New job quickly puts Hagan in a bind
My column today:
It didn’t take long for Kay Hagan to get in a bind.
“Less than a month into my service here in the U.S. Senate,” the Greensboro Democrat said in a floor speech last week, “I’m faced with a situation in which the health of millions of my state’s children are at odds with a key industry in North Carolina.”
How she resolved the dilemma may forecast Hagan’s approach to her difficult job over the next six years. ...
The headline was that Hagan chose health care. She voted for a broad expansion of the Children’s Health Insurance Program funded entirely by an increase of 61 cents per pack in the federal cigarette tax.
Hagan put forth good arguments for supporting and for opposing the measure, which ultimately passed 66-32. In arriving at her decision, she did two things I think were exactly right.
* She supported an amendment proposed by Sen. Jim Webb, D-Va., that would have held the cigarette tax hike to 37 cents. Additional revenue would have come from closing what Webb called a tax loophole on “carried interest” compensation earned by hedge-fund managers.
Webb withdrew his amendment before it could come up for a vote, making it merely symbolic. Nevertheless, Hagan did not decry one funding mechanism without at least pointing to an alternative
.
* She communicated. She delivered impassioned remarks meant for multiple audiences, including Senate leaders and colleagues, constituents, home-state media and probably the tobacco industry. She made sure everyone could understand her concerns and conclusions.
A legislator owes as much every time she votes on an important bill, but too many of them are considerably less forthcoming. If Hagan continues this pattern, she will develop a welcome rapport with North Carolina interests.
Hagan described her predicament with commendable candor. “The staggering thought of 10 million young children without the health care coverage they need is unacceptable to me,” she said. Yet, “the way in which this bill taxes only cigarettes is unfair, and I believe the proposed 61-cent increase is outrageous.”
In the end, she accepted the outrageous instead of the unthinkable.
Frankly, I thought she made a stronger case for going the other way. Cigarette taxes are regressive, making poor smokers pay for health care for children from better-off families, she observed. The higher tax burden will cost North Carolina up to 3,000 jobs and $36 million in state tax revenues, she said. The tax places a disproportionate share of the program’s cost on just a few states. Why not tax junk food and sugary drinks, Hagan asked, to spread the burden? And, because cigarette smoking is declining, the children’s health program is tied to an unreliable funding source.
With all that laid out, Hagan just as credibly could have stated, “As committed as I am to children’s health, I cannot in good conscience vote for this bill as presently funded.” It would have passed anyway, and she would have let Senate leaders know she was serious about protecting a North Carolina industry.
But, what about the politics? There would have been disappointment among children’s health advocates in North Carolina but probably appreciation for her reasoning. In Washington, though, this was a Democratic bill, and it was supported by every Senate Democrat, including those from tobacco states.
Hagan’s Republican colleague from Winston-Salem, Richard Burr, voted no, citing the additional tax that “would disproportionately hurt workers and farmers in North Carolina.” He supported a Republican amendment that would have reduced the cost but was rejected.
Burr, up for re-election next year, was immediately assailed by Americans United for Change, a liberal organization affiliated with labor groups and MoveOn.org.
“Senator Burr should explain to North Carolina families why he voted to deny health care for millions of children in need,” an AUC news release challenged.
Burr did explain, although not in as much detail as Hagan.
Correction: Burr did speak extensively and in detail on the Senate floor about his objections to the bill and his support for the alternative.
Had Hagan also voted no because of the cigarette tax, Burr might have gained political immunity from partisan attacks like this one. Democrats couldn’t toss grenades at Burr if Hagan were standing next to him.
Her position likely had nothing to do with politics, but there are times when party loyalty dictates a legislator’s vote even when it clashes with home-state concerns. In this case, Hagan could cite good reasons to support a vote either way. There was no wrong answer. Next time, she might find herself in an even tighter bind.
Thanks for reading. You can call me at 373-7039, email me at dgclark@news-record.com or post a comment here.
Comments (21)
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I like to read about the stimulus plan, and what the ILLEGALS get, compared with what our seniors get, that worked for this country all there lives. You remember Kay who was against this wasteful plan, before she was for the wasteful plan. Maybe Kay could help us understand weather ILLEGALS children are covered under this health care program are not. Seems Kay does not like to answer letters on this matter.
Posted on February 4, 2009 5:07 AM
It appears citizenship status is not checked when determining eligibility for this program:
http://www.ncsl.org/programs/health/forum/pub6682.htm#executivesummary
Posted on February 4, 2009 6:10 AM
I do hate to hear a grown woman cry.
Posted on February 4, 2009 9:30 AM
That's right, Doug J, the little children with their nefarious plan to sneak into the country to go to the doctor!
Posted on February 4, 2009 10:25 AM
''In the end, she accepted the outrageous instead of the unthinkable.''
Well said, Doug. Kids need health care. Period. Whether they were born here, or brought here by others. I'm not aware of a mad rush of little children sneaking across the border on their own. But maybe I've missed something.
Posted on February 4, 2009 11:31 AM
Thanks Cara Michele.
Children without other access to health care will show up at hospital emergency rooms, where treatment is very expensive. Children not treated for illnesses will infect other children.
The desire to provide health care for children, however, should not overwhelm the need to use resources wisely. Legitimate questions were raised about the cost of the SCHIP program and about why eligibility should be broadened so widely when millions of children already eligible weren't enrolled. Questions of mismanagement?
Posted on February 4, 2009 12:03 PM
Good question, Doug. One of these days I need to buy (physician and blogger) Joe Guarino a cup of coffee and pick his brain on this subject. He's very knowledgeable in this area and writes about it.
Posted on February 4, 2009 12:47 PM
Doug:
The eligibility rules that you described come from a January 2000 report. Illegal immigrants were ineligible for SCHIP when it was originally enacted. Recent legal immigrants were also ineligible.
In the just passed legislation, applicants must be citizens or legal immigrants. Applicants must provide names and social security numbers (in addition to other documentation to establish income eligibility). The names and social security numbers are checked against the SSA database. If they don't match, the household is dropped from the program. Illegals could potentially receive benefits for up to 90 days while the verification is occurring.
Posted on February 4, 2009 4:36 PM
Thanks for the update, Dave. The ER it is, then.
Posted on February 4, 2009 5:21 PM
No Andrew Clark, they are already here by the millions. They take jobs ( not that our people need them) take spaces in college from our kids
Dave Ribar, according to Obama, just seconds ago ILLEGALS will be fully covered.
So while American families kill their selves making 50,000 a year, struggle to make ends meet, must pay for their insurance, illegals will get it free. God it great to break into America.
I all for American children having health care, i just hate the hell out of illegals and the way we are required to suck their butts.
I pay close to $9,000 for my insurance.
Hell, I be better off to jump the boarder, and let the taxpayers support me.
Just heard that it will take 24 million new smokers to cover the cost of it.
Posted on February 4, 2009 5:23 PM
DJ:
Perhaps you could provide a link to back this up.
I've read sections of the bill addressing documentation for immigrants (the bill is HR 2 on the Thomas, Library of Congress web-site, http://thomas.loc.gov/ ). The legislation extends benefits to LEGAL immigrant children who weren't covered before but does not appear to cover ILLEGAL immigrant children.
The text that I was able to find of the President's signing remarks ( http://www.democrats.org/a/2009/02/president_obama_4.php ) seems to bear this out:
"That is why we have passed this legislation to continue coverage for seven million children, cover an additional four million children in need, and finally lift the ban on states providing insurance to legal immigrant children if they choose to do so."
Posted on February 4, 2009 6:47 PM
Andrew Clark wrote:
"That's right, Doug J, the little children with their nefarious plan to sneak into the country to go to the doctor!"
Illegal aliens entered the U.S. to get medical help for their illegal alien daughter and sued Duke Hospital. It cost Duke $4 million to settle.
http://en.wikipedia.org/wiki/Jesica_Santillan
Posted on February 4, 2009 8:29 PM
Jaycee:
Duke killed the girl by not checking her blood type before transplanting organs.
Her initial operation was covered through her mother's insurance and through private donations, not public dollars.
For another description of these events see http://www.newsobserver.com/559/story/546882.html .
BTW, Jesica's parents never filed a lawsuit. The $4 million did not go to Jesica's parents; instead Duke established a fund to treat Latino children ( http://www.allbusiness.com/health-care-social-assistance/ambulatory-health-services/556411-1.html ). Duke did settle with Jesica's parents but for undisclosed terms.
Posted on February 4, 2009 9:36 PM
Obama said it in the signing. I called two congressman office yesterday. The question I asked was do ILLEGALS children get free health care under SCHIPS. Neither office knew the answer, both said they would get in touch with me. Bless their hearts both called back, the answer from both offices was, you a eligible as long as you can show ID. The example they gave me was a driving permit. Hell NC issued driving permits like cereal box tops. (still do).All you have to do is show a social securtiy number, any form. My wife was sent back home for not having it. The day I had my cancer operation, 12 border jumpers were in the clinic, not one spoke a word of English. I asked the nurse, who paying for them, answer you are. Now Dave and Doug tell me me whats your love affair with these folks that break Ito our country, and place the cost on us?
Posted on February 5, 2009 6:38 AM
DJ:
Your reading skills are clearly failing you. Obama's statement was posted above as was a link to the legislation itself as was a description of the documentation procedures. As that post stated, it is possible for illegal immigrants to receive S-CHIP benefits for a short time (up to 90 days) while their names and social security numbers are being checked. The provision is actually there to protect children who citizens and legal immigrants.
Note, however, that names and social security numbers are NOT the only information needed for benefits. Any household applying would also have to show that they are income eligible; these documents would have to match the names and SSNs. You can look on the NC DHHS application page ( http://www.dhhs.state.nc.us/DMA/medicaid/apply.htm ) to see what other documentation is required. You can also review the application itself ( http://info.dhhs.state.nc.us/olm/forms/dma/dma-5063.pdf ). All of the information on the application is subject to verification.
It's not clear why you're tagging Doug with this, though it does seem consistent with the reading issue discussed earlier. Doug's offense seems to be that he wrote a balanced column that carefully described Sen. Hagan's tough decision between two important constituencies--uninsured children and tobacco producers.
For my part, the concern (love affair sounds icky) is with needy American children who would have to jump through numerous extra administrative hoops to get benefits. It's a matter of not cutting off your nose to spite your face.
Posted on February 5, 2009 8:08 AM
The parents were illegal aliens, as was their daughter.
They violated federal law to enter our country illegally and specifically to take advantage of our health system.
Duke was extorted into establishing a fund to the tune of $4 million.
No matter how you slice it, a family of illegal aliens targeted our health system and somebody had to pay out $4 million because of it.
That's outrageous.
BTW, your first link to the N&O is an "opinion" piece, not a factual report.
Posted on February 5, 2009 3:29 PM
The http://www.allbusiness.com/health-care-social-assistance/ambulatory-health-services/556411-1.html story doesn't sound like extortion. From that story.
----------
"Jessica's sad outcome profoundly affected all of us at Duke, particularly her caregivers in children's services and on the pediatric intensive care unit," Ralph Snyderman, MD, president and CEO of the Duke University Health System, said in a news release. "One of the ways we intend to honor her memory forever is to improve the organ transplantation process, not just at Duke Hospital but nationwide, and to be a leader in improving patient safety. Importantly, we also wanted to honor this brave young woman by creating a perpetual fund at Duke Hospital that would help Latino patients deal with the many cultural issues they face."
Snyderman denied possible legal action over the botched transplant drove creation of the fund. "We have not discussed this with attorneys," Snyderman said according to the Associated Press.
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Foreign nationals are allowed to obtain medical care in this country; private philanthropy paid the cost of the initial operation.
Duke didn't pay because someone "targetted" the institution; Duke established this fund and subsequently settled with the Santilla family because they made a tragic and easily preventable medical error that killed a young girl.
Posted on February 5, 2009 5:02 PM
If you think Duke paid out $4 million from the goodness of their heart then you're too mentally challenged to engage in public conversation.
Duke did it to avoid losing more $$$ in a lawsuit that was sure to come.
It's called "settling out of court."
Posted on February 5, 2009 5:43 PM
Jaycee:
No, actually, settling out of court is settling out of court, which Duke did ( http://findarticles.com/p/articles/mi_m0YUG/is_12_14/ai_n17208438/pg_1 ).
You say that Duke was sued, but a news article says that no lawsuit was filed. Now you say that a lawsuit was sure to come, but the mother states that she didn't want one. You say that Duke was extorted; Duke says it wasn't.
The mental challenge seems to be for you to come up with something that isn't contradicted by the people involved.
Posted on February 5, 2009 7:46 PM
I seemed to recall a lawsuit for $7 million, but apparently I was mistaken.
Just because a newspaper reports that a woman said this or that doesn't make it the final word. No one except the illegal alien woman herself knows how many shyster lawyers she talked to or what pressure was put on Duke to cough up $4 million. You don't know; I don't know. Reporters don't know. So don't quote me a newspaper article and assume it's the truth, the whole truth, and nothing but the truth.
If you think no suit would have ever come if Duke had told the illegals to kiss their butt then I have some beachfront property in Arizona I'd like to sell you...
Posted on February 5, 2009 10:35 PM
Jaycee:
You bring up an example, said that something occurred (without any documentation), and now say that you "don't know." You further claim that it is unknowable to anyone but the mother, whom you also claim we can't believe.
Sounds like jumping to an unfounded conclusion to me.
With respect to the Arizona beachfront, it's good to see you finally recognizing the dire consequences of global warming.
Cheers.
Posted on February 6, 2009 10:33 AM