votes. At the Morning Call, Professor Christopher Borick of Muhlenberg College argues against the idea:

Herein lies the problem: The congressional district system that serves as the heart of the proposed election system is about as rotten of a core as you will ever find. Congressional districts are generally designed with a single purpose — preservation of party dominance in that district. The gerrymandering of congressional districts has successfully killed off real competition in a vast majority of districts throughout the state and nation. In only a handful of districts do you see real and regular competition between Democrats and Republicans.

Yet even with the failings of congressional districts glaringly apparent to even the most casual observer, the proposal floated by Republican leaders in Harrisburg, such as Senate Majority Leader Dominic Pileggi, seeks to make such districts the foundation upon which presidential elections in Pennsylvania will be built. In the parlance of card players, Harrisburg is considering doubling-down on a very bad hand, and the ability of Pennsylvania's voters to cast meaningful votes for president is at stake.

...

If Pennsylvania turns to a system where Electoral College votes are chosen district by district, you will ensure that most of the state's electoral votes will be determined before the race even begins, much in the way that a majority of Pennsylvania's members of Congress are currently selected. Of course, presidential candidates will spend neither time nor money campaigning where the outcome is pre-ordained; it makes no sense to use precious resources on done deals.

Another Proposal on the Electoral College

Our textbook talks at length about the electoral college. Previous posts have dealt with a plan to ensure that the winner of the national popular vote will win a majority of electoral votes. Another potential change has surfaced. At The New York Times, Nate Silver writes:

Republicans in Pennsylvania are considering a proposal that would award 18 of the state’s 20 electoral votes to the winner of each of its congressional districts, leaving the remaining 2 to the winner of the state at large.

Had the proposal been in place in 2008, when Pennsylvania had one more electoral vote prior to reapportionment, Barack Obama would have carried only 11 of the state’s 21 electoral votes despite winning Pennsylvania by a 10-point margin.

Silver points out several ways the plan could backfire on Republicans in general and Pennsylvania Republicans in particular:

• First, it could actually deprive them of electoral votes if their nominee actually won the statewide tally in Pennsylvania, which is entirely plausible.
• Second, it would undermine the integrity of the electoral college as a whole, which could hurt the party. He poses a question: if Democrats "swept the statehouse in Texas one year, or in Georgia, or Missouri, what would stop them from adopting the Pennsylvania plan if this were the new normal?"
• Third, Silver cannot "think of many better ways to motivate these voters [Democrats] than to convince that Republicans are trying to steal the election, and remind them of what happened in 2000, themes that will become prominent should the Pennsylvania plan come to pass."
• Fourth, "Pennsylvania would effectively demote itself to something like New Mexico in the electoral pecking order — a state with five or six swing votes rather than 20. That means fewer favors from Washington, fewer visits from the candidates, less of a windfall for the state’s economy, and less face-time for its politicians."
• Finally, the plan could well become unpopular and thus hurt the legislators who voted for it.

At the conservative Weekly Standard, Jeffrey Anderson writes:

Needless to say, none of this would be good for the Electoral College, one of the most valuable reminders of federalism; one of the best guarantees of a president with cross-sectional appeal; one of the greatest assurances that presidential candidates will spend time in, and will not neglect the will of, middle America; and (an underappreciated virtue) one of the best checks against a nationwide controversy over the winner. (Imagine if every vote had to be recounted by hand nationwide — because the popular vote was nearly tied — rather than merely in a few counties in, say, Florida.)

Wealthy Members of Congress

In our chapter on Congress, we discuss the question of whether lawmakers should constitute an exact mirror image of the population. As The Daily Item (PA) reports, there may actually be some advantages to having wealthy lawmakers:

Of the 19 Pennsylvanians who will enter the U.S. House in the 112th Congress -- those who while stumping forced down hot dogs at July 4 picnics and swilled beer at Oktoberfests -- six incumbents are millionaires, and two incoming Republicans are tipping the pay scale well above seven figures.

Wealthier politicians may be able to better relate to those in lower economic classes because they can concentrate solely on their constituency -- instead of those whose financial backing they would have needed to get elected.

So says a Bloomsburg University political science professor.

"It's a benefit to having money, because you don't need any outside help, so you don't have to owe anyone," Gloria Cohen-Dion said Friday. "Having the ability to have an impact is what makes one powerful."

Newcomers Mike Kelly, of northwestern Pennsylvania's 3rd Congressional District, is worth $17 million; and Lou Barletta, Hazleton, who will represent the state's 11th District, is worth more than $1 million, according to recent financial disclosure statements.

Democrat Paul Kanjorski, who lost to Barletta, is leaving office with about $6.5 million.

And Chris Carney, of Dimock, who fell to Republican Tom Marino in the 10th Congressional District race, has $500,000 -- about $150,000 more than he had when he was first elected in 2006.

"I think it is a mistake to assume that an individual's personal wealth or success, or lack of it, would prevent him or her from being able to relate to people of all walks," said Marino, himself in the middle of the pack of Pennsylvania's next U.S. representatives at around $620,000.

"If we are true representatives, then those of us who campaigned 'from Main Street' will remain in tune with all residents of our districts," said Marino, of Cogan Station, Lycoming County. "Main Street is a diverse place where you'll find blue-collar workers and professionals, the unemployed and business owners."

Cohen-Dion agrees with Marino.

"I think most public servants go in to office because they care," Cohen-Dion said.

...

Henriet Hendriks, an assistant professor of political science at Susquehanna University, said the more money, the better the government.

"If a person has money entering office, it makes it easier on them to concentrate on government," Hendriks said.

"They don't have to worry about pleasing people to donate to their campaigns," Hendriks said. "Because it is a two-year term, many people start campaigning right away once they are elected to assure more money, whereas that isn't the case when a person has personal wealth."