October 22, 2018

Trump’s ACA Order Creates Health-Care Chaos

US President Donald Trump (L) and White House senior advisor Jared Kushner take part in a bilateral meeting with Italy's Prime Minister Paolo Gentiloni (not seen) in Villa Taverna, the US ambassador's residence, in Rome on May 24, 2017. Photo by Mandel Ngan/AFP/Getty Images

So now we face yet another assault on the health and safety of our nation due to the barrage of efforts by the current administration to dismantle certain provisions in the Affordable Care Act (ACA). This creates great risk and chaos within a system that is aimed at providing both proactive and reactive care to individuals in our country.

As a Jewish community, we should be outraged at the callous attempt to shirk society’s obligation to care for one another, both in terms of last week’s decision to cut subsidy payments to insurers (“cost-sharing reduction payments”) and the ruling to withhold the ACA’s promise of no-cost contraceptive coverage. As conversations and negotiations change by the hour, we are both encouraged to learn of bipartisan cooperation to save the cost-sharing reduction payments while at the same time disappointed with the administration’s insensitive statements and recommendations to eliminate someone’s health care.

This supersedes all other commandments, as it is inferred from one of the most well-known rabbinic teachings, the concept of pikuach nefesh, saving a soul, found in Mishnah Yoma. The text suggests that saving the life of yourself or another is so great that one is permitted to break the laws of Shabbat for the safety of human life. We must interpret this to modern day and protect the lives of millions who will be affected by attempts to cripple the Affordable Care Act. To dismantle a life-saving system is antithetical to the concept of pikuach nefesh.

Furthermore, the book of Leviticus (19:16) teaches that one should not stand idly by the blood of their neighbor. Many among us acknowledge the ACA is not a perfect system and does not go far enough to provide adequate health care to our entire society. Yet, to make provisions that seek to strip health care from any individual is to create a situation in which we as a society will be standing by the blood of our neighbor.

Although negotiations are ongoing, last week’s initial decision by the Trump administration to sign an executive order sends a signal to the insurance companies that their participation in the ACA is not cost-effective for their company. As insurance companies cease their participation in the ACA, it places many people in our society at great risk of losing their health care, putting their lives and the lives of their loved ones at risk.   

The Jewish community must look at the current health care debate and ask ourselves: Is the Trump administration seeking to save lives, or, by suggesting that we eliminate the cost-sharing reduction payments, are its actions creating a risky environment that will harm lives?

The answer is clear. We as Jews have a responsibility to care for one another. If the future health care of an individual is unknown, then we are ignoring our commandment of pikuach nefesh, to save lives.

It is the responsibility of us all to ensure the health and safety of one another.

The administration is taking a further step by issuing rules that would allow employers and insurers to withhold the ACA’s promise of no-cost contraceptive coverage. This is a direct attack on women, who should be the only decision makers for their bodies. Many have celebrated this recent ruling as a win for religious freedom but many organizations have a contrary view.

Any government-backed initiative that allows for discrimination based on religious belief is an affront to our religious freedoms. A provision in Trump’s order puts women’s reproductive health decisions in the hands of their employers and insurers. Our country has a long legacy of religious freedom, and recent attempts to incorporate discrimination into the legislative process based on religious freedom are antithetical to the core beliefs of our religion and the core beliefs of this nation.

We have a strong and healthy tradition of debate and dissent within the Jewish framework, but it seems clear that the dismantling of the ACA creates a dangerous situation in which the health care of many in our society will be in the balance. We must go beyond offering a misheberach for those in need of healing. The ACA and other initiatives that seek to provide sustainable and reliable health care to all link our prayers to our actions as we seek to truly heal those in need. 


Rabbi Joel Simonds is the founding executive director of the Jewish Center for Justice.

Trump’s Changes to ACA Are Worth Celebrating

President Donald Trump on July 24. Photo by Joshua Roberts/Reuters

On Oct. 12, President Donald Trump signed an executive order rolling back a handful of Obamacare’s regulations.

Patients and employers should celebrate the move. The administration is taking action where Congress could not, increasing the number of insurance choices available to Americans — and reducing their cost.

The order directs the Departments of Health and Human Services, Labor and Treasury to come up with regulations that would allow for three key changes.

First, Trump’s order aims to expand access to association health plans, or AHPs. These plans allow small, like-minded employers to join forces to purchase a large-group insurance policy together.

The Obama administration cracked down on AHPs by decreeing that small employers banding together under the banner of an association would not be eligible to buy a large-group policy to cover them all.

That was crucial, because Obamacare imposed many costly regulations and mandates on individual and small-group insurance but not on policies issued in the large-group market.

The administration is … increasing the number of insurance choices available to Americans.

Among those regulations are the essential health benefits mandates, which require all policies to cover 10 benefits, regardless of whether employers or beneficiaries want them.

These mandates inflate the cost of insurance. Many small businesses and employees would gladly take lower premiums and deductibles in exchange for policies that don’t cover expensive services.

But they don’t have that option; their only choice is expensive, comprehensive insurance. So it’s no wonder that only one-third of businesses with fewer than 50 employees offer health insurance — or that just one-third of 1 percent of employees at such firms have coverage through Obamacare’s Small Business Health Options, or SHOP, exchange.

Crucially, those with pre-existing conditions will be protected if their employer opts for an AHP. The executive order emphasizes that employers cannot exclude employees from joining the plan, nor can they charge different premiums to different individuals covered by the plan.

Trump’s executive order also relaxes restrictions on low-cost, short-term health insurance plans. Obamacare set the maximum term for such plans at three months; the executive order will probably extend that term to just under a year and allow the plans to be renewed.

Obamacare slapped strictures on short-term plans to try to force people into the insurance exchanges. But exchange plans have proven too expensive for many individuals, thanks to the many mandates governing them. 

The third component of Trump’s executive order would boost the power of health reimbursement arrangements, or HRAs. These accounts enable employers to allocate tax-free dollars to employees to help them with qualified healthcare expenses.

HRAs are particularly popular with small businesses. Under Obamacare, those with fewer than 50 employees are not obligated to offer health insurance to their workers. Many do so anyway. Others may not be able to afford to provide coverage, especially if their only options are on Obamacare’s expensive marketplaces. HRAs can allow them to give their employees at least some help paying for care.

Under the executive order, the administration is likely to broaden the definition of qualified health care expenses to allow for HRA funds to cover insurance premiums. That could help scores of people who previously could not afford coverage pay for it.

Republicans have promised for the better part of eight years to expand access to low-cost coverage by repealing and replacing Obamacare. President Trump’s executive order finally makes good on that promise, albeit to a small degree.

And, on Oct. 13, President Trump announced that he would immediately stop paying the illegal CSR (Cost-Sharing Reduction) subsidies to insurers.  These payments of $7 billion a year were never appropriated by Congress.  A specific instruction to pay that money is required by the U.S. Constitution before federal money can be paid. 


Sally C. Pipes is president, CEO and the Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute.

Pirkei Avot, the GOP and health care

Sen. Majority Leader Mitch McConnell, accompanied by Sen. John Barrasso (R-Wy.) and Sen. John Thune (R-SD) and Sen. Roy Blunt (R-Mo.), speaks with reporters following the party luncheons on Capitol Hill on Aug. 1. Photo by Aaron P. Bernstein/Reuters

Moses received Torah at Sinai. He transmitted it to Joshua, and Joshua to the elders, and the elders to the Prophets, and the Prophets to the Men of the Great Assembly. They said: raise up many disciples, be deliberate in judgment, and build a fence around the Torah.

Mishnah Avot 1:1

It is procedure that marks much of the difference between rule by law and rule by fiat.

Wisconsin v. Constantineau (1971)

Process is boring, but it also is crucial, as the Supreme Court observed. And it is particularly crucial for Jews as we consider the Republican effort to repeal Obamacare.

This is a live issue. Despite July’s failure of Senate Majority Leader Mitch McConnell’s plans, Republicans have made clear that they will continue to pursue repeal. And both his and House Speaker Paul Ryan’s abuse of Congressional process show that they are adept at rule by fiat.

To be clear: I believe the repeal plans are a moral abomination. But apart from substance, let’s look at the procedure. The GOP’s Obamacare repeal process mocks democracy. Health care approaches one-fifth of the entire U.S. economy, yet the process was conducted in near total secrecy. On the House side, the bill was written behind closed doors without any input from the Democrats. Ryan rushed it to the floor before the Congressional Budget Office could even determine what its effects would be. If enacted, the American Health Care Act would strip 23 million people of coverage, but the process was designed precisely so that Congressmembers would be kept in the dark.

McConnell’s process was even more secretive; the Senate bill was cooked up in his office with no input from patients, health experts, advocacy groups — or even most of the Republican caucus. The March of Dimes paid for McConnell’s polio treatment as a child; he refused even to meet with the organization. His last-ditch attempt — the so-called “skinny” repeal — was introduced five hours before it was supposed to be voted on, with no hearings or public input whatsoever. GOP senators have announced yet another plan to rush through a health package with the same high-handed secrecy.

All legislation resembles sausage-making, but this was fetid even for a slaughterhouse. Julie Rovner, who has covered this issue since the 1980s wrote, “The extreme secrecy is a situation without precedent. … I have been here for 30 years and never seen anything like this.” Journalist Ezra Klein noted that “Republicans are making life-or-death policy for millions of Americans with less care, consideration and planning than most households put into purchasing a dishwasher.” John Podhoretz, no liberal, tweeted, “I have never seen such unanimity in the horror everyone on all sides is expressing toward the Senate process on this health care bill.” (Spare me references to the creation of Obamacare, which took 14 months, included literally hundreds of GOP amendments, dozens of hearings and extended bipartisan negotiations.)

But why is it a Jewish issue? Let’s consider the epigraph from Pirkei Avot. This Mishnah is perhaps Judaism’s most foundational text, and it links the chain of rabbinic authority to three central moral injunctions, particularly “be deliberate in judgment.”

Most classical commentaries, from Rambam to the Chasidic masters, do little with this passage. They gloss it as simply “do not move too fast” or “be careful.” This might be useful, but it really misses the point. Telling us to “be deliberate in judgment” requires us to consider the deeper question of how we do that: What conditions will make us deliberate? Unsurprisingly, much of Avot concerns the proper behavior of public decision-makers: It warns how the wielders of state power betray those who trust them (Avot 2:3).

Being serious about deliberation in judgment means we must establish institutional practices that make us deliberate. Both character and structure matter. This reflects virtually all Jewish spirituality: Our tradition creates practices to bring the soul closer to God. Commanding us to remember God is not good enough. We do it by practices such as uttering blessings, wrapping tefillin, observing Shabbat, etc.

In other words, Avot 1:1 is the “Jewish Due Process” clause. It holds that if anyone makes crucial decisions about people, they must follow proper procedure. Only then can they truly be “deliberate in judgment.” Like long-settled judicial principles of “due process,” “deliberation in judgment” requires that those affected by state power have a right to be heard, to contest those whose interests are adverse, to have transparent and open government, to have decisions made on the basis of evidence and rational judgment rather than arbitrary caprice. If leaders make decisions without hearing from those affected and subjecting their own thoughts to scrutiny, they are not really deliberating at all. Such “process” is not judgment. At best, it is no more than a series of irritable mental gestures; at worst, tyranny with window dressing.

When Congress holds literally tens of millions of lives in its hands, to refuse to listen to those who will suffer mocks the Torah’s requirement of deliberation in judgment. McConnell and Ryan do not care. Do we?


JONATHAN ZASLOFF is professor of law at UCLA, where he teaches, among other things, property, international law and Pirkei Avot. He also is a rabbinical ordination candidate at the Alliance for Jewish Renewal.

Reform movement joins health advocacy groups in urging rejection of Obamacare repeal

Protestors gather during a demonstration against the Republican repeal of the Affordable Care Act, outside the U.S. Capitol in Washington, D.C., on June 21. Photo by Aaron P. Bernstein/Reuters

The Reform movement joined an array of health advocacy groups in urging the U.S. Senate to reject a repeal of the Affordable Care Act, the signature Obama presidency health care reform legislation.

“Every U.S. Senator should vote no on health care repeal,” said the full-page ad appearing Monday in The New York Times signed by 28 groups.

The majority of groups were major health care advocacy organizations, including the Cancer Advocacy Network, the March of Dimes, the American Lung Association and the American Academy of Family Physicians. The Union for Reform Judaism was among a handful of faith-based groups, including Protestant and Roman Catholic.

Republicans have long objected to the legislation known as Obamacare, saying it has driven up insurance prices in some areas of the country and put Americans at risk. Defenders say it has expanded the number of Americans who are insured.

President Donald Trump has made its replacement the signature mission of his first year in office, and it seemed likely with Republicans controlling both chambers of Congress. The U.S. House of Representatives passed a replacement bill earlier this year. Republicans in the Senate, unable to come up with a compromise that would satisfy both moderates and hard-line conservatives among them, are now considering whether to simply repeal the bill, with a two-year delay to come up with a replacement.

A vote should take place this week; the outcome remains in doubt.

Health care advocacy groups, including an array of Jewish organizations, say a repeal could be disastrous, resulting in tens of millions of Americans losing their insurance. Also of concern are proposed cuts to Medicaid, the federal program subsidizing insurance for the poor.

How the Dems can lose 2018

Activist Linda Sarsour in New York City on June 29. Photo by Joe Penney/Reuters

Last week, the Democrats released a new bumper sticker for their 2018 Congressional campaign: “I mean, have you seen the other guys?”

It’s not a bad political notion so far as it goes — opposition in politics is an effective tool, as Democrats learned from Republicans, who campaigned against Obamacare and Democratic spending policies to the tune of 1,000 state legislature seats, 12 governorships (including in states such as Michigan and Massachusetts), 10 Senate seats and 63 House seats. Now Democrats hope to reverse the math.

But there’s something else going on here, too. Democrats hope that campaigning as #TheResistance will suffice to prevent voters from looking too hard at their own moral and political shortcomings. That’s because for all the talk by Democrats about Republican extremism, Republicans actually have moved closer to the center on policy, while Democrats have embraced an ugly combination of Bernie Sanders-style socialism and college campus-style intersectionality.

Leave aside the boorish antics of President Donald Trump and the incompetence of Congressional Republicans. Here is the fact: Trump is the most moderate Republican president since Richard Nixon. He has successfully passed almost no major policy in seven months. His foreign policy on North Korea and Syria is barely distinguishable from former President Barack Obama’s. His approach to the Israeli-Palestinian conflict has been praised by Palestinians and former Obama officials. He’s the most pro-LGBT Republican in presidential history; his stance on abortion has been vague; his White House chief strategist has openly embraced higher taxes on upper-income earners, as well as a massive infrastructure spending program; he has embraced the central premises of Obamacare. Trump may act in ridiculous ways that defy rationality — his Twitter feed is littered with stupidity and aggression, of course — but on policy, Trump is closer to Bill Clinton of 1997 than President Obama was.

Democrats, meanwhile, are moving hard to the left. When former Clinton adviser Mark Penn wrote an op-ed for The New York Times calling for Democrats to move back to the center, he was roundly excoriated by the leading thinkers in the Democratic Party. He was an emissary of the past; he had to embrace the new vision of the leftist future. That leftist future involved radical tax increases, fully nationalized health care, and — most of all — the divisive politics of intersectionality. Sens. Sanders (I-VT) and Elizabeth Warren (D-Mass.) may own the policy side of the Democratic coalition, but the heart of the Democratic coalition lies in polarization by race, sex and sexual orientation. Forget a cohesive national message that appeals to Americans regardless of tribal identity: The new Democratic Party cares only about uniting disparate identity factions under the banner of opposing Republicanism.

The clearest evidence for that alliance of convenience came earlier this month, when Democratic darling and Women’s March organizer Linda Sarsour was caught on tape promoting “jihad” against Trump. Sarsour said that the sort of “jihad” she liked was “a word of truth in front of a tyrant or leader.” But she deliberately used the word “jihad” because of its ambiguity, not in spite of it: Sarsour has stated that pro-Israel women cannot be feminists; she supports the imposition of “Shariah law” in Muslim countries; she has stated of dissident and female genital mutilation victim Ayaan Hirsi Ali that she wishes she could take her “vagina away”; she has long associated with the terrorist Muslim Brotherhood; she opened her “jihad” speech by thanking Siraj Wajjah, an unindicted co-conspirator in the 1993 World Trade Center bombing who has repeatedly advocated for a violent form of “jihad.”

Democrats hope that campaigning as #TheResistance will suffice to prevent voters from looking too hard at their own moral and political shortcomings.

Democrats rushed to her defense nonetheless, hoping to preserve the intersectional concerns that animate their base. Never mind that Sarsour is no ally to LGBT rights, or that she blames “Zionists” for her problems. She represents an important constituency for Democrats, and so she must be protected. More than that, she speaks anti-Trumpese fluently, and thus is an important figure for Democrats.

This isn’t rare on the left anymore. Much of the Democratic establishment supported Rep. Keith Ellison (D-Minn.), a longtime Nation of Islam acolyte who spent years defending that group’s most extreme anti-Semitic rhetoric — a man so radical that he openly associated with the Campaign to End the Israeli Occupation, which recently labeled Democratic Senate Minority Leader Chuck Schumer (D-N.Y.) an “Israel Firster.”

Even as the Democratic Party embraced Sarsour and defended her ambiguous use of the word “jihad” — after all, she was opposing Trump the Impaler — leftist spokespeople rushed to microphones to denounce President Trump’s speech in Poland, in which he called for a defense of “the West” and “our civilization.” Leftist columnist Peter Beinart labeled the speech racist. As Jonah Goldberg of National Review points out, we now have a Democratic Party that spends its time defending the use of the word “jihad” against the president but labeling the phrase “the West” a problem.

Bold strategy, Cotton. Let’s see how it works out.

And so Democrats must focus on President Trump. They must hope that he smacks himself in the face with a frying pan. They must bank on some sort of Trump-Russia collusion revelation. They must pray that the focus stays on Republicans rather than turning back to Democrats. After all, Sanders-Sarsour doesn’t sound like a winning combination.


BEN SHAPIRO is editor-in-chief at The Daily Wire, host of the most listened-to conservative podcast in the nation, “The Ben Shapiro Show,” and author of The New York Times best-seller “Bullies: How the Left’s Culture of Fear Silences Americans.”

Jewish groups urge Senate to oppose health care bill

Protestors gather during a demonstration against the Republican repeal of the Affordable Care Act, outside the U.S. Capitol in Washington, D.C., on June 21. Photo by Aaron P. Bernstein/Reuters

A coalition of Jewish organizations led by the Religious Action Center of Reform Judaism urged members of the U.S. Senate to oppose the bill that would repeal the Affordable Care Act, or Obamacare.

The letter sent to all 100 senators Tuesday, signed by 14 organizations, says that the Better Care Reconciliation Act of 2017 would undercut Medicaid, the federal program that currently pays for half of all births in the United States and about 62 percent of seniors who are living in nursing homes.

The Senate bill would lower government spending on Medicaid by capping the per capita cost of serving various groups, such as children, adults, people with disabilities or the elderly. According to the Congressional Budget Office, the Republican-backed bill would reduce projected Medicaid spending by $772 billion in the coming decade, and 15 million fewer people would be covered by Medicaid in 2026 than under the current law.

“Among other harmful provisions, transforming Medicaid into a per-capita cap system would not only take away health care from those who have benefited from the ACA’s Medicaid expansion, but would harm populations that have been covered by Medicaid since its inception,” according to the letter. “States will face impossible choices prioritizing among people with disabilities, low-income Americans, and children and will have no option but to slash services that are essential for the daily lives of millions.”

Signers of the letter include Bend the Arc-Jewish Action, Jewish Federations of North America, National Council of Jewish Women, the Network of Jewish Human Service Agencies, and Reform, Conservative and Reconstructionist groups.

Jewish Federations of North America estimates that the care providers affiliated with Jewish federations receive $6 billion from the Medicaid program annually.

Hunk hawks hideous health bill

Sen. John Thune (R-S.D.)

John Thune is the most handsome man in the U.S. Senate. Square jawed, gleaming smile, cowboy tan, the 6’4” South Dakota Republican’s rugged good looks are antipodal to the mien of majority leader Mitch McConnell, whom Jon Stewart has definitively established is Yertle the Turtle’s doppelgänger. If the human brain’s positive bias toward attractive people didn’t cue me to infer that Thune is a great guy, a real straight shooter, I’d be as outraged by the assault on Americans’ health that Thune and his co-conspirators are currently waging, and by the subversion of American democracy they’re using to ram it through, as I am when its public face is McConnell’s.

Thune is a member of the all-white, all-male “gang of 13” staunchly conservative Republicans whom McConnell tasked two months ago with secretly writing a new GOP health bill in the Senate.

Because a parliamentary tactic will embed this Affordable Care Act (ACA) repeal — and alleged replacement — into a budget reconciliation bill, it’s exempt from being filibustered by Democrats. That means the bill will need only 50 of the 52 Republican senators, along with Vice President Mike Pence’s tie-breaking vote, in order to pass, instead of the 60 votes it takes to shut down a filibuster, which would require at least eight Democrats to defect.

Because the House also must pass the bill with only Republican votes, it needs to be mean enough to win over the House’s far right Freedom Caucus, “mean” being President Donald Trump’s new description of the formerly “beautiful” House health bill he fêted in the Rose Garden in May. That’s why the American Health Care Act (AHCA) that McConnell and House Speaker Paul Ryan want Trump’s signature on before July 4 likely will deprive 23 million Americans of health insurance; end Obamacare’s minimum benefits, like mental health services and maternity care; deny coverage for pre-existing conditions; permit lifetime benefit caps; cut $800 billion from Medicaid and turn it into block grants to states, effectively killing the program — oh, and give the top 0.1 percent of households an average tax cut of nearly $200,000.

I say “likely,” since the actual content of the bill has been shrouded in secrecy. Because a majority of Americans oppose those changes to a law that a majority of Americans support, McConnell knows that his only chance to pass it before the public catches on and rises up is a total blackout of information as they write the bill, which is what’s happening now, and once they reveal it, a blitzkrieg without committee hearings or time for town halls, hurtling toward a final vote within a matter of hours.

This is not normal. It’s not how a bill affecting one-fifth of our economy is supposed to be considered. McConnell’s plan is to make it seem normal, which is why they’re deploying the credibility of John Thune’s chiseled cheekbones: to sell a coup d’état as if it were a “Schoolhouse Rock!” civics lesson.

The day after a gunman opened fire on a Republican congressional baseball practice, prompting calls to for a return to civil discourse in our politics, Thune was on MSNBC’s “Morning Joe” saying we all must do our part to achieve the unity that this moment requires. Speaking of unity, journalist Mike Barnicle piped up, what about the health care bill being written in secret? “Nobody knows what’s in this bill,” Barnicle said. As a starter, he asked, in the spirit of reaching across the aisle, of bipartisanship and openness, “How about … telling us what’s in this bill?”

Thune’s answer made me marvel that a man with such good hair could deceive so baldly.

There’s really no bill to share, he said. What’s going on now is just discussions, just policy options. It will be openly shared when it’s reduced to legislative language, he said, as though that’s just how the lawmaking process works.

It’s not. Drafts of bills are routinely made public long before legislative language is locked in. They’re distributed as outlines, memos, letters, emails, talking points, PowerPoints, lists, charts, conference calls, cut-and-pastes, works in progress, principles, summaries, overviews, abstracts. They’re the basis for innumerable meetings with constituents, stakeholders, interest groups, media, members of both parties, think tanks, analysts and experts. That’s American democracy in action. What’s happening now is not.

Besides, Thune added, there’s been so much discussion of health care over the past decade, “it’s like any of us are unfamiliar with what the issues are.” We’ve already discussed them.

The ACA was the subject of hundreds of committee hearings and markups, hundreds of hours of congressional debate, hundreds of town halls and public forums and two years of news coverage. But that discussion was about expanding Medicaid, not eliminating it; about increasing benefits, not cutting them; about providing health insurance to millions, not giving tax cuts to millionaires. If the media were to give the AHCA’s issues the kind of scrutiny and airtime it gave Obamacare, Republicans would now be running from it like a dumpster fire.

To be sure, John Thune would make one handsome fireman. But I doubt even he could convince his colleagues in Congress to bunk in a burning building.


MARTY KAPLAN is the Norman Lear professor at the USC Annenberg School for Communication and Journalism. Reach him at martyk@jewishjournal.com.

#IamAPreexistingCondition

President Donald Trump gathers with Congressional Republicans in the Rose Garden of the White House on May 4. Photo by Carlos Barria/Reuters

So it turns out that not even late-night TV host Jimmy Kimmel’s emotionally wrenching story about his newborn baby’s heart defect and subsequent life-saving surgery was enough to persuade three more GOP House members to vote against the latest version of the American Health Care Act (AHCA). Kimmel’s baby, like millions of other Americans, now has a “pre-existing condition” that insurers traditionally have treated almost as a badge of shame, and subject to increasingly high insurance premiums and deductibles.

That’s because the AHCA, as it presently stands, will allow states to apply for a waiver to the Obamacare requirement that insurers must charge all people the same rates, no matter their medical histories. Removing that requirement means that insurers will be able to charge exorbitant premiums if you have a pre-existing condition and have let your insurance lapse, which, in practical terms, can lead to financial ruin in trying to keep purchasing insurance coverage.

The “big 10” of patient advocacy groups, including the American Cancer Society Cancer Action Network, American Diabetes Association and American Heart Association, came together to oppose AHCA, saying in a joint release, “Weakening protections in favor of high-risk pools would also undermine the ban on discrimination based on health status. The individuals and families we represent cannot go back to a time when people with pre-existing conditions could be denied coverage or forced to choose between purchasing basic necessities and affording their health care coverage.”

The last-minute GOP solution to address the issue of people with pre-existing conditions was to add in $8 billion more for patient “high-risk pools,” which were used by 35 states before Obamacare and often came with high premiums, high deductibles and sometimes capped enrollment. A just-released independent analysis from the health consultancy firm Avalere Health showed that the $23 billion earmarked by the bill for those pools would cover only 110,000 Americans, a mere 5 percent of the 2.2 million enrollees in the individual insurance market today with some type of pre-existing chronic condition.

With such a large gap between the available funding and the number of impacted Americans (that will only grow as our population ages), it means that if one of the larger states receives a waiver, there will be even less money to go around. As the summary of the Avalere Health study states: “For example, Texas alone has approximately 190,000 enrollees in its individual market with pre-existing chronic conditions, nearly 80,000 more people than the funds earmarked for the entire country would cover. Florida has 205,000, nearly 95,000 more than the funds allotted nationally amounts would cover.”

What exactly are these pre-existing conditions? Sen. Sherrod Brown (D-Ohio) took to Twitter to list many of them, from AIDS/HIV, acid reflux, acne, ADD, addiction, Alzheimer’s/dementia, anemia, aneurysm and angioplasty to skin cancer, sleep apnea, stent, stroke, thyroid issues, tooth disease, tuberculosis and ulcers. In the hours after the House vote, the No. 1 trending hashtag on Twitter was #IAmAPreexistingCondition, with individuals listing their diagnosed conditions, such as TashiLynnCA writing, “In 2010 my 10 year old brother was diagnosed with stage III Hodgkin’s Lymphoma. This is for him.” Older adults and veterans also shared. “‘I’m a disabled veteran that suffers from PTSD” tweeted RedTRacoon.

Friends of mine on Facebook are sharing that some doctors already are getting calls from worried patients, asking that their diagnoses be expunged from their medical records because they are fearful of having a paper trail documenting their conditions. People will be scared to go to emergency rooms, afraid that they will be identified as having one or more conditions on the list.

For the 20 percent of Americans who have some type of disability covered under the Americans With Disabilities Act of 1990 (ADA), this potential change in how much people with pre-existing conditions can be charged for health insurance hits hard. @LCarterLong from Washington, D.C., wrote, “Born three months premature. Weighed 2 lbs. Alive b/c of an incubator. Have cerebral palsy. Use orthotics to walk.” Alice Wong, founder of the Disability Visibility Project in San Francisco, tweeted, “Wheelchair and vent user. Born with spinal muscular atrophy. Docs told my parents I wouldn’t live past 30.”

This sharing of pre-existing conditions is paradoxically bringing together a very disparate group of Americans who may not have felt much in common before this vote, and who now are being prompted into action. Disability advocacy groups that usually find themselves competing with one another for attention and funding are finding common cause in opposing the ACHA. Republican House members who voted for the bill will be wearing targets on their backs in the 2018 election. As Japanese Admiral Isoroku Yamamoto said after the 1941 attack on Pearl Harbor, “I fear all we have done is to awaken a sleeping giant and fill him with a terrible resolve.”


MICHELLE K. WOLF is a special needs parent activist and nonprofit professional. She is the founding executive director of the Jewish Los Angeles Special Needs Trust. Visit her Jews and Special Needs blog at jewishjournal.com/jews_and_special_needs.

The stigma of the unworthy unhealthy

President Donald Trump, middle, gathers with Vice President Mike Pence, right, and Congressional Republicans at the White House on May 4. Photo by Carlos Barria/Reuters

There was something sublimely degrading about the beer bash President Donald Trump threw May 4 for House Republicans who passed his health care bill by the narrowest of partisan margins.

Start with the host, who will say or do anything. By now it’s apparent that the president is untethered to reality. If he were to be impeached, a compassionate chief justice might declare him incompetent to stand trial because he lacks the mental capacity to be responsible for his words or acts. But the Republicans who sniffed his musk last week aren’t blissed by the clueless stupor his narcissism affords him. They’re fearful of their constituents. No wonder that, of the 217 congress members who voted his way, only two — one in Idaho, one in upstate New York — held district town halls this past weekend. They did not go at all well. When the rest of the cowering Republican conference is forced to face their voters, it will be similarly ugly.

They must be baffled by how devoid of mojo their old battle cries have become. “Jobs-killing Obamacare” packs no punch in an economy that’s added more than 10 million jobs since the Affordable Care Act passed. “Disaster” and “death spiral” sound demented to someone who’s gone from no insurance to comprehensive coverage. “Higher premiums, higher deductibles, higher co-pays” may in some cases be accurate, but for Americans long suffering from rising prices, the real news is the slowing of the rate of increase.

Republican capitulation to the Freedom Caucus’ demand to torpedo Obamacare’s coverage of pre-existing conditions has prompted hundreds of heartbreaking — and televised — stories of congenital defects, deadly tumors, chronic ailments, addictions and mental illnesses, whose long-term treatment was until recently made affordable by irrevocable insurance, but which now is slated for sacrifice in exchange for a trillion-dollar cut to Medicaid and a humongous tax cut for the wealthiest. Not only will those stories, juxtaposed with Rose Garden revelry, make for mercilessly effective ads in the coming midterm campaign; they also sound the death knell for the most toxic trope in the Republican rhetorical armory: the stigma of the unworthy unhealthy.

The label descends from the widespread distinction, as recent as a century ago, between the worthy and the unworthy poor. The worthy poor — widows, orphans, the blind — were indigent through no fault of their own, victims of random misfortune, life’s vicissitudes, circumstances beyond their control. But the unworthy poor were the cause of their own impoverishment. Lazy, morally weak, addled by drink, gamblers: They had only themselves to blame. The worthy poor deserved charity; the unworthy, a kick in the pants.

The Depression altered the presumption that bootstrapping is the royal road to success. If there aren’t any jobs, it doesn’t matter how much moxie you have. From our common catastrophe came a new compact. Every person is worthy of basic human decency, a safety net to catch us, a freedom from want we pledge to one another. To secure it? Not the market, not inheritance, not the luck of our genes — the government. And so from Social Security to Medicare, unemployment insurance to food stamps, we committed public resources to promote the public good.

Universal health care was always the outlier in America — not just the notion that government should provide it, but the idea that it’s an inalienable right. You could see that wariness, stoked by decades of propaganda, in a Wall Street Journal-Harris poll two years before Obama was elected. Asked whether unhealthy people should pay more for insurance, a majority of Americans – 53 percent – said yes. You can hear that same animus today in Alabama Republican Rep. Mo Brooks’ defense of Trumpcare: “It will allow insurance companies to require people who have higher health costs to contribute more to the insurance pool that helps offset all these costs, thereby reducing the cost to those people who lead good lives. They’re healthy, they’ve done the things to keep their bodies healthy, and right now, those are the people who have done the things the right way that are seeing their costs skyrocketing.”

“Moral hazard” is how economists describe the ability to evade the bad consequences of risky decisions. The Wall Street bailout, which prevented a global meltdown, absolved the banks of having hell to pay. I get why House Republicans almost sank it; it maddened me, too. To them, the ACA’s passage two years later reprised that escape from accountability. It didn’t penalize people enough for being addicted to nicotine, for consuming the sugar and fat marketed to them, for escaping a stressful day with a sedentary night.

The ACA has helped millions of Americans with illnesses unrelated to personal decisions get access to health care. At the same time, it established a no-fault policy for having made choices that are bad for you. Under current law, your right to treatment doesn’t depend on how or why you became dependent on opioids or alcohol, or whether your high blood pressure or cholesterol might have been prevented by behavior change. All that counts is that you’re seeking a path to health. We don’t punish the sick for being unhealthy; life has done that enough. There are not the worthy unhealthy and the unworthy unhealthy. All there is is us.


Marty Kaplan is the Norman Lear professor at the USC Annenberg School for Communication and Journalism. Reach him at martyk@jewishjournal.com.

Blamer-in-chief

Photo by REUTERS/Carlos Barria

“I blame myself — it was my fault, and I take full responsibility for it,” Donald Trump said, not once, ever, in his entire life.

Here’s what else the president didn’t say about the rout and ruin of repeal and replace: “I was clueless about health care policy. Instead of reading my briefing books or even my own bill, I played golf. I bullshitted my way through every meeting and phone call. And when it was explained to me that this dumpster fire of a bill would break my promise that everybody’s going to be taken care of much better than they are now, which was a huge applause line, by the way, I threw my own voters under the bus.”  

In the wake of his Waterloo, instead of manning up, Trump blamed Democrats for not voting to strip health insurance from 24 million people, not voting to cut Medicaid by $880 billion in order to cut taxes by $883 billion and not voting to obliterate the signature legislative accomplishment of the Barack Obama years. “Look,” he complained with crocodile bafflement to The New York Times, “we got no Democratic votes. We got none, zero.” Yet not once had Trump or Speaker of the House Paul Ryan asked a single Democrat what it would take to get them to support a health care bill. “The good news,” Trump said, seeing the sunny side of the catastrophe he predicts is coming, is that the Democrats “now own Obamacare.” Don’t blame me — it’ll be their fault when it explodes, not mine.

Trump blamed Republicans, too. The morning of Friday, March 24, when the bill was still in play, he tweeted that if the Freedom Caucus stops his plan, they would be allowing Planned Parenthood to continue. That afternoon, amid the wreckage, Trump told The Washington Post’s Robert Costa that he was just an innocent bystander. “There are years of problems, great hatred and distrust” in the Republican Party, “and, you know, I came into the middle of it.”

White House aides, bravely speaking without attribution, blamed Ryan for snookering the rookie-in-chief into tackling Obamacare before tax reform. Trump himself told Costa, “I don’t blame Paul.” He repeated it: “I don’t blame Paul.” Then again: “I don’t blame Paul at all.” The laddie doth protest too much, methinks. By tweet time Saturday morning, clairvoyantly touting Jeanine Pirro’s Saturday night Fox News show, Trump had found a surrogate to stick the knife in Ryan without his fingerprints on it. “This is not on President Trump,” Pirro said, avowing that “no one expected a businessman,” “a complete outsider,” to understand “the complicated ins and outs of Washington.” No, it’s on Ryan, she said. Ryan must step down.

Blame precedes politics. In Western civilization’s genesis story, Adam blamed Eve for tempting him, and he blamed God for Eve. But America’s genesis story contains a noble, if apocryphal, counter-narrative: When George Washington’s father asked him who chopped down the cherry tree, the future father of his country didn’t blame someone else — he copped to it. That’s the legacy Harry Truman claimed when put “The buck stops here” sign on his Oval Office desk.

But Trump is the consummate blame artist, a buck-passer on a sociopathic scale. He kicked off his campaign by blaming Mexico for sending us rapists and stealing our jobs. He blamed Hillary Clinton for founding the birther movement. He blamed Obama for founding ISIS. He blamed Obama’s Labor Department for publishing a “phony” unemployment rate. He blamed 3 million illegal voters for his losing the popular vote to Clinton. He blamed the botched raid on Yemen on U.S. generals. When U.S. District Judge James Robart ruled against his Muslim travel ban, he blamed Robart for future terrorism: “If something happens, blame him and the court system.” He blamed “fake news” for treating Michael Flynn, “a wonderful man” whom he fired as his national security adviser, “very, very unfairly.” He blamed Obama for wiretapping Trump Tower. He made his spokesman blame British intelligence for carrying that out. When GCHQ called that a crock, Trump played artful dodger: “All we did was quote … a very talented lawyer on Fox. And so you shouldn’t be talking to me, you should be talking to Fox.”

Obamacare is imperfect but fixable. But Trump wants to bomb it, not improve it. He wants to light the fuse and then blame Democrats for exploding it. Trump could shore up the insurance exchanges that cover 10 million Americans by marketing them when enrollment opens again in November — but I bet he won’t. He could instruct government lawyers to appeal a lawsuit halting federal subsidies for co-payments and deductibles of low-income enrollees that House Republicans won last year — but I bet he won’t. On the other hand, he has the power to narrow the essential benefits Obamacare requires insurers to provide by, say, limiting prescription drug coverage and lowering the number of visits allowed for mental health treatment or physical therapy — and I bet he will.

Will Trump get away with it? He’s spent a lifetime banging his highchair and blaming the dog for his mess. No wonder he calls the free press fake news; no wonder he calls citizen activists paid protesters. You call someone who gets away with blaming others “unaccountable.” You know what the antonym of that is? Impeachable.

The cruelest cuts of all

U.S. House Majority Leader Kevin McCarthy, House Speaker Paul Ryan, and Rep. Greg Walden hold a news conference on the American Health Care Act on Capitol Hill. March 7. Photo by Eric Thayer/REUTERS.

Many Americans were no doubt pleased to hear that the Donald Trump administration’s first budget proposal spared Social Security and Medicare, but the health and well-being of 74 million vulnerable, lower-income Americans who receive Medicaid are still very much in jeopardy. In fact, the means-tested Medicaid program now is directly in the bull’s-eye of cuts and drastic changes the Trump administration and Republican leaders are considering as part of their vow to replace the Affordable Care Act (ACA), also known as Obamacare.

Created in 1965 as part of President Lyndon Johnson’s “War on Poverty,” Medicaid is our country’s largest health care insurance program, with 74 million enrollees, or about 1 in 4 Americans, surpassing the better-known health insurance Medicare program with its 55 million-plus enrollees. Medicaid provides health care services for low-income individuals, including families with children, seniors, people with disabilities, those in foster care, pregnant women and low-income people with specific diseases, such as tuberculosis or HIV/AIDS. Chances are, you probably know many people on Medicaid, such as a 54-year-old woman who is without private insurance, too young for Medicare, who then developed breast cancer; or a young adult who developed a traumatic brain injury after an automobile accident.

Some 60 percent of Medicaid’s spending is for the elderly and the disabled. For many people with disabilities, Medicaid services are the only way they are able to live and work in the community with friends and families. Medicaid helps children and adults with a significant disability — such as autism, cerebral palsy or intellectual disabilities — to remain at home and avoid placement in costlier and harmful segregated nursing homes or institutions. Medicaid also provides services, such as personal care aides who help people in their own homes with everyday needs like bathing, dressing, eating and managing medications. And because adults with disabilities have such a low employment rate (30 percent), they don’t have any other health insurance options for their ongoing and acute medical needs except Medicaid. Under the ACA, there has been a large expansion of Medicaid, although some Republican governors declined that Medicaid expansion.

In California, the program is called Medi-Cal, and as is the case in every state, the feds pay close to 60 percent of the program’s overall expenses. Under the current structure, the federal government has a commitment to help states cover costs, and in turn, states must provide specific benefits to certain groups of people, including people with disabilities. Although Medi-Cal has issues, including a very low reimbursement rate, which prompts many specialists and other providers to limit or simply stop taking on Medi-Cal patients, it is nevertheless a crucial and lifesaving program.

Currently, Medicaid is an open-ended entitlement for states — if residents meet strict income and asset criteria and other health/disability-related criteria, then they can enroll. During economic recessions, more people enroll; other factors, such as expensive new lifesaving prescriptions drugs, also can increase the costs of administering the program. The “block grants” being touted by the Trump administration as a way of giving states more control over their state Medicaid program will translate into a whole new definition of pain, as each state would receive a fixed amount of money based on a predetermined formula, most likely at a per-capita rate. A recent editorial by The ARC (formerly known as the Association for Retarded Citizens, started by parents who had children with disabilities in the 1950s) analyzed the problem: “Unlike the current funding system, the amount provided under a per capita cap will not automatically increase when the cost of providing covered services to eligible individuals goes up. The intent of the per capita cap is to reduce federal spending by restructuring the program and significantly cutting the cost to the federal government. Using this technique, the federal government limits spending, regardless of the needs of the people receiving Medicaid services.”

State governments will be forced to make decisions from an array of bad choices, such as increasing state taxes, limiting services to existing Medicaid patients, reducing eligibility or cutting already low reimbursement rates even further. Health outcome disparities between states will grow as wealthier states can help backfill some of these cuts but poorer states will not be able to do the same. Without early intervention, many infants and toddlers with disabilities will be denied therapies that can change their lives’ trajectories. Without community services and support, too many adults with disabilities will be stuck at home, dependent on aging parents and even forced into unnecessary institutionalization, a huge step backward in the civil rights of people with disabilities. Many Medicaid patients will suffer from delayed or denied medical treatment, and some people may even die.

Kellyanne Conway, counselor to President Trump, has said publicly that moving to Medicaid block grants will ensure “that those who are closest to the people in need will be administering the program,” but what kind of freedom is choosing between bad, worse and terrible? 

Michelle K. Wolf is a special needs parent activist and nonprofit professional. She is the founding executive director of the Jewish Los Angeles Special Needs Trust. Visit her Jews and Special Needs blog at jewishjournal.com/jews_and_special_needs.

Israel’s Yad Sarah has prescription for U.S. health care system

Photo by Yoninah/Wikipedia

A new Congress and a new administration are reassessing the efficacy of America’s health care system — and exploring solutions to contain rising costs while delivering better care. They could be well served by looking to a small nation thousands of miles away and one organization that has transformed that country’s health care landscape: Yad Sarah. 

Yad Sarah is the State of Israel’s largest volunteer-staffed organization. We take care of anyone in the country after a hospital stay — whether they are a factory worker, a first-time mom, a senior in hospice, a young adult with a broken leg, or a top business or political leader.

The United States might be able to learn from Yad Sarah’s unique model for home health care delivery. Take our signature service: free or low-cost loans of medical equipment — wheelchairs, crutches, oxygen machines — which are available at local branches around the country or delivered to patients’ homes for a few dozen shekels or less. It developed organically and modestly, with our founder, Uri Lupolianski, and his wife, Michal, distributing vaporizers to sick children from their Jerusalem apartment. As the years passed, their ability to help care for people grew to more than 100 branches with thousands of volunteers.

This is much more efficient and cost-effective than the U.S. system, where only those with insurance have access to devices at home, those devices are often discarded after a short period of use, and the devices don’t always arrive in a timely manner. For instance, when my mother-in-law left the hospital and came home to stay with my family, Medicare paid for and sent a wheelchair. She never used the wheelchair and was rehospitalized 10 days later, passing away after a month. For three years, I looked unsuccessfully for someone who could use the wheelchair — no hospital, doctor’s office or other medical caregiver would take it.

Yad Sarah works to give people in Israel access to medical resources for next to nothing, in a way that ultimately reduces stress on the national medical system while increasing the quality of care received. Half of Israel’s families have used one of our services at some point in their lives. Our annual budget of $23 million — drawn almost entirely from philanthropic contributions — saves the Israeli economy $400 million each year in health care costs.

Of course, a volunteer-based program like Yad Sarah cannot work for a country of 300 million people the same way it does for a country of 8 million. But that doesn’t mean a similar program in the U.S. — whether implemented by nonprofit organizations or governmental agencies — couldn’t have a transformative effect. Recycling programs for durable medical equipment could allow for more agile, efficient and cost-effective health care.

Implementing innovative programs has a domino effect: After establishing our lending service, we followed with our home hospitalization program. It allows individuals to be under the care of family members, whether they are in hospice, suffering from a chronic condition or recovering from a severe short-term illness. Most patients would rather have the dignity and comfort of being at home — and they tend to experience less stress, fewer health complications and faster rehabilitation.

The United States might be able to learn from Yad Sarah’s unique model for home health care delivery.

Not only does the home hospitalization make patients more comfortable and drastically reduce costs, it also addresses the chronic overcrowding of Israeli hospitals, where patients too often are lying in hallways, being released prematurely, and dying from infections they receive in those hospitals — 4,000 each year. While the U.S. and other developed countries have home hospitalization programs, none is run by volunteer-staffed organizations, a key element that enables us to ensure everyone has access to these programs in a timely and cost-effective manner. 

Yad Sarah’s other programs are just as effective at supplementing Israel’s medical system to make care more efficient. This includes driving sick or injured people to medical appointments, offering therapeutic programs at day rehabilitation centers, and supporting families coping with domestic violence. We also provide an emergency alarm response service, which offers peace of mind for nearly 20,000 homebound, frail and isolated older adults; free legal information and representation for elderly people at risk for abuse; after-school programs for children with disabilities; and free dental care for adults living in poverty.

This all started with one couple lending out vaporizers in one city. But making part of health care a public, volunteer-supported endeavor serves Israel well. Yad Sarah saves hundreds of millions of dollars and vastly increases patients’ quality of life. We are true partners in ensuring the health and well-being of Israel’s citizens — the elderly widows, the young children, revered politicians, the brave soldiers and, yes, our volunteers and donors themselves. As the U.S. considers how to address our health care challenges, Yad Sarah’s experience can shed light on important lessons.


ADELE GOLDBERG is the executive director of Friends of Yad Sarah.

The function of the university in the age of Trump

The modern university, as we know it, originated from the imaginative proposals of Wilhelm von Humboldt, a Prussian philosopher and civil servant. In 1810, von Humboldt devised plans for educational reform that called for a new type of institution — one in which research and teaching would be unified, academic freedom would be guaranteed and freedom from state intervention would be assured. This plan gave birth to the University of Berlin, now known as the Humboldt University of Berlin, on which the great American and world universities are based.

I have been thinking a great deal about the origins and function of the university in the age of Donald Trump. To put it mildly, the initial shock of his election has not passed. On the contrary, it has been compounded by the president-elect’s intemperate and ill-considered statements, on subjects ranging from the Broadway smash hit “Hamilton” to well-established American policy on China. His roster of appointments has done little to alleviate fears of the thorough erasure of the boundary between politics and business, with the concomitant threat of the privatization — and resulting monetization — of once-treasured government tasks.  And, of course, lurking in the background is Trump’s opportunistic bigotry, stoked by his alt-right supporters, whose chief targets to date have been Muslims, but also have included at times Jews, women, gay and transgender people, and journalists.   

All of these worrisome signs, which point to an ongoing assault on the democratic institutions of this country, make it vitally important to fortify civil society. The university, in particular, must become a key site of vigilance, resistance and critical thinking in American civil society in the age of Trump. This is not a violation of its historic function but consistent with the Humboldtian ideal of the university as an institution in the service of society. Not as a tool of the state, but in the service of society at large!   

At many points in modern times, the university has been an ally — and even beholden — to the state. And at various points in time, the university has been a site of resistance to the hegemonic impulses of the state. One notable example arose when the German-Jewish scholar of medieval history, Ernst Kantorowicz, refused to sign an anti-communist loyalty pledge at the UC Berkeley, in 1949. Despite his own conservative and anti-communist views, Kantorowicz, who took flight from Germany in 1938, feared government attempts at thought control.  Another example of wider impact was when Students for a Democratic Society (SDS) and other groups mobilized millions of university students in the late 1960s to protest  the United States’ military engagement in Vietnam.

Today is another moment when the university needs to prepare itself to stand as a force of resistance to the most dangerous tendencies of Trumpism. It is entirely possible that the alarm bells that the president-elect has triggered in those concerned about the fate of democracy will be for naught. But it also is possible that Trump will continue to promote his xenophobic brand of populism to damaging effect. In that case, the university must provide a central line of defense. In what concrete ways can the university play this role?

– University officials must articulate clearly that their institutions will not only remain sites of free and open discourse, but that all students, regardless of their origins and legal status, will be protected on campuses.  

– Philosophers must use their analytical precision to hone the critical thinking skills of students and join with them in defending the intellectual foundations of a just society. 

– Political scientists must use their knowledge of the American political system to warn against the erosion of democratic institutions and consider ways to shore them up in the face of a hostile executive branch.

– Legal scholars must use their knowledge of the courts to strategize about ways of resisting mass deportations, threats to free speech and other assaults on the constitutional order of this country.

– Health economists must use their knowledge of the country’s labyrinthine medical system to assist those poor Americans who will suffer as a result of the projected rollback of Obamacare.

– Public policy officials must use their knowledge to conceive anew of local and state jurisdictions as bastions of support for average Americans who may no longer be served by the federal government.

And scholars of Jewish studies also have a role to play.  A month ago, hundreds of Jewish studies scholars published a letter in the Jewish Journal that was shared on Facebook more than 21,000 times. The letter noted that students of Jewish history understand well “the fragility of democracies and the consequences for minorities when democracies fail to live up to their highest principles.”  

In the months and years ahead, Jewish studies scholars — and historians more generally — must use their knowledge to identify warning signs that, in the past, led to state-sponsored stigmatization of groups, abrogation of rights and violence. And they must caution us against ignoring warning signs today. 

All of this vigilance does not mean that the classroom should become a bully pulpit for one ideology or another. It means that first-rate scholarship must not wither in the face of pressure. Indeed, it means the university, now more than ever, must remain true to its Humboldtian origins as the site of academic freedom — and as an institution that serves society by applying knowledge of the past to the betterment of society in the present. 


David N. Myers is the Sady and Ludwig Kahn Professor of Jewish History at UCLA.

Trump or Cruz? Republicans face tough choices as primary race churns forward

Republicans desperate to stop Donald Trump from capturing the party's presidential nomination may have to unite behind Ted Cruz, a polarizing figure who has made many enemies within the party.

Cruz, 45, a senator from Texas, won nominating contests in Kansas and Maine on Saturday, bolstering his argument that he is the leading alternative to Trump, 69, the blunt-spoken billionaire businessman.

Many mainstream Republicans are reluctant, however, to rally behind Cruz, whom they see as too conservative for the general electorate in the Nov. 8 election to succeed Democratic President Barack Obama.

Cruz has run as an outsider bent on shaking up the Republican establishment in Washington. A favorite of evangelicals, he has called for the United States to “carpet bomb” the Islamic State militant group and has pledged to eliminate the tax-collecting Internal Revenue Service and four Cabinet agencies.

But he angered many Republican colleagues when he led an unsuccessful effort to repeal President Barack Obama's Affordable Care Act that shut down the government for 16 days in 2013.

Republican pollster Neil Newhouse said Cruz had not yet shown an ability to appeal beyond the most conservative voters.

“The way things are going, I think it's extraordinarily unlikely that Senator Cruz becomes the focal point for Republicans who want to stop Trump,” said Newhouse, who was lead pollster for 2012 Republican presidential nominee Mitt Romney.

Kim Reem, a member of the executive committee of the National Federation of Republican Women, said three factions were emerging among Republicans: those supporting Trump, those backing Cruz, and supporters of the party establishment. None are inclined to compromise, she said.

“I don’t see a path to making everybody happy,” she said.

Former U.S. Senator Trent Lott of Mississippi said he would have a hard time supporting a Cruz nomination. “He'd have to change his tactics and his conduct an awful lot,” he said.

Cruz has feuded with party leadership, including Republican Senate Majority Leader Mitch McConnell, and has often accused fellow Republicans of selling out conservative principles.

Although he has been in the Senate for four years, Cruz has not won a single endorsement from any other senator. He touts that on the campaign trail as evidence he is an outsider.

RUBIO FLORIDA HOPE

To win the nomination, 1,237 delegates are needed. According to The New York Times, Trump leads with 384 delegates and Cruz has won 300. U.S. Senator Marco Rubio, 44, of Florida, an establishment favorite still seen by some in the party as an option to Trump, has won 151 delegates and Ohio Governor John Kasich trails with 37.

Some establishment Republicans say the best way to stop Trump would be for Rubio to win the 99-delegate Florida contest and Kasich the 66-delegate Ohio primary. Opinion polls show Cruz trailing in both states, which award all their delegates to the top vote-getter on March 15.

Michigan, Mississippi, Idaho and Hawaii hold nominating contests on Tuesday. Recent opinion polls show Trump leading by a wide margin in Michigan, the day's biggest prize.

If Cruz, Rubio and Kasich can collectively prevent Trump from getting the needed majority of delegates, they could force a brokered Republican Party convention in July in Cleveland, aimed at producing a compromise candidate.

Even if Cruz gets the second-highest vote total, he may have trouble claiming the nomination at the convention over Trump.

If nothing else, the debate reveals deep divisions within the party.

Slater Bayliss, a Florida Republican who raised money for former Florida Governor Jeb Bush before he dropped out of the race, said: “From my perspective, Senator Cruz's views are indicative of only a very small cohort in our party.” 

Republican donors, unhappy with Trump policies like his calls to deport 11 million illegal immigrants and temporarily bar all Muslims from entering the United States have poured millions of dollars into attack ads over the past week. 

The Club for Growth, an advocacy group that pushes for lower taxes and spending, said on Monday it would spend $2 million on TV ads questioning Trump's conservative credentials in Illinois, one of six states or territories that holds a nominating contest on March 15.     

Outside groups have spent more than $10 million on anti-Trump advertising in Florida and $23 million in other states, according to federal records.

U.S. Supreme Court upholds key Obamacare insurance subsidies

The U.S. Supreme Court handed President Barack Obama a major victory on Thursday by upholding tax subsidies crucial to his signature healthcare law, with Chief Justice John Roberts saying Congress clearly intended for them to be available in all 50 states.

The court ruled on a 6-3 vote that the 2010 Affordable Care Act, widely known as Obamacare, did not restrict the subsidies to states that establish their own online healthcare exchanges. It marked the second time in three years that the high court ruled against a major challenge to the law brought by conservatives seeking to gut it.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Roberts wrote in the court's decision, adding that nationwide availability of the credits is required to “avoid the type of calamitous result that Congress plainly meant to avoid.

Roberts was joined by fellow conservative Justice Anthony Kennedy and the court’s four liberal members in the majority.

Shares of hospital operators, health services providers and insurers rallied broadly following the court's decision to uphold the subsidies. Top gainers included hospital companies Tenet Healthcare Corp., up 8.8 percent, and Community Health Systems Inc., up 8.5 percent.

The decision means the subsidies will remain not just in the 13 states that have set up their own exchanges and the three states that have state-federal hybrid exchanges, but also in the 34 states that use the exchange run by the federal government.

The case centered on the tax subsidies offered under the law, passed by Obama's fellow Democrats in Congress in 2010 over unified Republican opposition, that help low- and moderate-income people buy private health insurance. The exchanges are online marketplaces that allow consumers to shop among competing insurance plans.

The question before the justices was whether a four-word phrase in the expansive law saying subsidies are available to those buying insurance on exchanges “established by the state” has been correctly interpreted by the administration to allow subsidies to be available nationwide

Roberts wrote that although the conservative challengers’ arguments about the plain meaning of the statute were “strong,” the “context and structure of the act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”

SCALIA DISSENTS

Justice Antonin Scalia took the relatively rare step of reading a summary of his dissenting opinion from the bench.

In his reading of the statute, “it is hard to come up with a reason to use these words other than the purpose of limiting credits to state exchanges,” Scalia said.

“We really should start calling the law SCOTUScare,” he added, referencing the court’s earlier decision upholding the constitutionality of the law. SCOTUS is the acronym for the Supreme Court of the United States.

Conservative Justices Clarence Thomas and Samuel Alito joined Scalia's dissent.

The ruling will come as a major relief to Obama as he seeks to ensure that his legacy legislative achievement is implemented effectively and survives political and legal attacks before he leaves office in early 2017.

The current system will remain in place, with subsidies available in all 50 states. If the challengers had won, at least 6.4 million people in at least 34 states would have lost the subsidies whose average value is $272 per month.

“The subsidies upheld today help patients afford health insurance so they can see a doctor when they need one and not have to wait until a small health problem becomes a crisis,” said Dr. Steven Stack, president of the American Medical Association.

Rich Umbdenstock, head of the American Hospital Association, said the subsidies have allowed people to more easily seek care, calling the ruling “a significant victory.”

A loss for the Obama administration also could have had a broader impact on insurance markets by deterring younger, healthier people from buying health insurance, which would lead to premiums rising for older, less healthy people who need healthcare most, according to analysts.

The Democratic-backed law aimed to help millions of Americans who lacked any health insurance afford coverage.

The Obama administration has hailed the law as a success, saying 16.4 million previously uninsured people have gained health insurance since it was enacted. There are currently around 26 million people without health insurance, according to government figures.

Leading up the high court's ruling, Obama warned of far-reaching consequences of overturning a law that he said had become “woven into the fabric of America.” In a June 9 speech, Obama said taking away health insurance provided under the law to millions of people who need it the most “seems so cynical.”

Conservatives have fought Obamacare from its inception, calling it a government overreach and “socialized medicine.”

Opponents repeatedly but unsuccessfully sought to repeal it in Congress and launched a series of legal challenges. In 2012, Roberts, a conservative appointed by Republican President George W. Bush, cast the deciding vote in a 5-4 decision that upheld the law on constitutional grounds, siding with the court's four liberals.

The current case started as a long-shot legal challenge by conservative lawyers that oppose the law. Financed by a libertarian Washington group called the Competitive Enterprise Institute, the lawyers recruited four people from Virginia to be the plaintiffs. The lead plaintiff was a self-employed limousine driver named David King.

The plaintiffs said they were “deeply disappointed” with the ruling. The law “unfairly restricts the health insurance choices of millions of people, and it threatens their jobs as well,” they added.

A district court judge ruled for the government, as did the federal appeals court in Richmond, Virginia. But the Supreme Court then agreed to hear it.

The challengers said that the four-word phrase in the law indicates that only people who have bought insurance on state-established exchanges qualify for the tax-credit subsidies.

The Obama administration, backed by the healthcare industry, said other provisions in the law made clear that Congress intended the subsidies to be available nationwide regardless of whether states set up their own exchanges or leave the task to the federal government.

The case is King v. Burwell, U.S. Supreme Court, No. 14-114.

Ted Cruz enlists Christians for 2016 White House bid

Casting himself as the leader of a grassroots army, Sen. Ted Cruz (R-Tex.) made an explicit appeal to Christian conservatives on Monday as he became the first major figure to jump into the 2016 presidential race.

Cruz's unyielding tactics in Washington have made him a hero to many on the Tea Party right and a thorn in the side of the Republican establishment. Seeking to break into the front ranks of candidates, Cruz solicited the support of born-again Christians who play a major role in states with early nominating contests.

Speaking at Liberty University, a Christian school founded by televangelist Jerry Falwell, Cruz discussed his Baptist faith in personal terms and urged religious conservatives who have sat out recent elections to get off the sidelines.

“Imagine instead millions of people of faith all across America coming out to the polls and voting our values,” he said.

Cruz's prominent role in the 2013 government shutdown made him one of the better-known politicians in America even as he made enemies in both parties on Capitol Hill. Becoming a senator only two years ago, he made his mark last year with a 21-hour speech against Obamacare on the floor of the Senate.

But the Harvard-educated son of a Cuban immigrant starts the race for the November 2016 election as a second-tier candidate. Former Florida Governor Jeb Bush and Wisconsin Governor Scott Walker have locked down deep-pocketed donors and built sophisticated campaigns-in-waiting as they court voters across the country.

Cruz, 44, came in third in an informal poll of activists last month at the Conservative Political Action Conference, and Reuters/Ipsos tracking polls show him statistically tied with five other potential candidates, well behind Bush and Walker.

As the first to jump into the race, Cruz will get extra attention from the media and voters for several weeks as he tries to position himself as the conservative alternative to more centrist candidates like Bush and Walker.

MOBILIZING THE CHRISTIAN RIGHT

Campaign aides told the Houston Chronicle they do not expect to appeal to moderate or establishment-minded voters, but instead aim to run strongly among self-identified Tea Party members and pick up support from libertarians and religious conservatives.

That could help Cruz in early-voting states like Iowa, where 57 percent of Republican caucus goers identified as evangelical or born-again Christians in 2012. Cruz will likely have to compete for their support with former Pennsylvania Senator Rick Santorum, who won Iowa in 2012, and former Arkansas Governor Mike Huckabee, who won in 2008.

Liberty University president Jerry Falwell Jr. said many evangelicals have sat out recent elections out of disappointment with the more centrist candidates that have won the party's nomination.

“Certain Republican candidates have promised so much and delivered so little over the last 25 years and I think that's the reason. If someone could mobilize that bloc, it would be amazing,” Falwell told Reuters.

Speaking without notes, Cruz employed the cadence of a preacher as he told an overflow crowd of 11,000 about the religious journey of his father, who left the family when Cruz was three years old but returned after joining a Baptist church.

“If not for the transformative love of Jesus Christ, I would have been … raised by a single mom without my father in the house,” Cruz said.

In his speech Cruz called for the repeal of President Barack Obama's signature healthcare law and the abolition of the tax-collecting Internal Revenue Service. He cast divisive social issues in religious terms, referring to the “sacrament of marriage” and the “sanctity of human life.”

Cruz drew some of his strongest applause when he accused Obama of playing down the religious elements of Islamic State and fostering conflict with Israel, an important issue for evangelicals.

“I believe God isn't done with America yet,” Cruz said. “I believe in the power of millions of courageous conservatives rising up to reignite the promise of America.”

Cruz's birth in Calgary, Canada, has raised questions about his eligibility for the White House. The U.S. Constitution requires that the president be a natural born citizen. Cruz has said he qualifies by virtue of his mother having been an American citizen by birth.

Uncovered California

For those who have just perked up, whose eyes opened wide, sorry, this column contains no nudity or salacious content.  Parts of it may be obscene, yes, but not for the reason the words “Uncovered” together with “California” might portend. This is a family website, after all.  (It is, right?)
 
California’s Obamacare exchange is known as Covered California, and the Golden State, being the most populous, has the highest number per state of Obamacare marketplace enrollees at 17.5%, or 1.4 million people.  Because open enrollment is less than a month away, and Covered California is allowing early renewals, the airways, at least here in Los Angeles (so I am sure elsewhere in the state) have been inundated, it seems, by ads promoting the exchange, and by definition, Obamacare.  (And where is Covered California getting all that advertising money anyway?  Commercials here cost a fortune.) 
 
The president’s signature achievement, whose official name is the Affordable Care Act (ACA), is off the front page, but absolutely not off the kitchen table. Remember Politifact’s 2013  “Lie of the Year?”  “I intend to keep this promise, if you like your doctor, you will be able to keep your doctor, if you like your health care plan, you will be able to keep your health care plan.”  Thirty-seven times President Obama or a top administration official made that claim, along with other untruths about lower costs.  Well, and forget the healthcare.gov website fiasco, many people found out the president lied, because it became public he was aware of what would eventually happen.  NBC News reported a year ago, “… the administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans, even if they liked them.”
 
 
So what happened?  In 2013, millions of plans were canceled as insurance companies moved to comply with new federal requirements and subsequent increased costs.  And as individuals and families scrambled to find plans that worked for them, they discovered they would get less coverage for higher premiums, not the lower ones promised, and not be able to even keep their doctors in some way.  The small company mandate of new requirements was delayed, not the individual plan mandate, and some did benefit for sure, those getting government subsidies and others who never had insurance.  But, and the government still will not release all demographic data, the Department of Health and Human Services did admit that only 8 million became newly insured (not 10 million as some have reported), when the main point was to insure the 30 million+ uninsured.
 
The much ballyhooed goal of 7 million enrollees necessary to pay for the program was publicized for months, and when it was reached there was White House celebration, but even that so-called fact was not definitive.  According to the RAND Corporation's comprehensive Obamacare study, only a little over a third of the enrollees were previously uninsured.  The vast majority were those whose plans they preferred were canceled, and who had to get a new plan many of them just did not like.
 
Companies, insurance companies and insurance brokers have found all kinds of ways, some even illegal, to get around the new requirements of Obamacare, and so, the much higher associated costs.  Also, laying off workers or turning full time employees into part-time ones, or hiring part-time employees, to stay under the requisite number of 50+ employees when insurance must be offered, became a nasty by-product of Obamacare that harmed families and the economy.
 
For larger companies, the bad news is coming.  In fact, some of it is already here. This made the news last week: “Wal-Mart Stores Inc. is cutting health insurance for another 30,000 part-time workers and raising premiums for its other employees, as U.S. corporations push to contain costs in the wake of the federal health-care law.”  And, as delayed parts of the ACA (done so for political reasons) get close to implementation, other companies and insurance companies have already done the same as Walmart, and more will.  And many health care companies will just shut down operations or leave states where costs are just too prohibitive.  Some have already done so or announced they will, and they are even pulling their non-Obamacare plans.
 
And speaking of politics, watch this exchange from last week between Jonathan Karl of ABC News and Josh Earnest, the White House spokesman.  Karl asked, “Why is it that last year Oct. 1 was the (start of the Obamacare enrollment period) date, and this year it’s Nov. 15?  Why is it that people have to wait until after the election to find out whether they have a premium increase or decrease? And, as Earnest danced, this from Karl, “Can people be forgiven for thinking this looks like a political move?  People will not find out how much they are going to have to pay for their health insurance until after the election, whereas last year they found out on Oct. 1. Doesn't it seem a little bit convenient that people now have to wait ten or eleven days after the election to find out how much their insurance was going to cost?”
 
And Investor’s Business Daily just reported a couple days ago,“ObamaCare shoppers in search of the lowest-cost plan may come down with a mild case of rate shock when 2015 exchange enrollment begins next month.  An examination of next year's rates in the biggest city in 15 states and Washington, D.C., reveals that the cost of the cheapest bronze plan will jump an average of 13.9% for 40-year-old non-smokers earning 225% of the poverty level ($26,260).”Some cities will have lower costs, most higher, Seattle a whopping 64%.  Los Angeles will have an increase of 27%.  Do you think premiums for the more expensive silver, gold and platinum plans, across the board, won’t jump as well?  And what about non-exchange marketplace private and company-associated plans?  Do you think that when the new regulations mandate delay completely expires, their premiums won’t go higher? Much higher?
 
Look, universal health care is a noble and important goal, and I am glad there is coverage for people who would otherwise go without. I also think it was a good idea to allow young adults up to age 26 to remain on a parent’s plan.  But I wish both major parties could have settled their differences to make things work, because turning the whole system upside down was unnecessary, reckless, not carefully and completely thought out, and disastrous.
 
And unlike a number of private market plans such as Anthem and Blue Shield, Obamacare exchange plans including the same and other insurers, ration hospitals and doctors, making it very difficult to keep or find a health care provider that is available and affordable.  To make matters worse, many providers who are allowed to be included within exchange plans are deciding, or will decide, to exclude themselves or opt out, because in an atmosphere where provider business monetary return is being squeezed more and more, reimbursement for Obamcare exchange plan services is just way too low. Providers can’t be blamed for trying to stay profitable, but this adds to the feeling of anxiety and abandonment by subscribers, the patients who have lost their personal practitioner comfort zone.
 
Also, Obamacare was supposed to promote competition among those insurers who joined the exchanges, but there are states and counties where only one insurer is available. In fact, as reported by Forbes magazine, “In one of every six counties in America (17 percent), the state exchange offers only one insurer – a monopoly.  For another 35 percent of counties, only two insurers offer coverage. In another 25 percent, only three insurers are selling coverage.  To recap, consumers in more than half of the nation’s counties can “pick” from only one or two insurers on an Obamacare exchange. In more than three of every four counties, competition is limited to three or fewer insurers.”  And sadly, residents of some of the poorest counties in the country, where affordable health care is so desperately needed, are now at the mercy of only one insurer from which to choose.
 
Everyone wanted the uninsured covered.  And everyone agreed that pre-existing condition bias was unfair and needed to be eliminated.  Mandates and certain new requirements on everything and everyone, as well as shifting around moneys and existing federal health insurance programs, such as Medicare, only caused the baby to be thrown out with the bath water.
 
Very simply, most everything should have been left alone.  There were many things that worked but got scrapped, or were adequate enough but made dysfunctional, because liberal ideology frustrated what was really best for the country, snowballing into more and more bureaucracy, and in many cases resulting in mandatory, silly health care plan additions, whether needed or wanted or not, increasing costs and throwing everything into turmoil.  Many blame insurance companies for plan and coverage cancellations, but could insurers be trusted to keep everything the same and not try to recoup moneys that would be lost, at least for a short period of time?
 
Regarding a couple major points in the debate, Republicans should have given up, at least for the interim, their push for tort reform, which would limit lawsuit judgment dollars, something the Democrats and their trial lawyer supporters are vehemently against. Democrats, at least for the interim, should have agreed to allow consumers to shop for a health care company in any state, the kind of laboratory test competition which could drastically lower overall costs, but success would dash any hopes of a government-run, single-payer option, which is what the Democrats really desire.
 
Maybe over time, more uninsured than only the current 10% will enroll, but the turmoil that continues to this day has been horrible. Ask anyone in the health care industry – and I don’t mean the insurance companies – what they think about what has happened, not only with Obamacare exchange plans, but with the system as a whole.  You will find even the most ardent Obama supporters admitting that what may have been bad became a heck of a lot worse.  Ask doctors, billers, health care workers and of course patients, and especially the husband and wife sitting around the kitchen table trying to pick a plan that gives their family the coverage they want and need at a reasonable cost.  Most of the country has been spared the nightmare others have endured, but soon, the horror show will affect everyone.
 
So there you go.  There are many more problems related to Obamacare that I could note, but I think this has been enough.  Even my own eyes are glazing over, as I get more disgusted at what has been happening; I have been personally affected, and in a negative way. The parties could not come together to do what was best, what was right, so a pox on both their houses.  But who knows? Maybe, just maybe, in the coming months and years, the errors will be corrected.  But don’t hold your breath.  And I don’t just mean that as an idiom.  With whatever plan you have, you may not be able to find a doctor in your area, should you damage your lungs or heart.

U.S. birth control ruling fuels battle over corporate rights

The U.S. Supreme Court has opened up a new front in the battle over corporate rights by ruling that family-owned and other closely held corporations can mount religious objections to government action.

Monday's decision came in a case in which companies sought an exemption to a provision of the 2010 Obamacare healthcare law that requires employers to provide insurance coverage that includes birth control.

The court allowed the exemption and in so doing raises the possibility of religious-based exceptions on issues such as blood transfusions, antidepressants, and vaccinations, liberal Justice Ruth Bader Ginsburg warned in her dissenting opinion.

She added that there was nothing in the majority opinion, written by conservative Justice Samuel Alito, that foreclosed the possibility of a publicly traded company making a similar claim.

The majority's logic “extends to corporations of any size, public or private,” she said.

Alito said there would be various obstacles to such a company making a claim. He questioned whether a broad array of shareholders would ever agree to run a company under the same religious beliefs. He said it “seems unlikely” that big public companies would ever want to make a religious claim.

The high court ruled 5-4 in lawsuits brought by two family owned companies, Hobby Lobby Stores Ltd and Conestoga Wood Specialties Corp. It concluded for the first time that such closely held corporations could make religious-based objections under a 1993 law called the Religious Freedom Restoration Act (RFRA).

Some lawyers critical of the decision said it paved the way for business owners to discriminate against certain employees, including gays and lesbians. Others said corporations could seek exemptions from environmental regulations.

The court's majority and lawyers representing the companies involved in Monday's case insisted the ruling is narrow.

Who ends up being correct about the scope of the ruling will become clearer when lower courts test the limits of the decision in future cases.

CORPORATIONS AS PEOPLE

Four years ago, again on a 5-4 vote, the court endorsed corporate rights in another context: campaign finance. The ruling in Citizens United v. Federal Election Commission cleared the way for increased corporate and union spending during federal elections.

It drew sharp criticism from the left, including from President Barack Obama who, with Supreme Court justices in attendance at his 2010 State of the Union address, accused them of opening the floodgates for special interests to spend without limit on U.S. elections.At the time Alito, most notably among the justices present at the speech, shook his head and mouthed the words, “Not true.”

Emphasizing a partisan split on how the law should treat corporations, Mitt Romney, Obama's Republican opponent in the 2012 presidential election, memorably told a protester on the campaign trail that “corporations are people, my friend.”

The idea that corporations have some of the same rights as people is not new in U.S. jurisprudence, but Monday's ruling and the Citizens United case have both expanded on it in new areas of the law. Seizing upon the rhetorical links between the cases, Ginsburg on Monday cited then-Justice John Paul Stevens' lengthy dissenting opinion in Citizens United, in which he said corporations “have no consciences, no beliefs, no feelings, no thoughts, no desires.”

When judged alongside Citizens United, Monday's ruling provided further ammunition to liberal activists who claim the Supreme Court majority is too pro-business at the expense of workers.

“The court's conservative majority will bend over backwards to find that corporations can make every claim that individuals can bring,” said Doug Kendall, executive director of the Constitutional Accountability Center, a liberal group critical of what it describes as the court's pro-business bias.

Others disagreed that Monday's ruling was such a major development. The court's conclusion that the word “person” in the religious freedom law applies to closely held corporations was a reasonable one, said Ilya Shapiro, a legal scholar at the libertarian Cato Institute. “This was a technical, statutory ruling,” he said.

When analyzing religious objection, courts are required under the religious freedom law to determine whether the government regulation unduly burdens the company's owners, and, if so, whether it furthers a compelling government interest and whether the regulation is the least restrictive way of achieving that goal.

Alito said the ruling dealt specifically with the birth control provision, noting that in other cases, like immunization, the government was likely to be able to show that it had a compelling interest and that there was no less restrictive means for it to achieve its goal.

In Monday's ruling, the court indicated that regulations that already allow for exemptions, as the birth control mandate does for religious institutions, might be especially vulnerable.

Alito addressed Ginsburg's concerns about potential future cases in his majority opinion. He said it did not give corporations carte blanche to object to an array of government action, including bans on employment discrimination.

Ginsburg was not persuaded. The court's “expansive notion of corporate personhood … invites for-profit entities to seek religion-based exemptions from regulations they deem offensive to their faith,” she wrote.

Obamacare will be Obama’s second big takeaway

We tend to use shorthand to talk about our presidents. Lincoln saved the Union and freed the slaves. Kennedy committed us to the moon landing and built the Peace Corps. FDR ended the Depression, created Social Security and won World War II.  

It’s hard to know in the middle of a presidency what will be remembered, and even then it may change. Right now, LBJ is getting a new look beyond Vietnam, to include civil rights, poverty and Medicare. Someday Nixon will move beyond Watergate, and negotiations with the USSR and China will have their due. Even poor Jimmy Carter may someday get some props for the Middle East peace agreement. Can’t hold out a lot of hope for George W. Bush, though, unless painting becomes a historical test of presidents.

In the moment, presidencies are so eventful, it’s hard to guess what will last. The killing of Osama bin Laden? Who talks about that anymore?  More people talk about Monica Lewinsky, which sadly will loom large in remembering Bill Clinton, an otherwise very successful president.

It’s clear, though, that for Barack Obama, the Affordable Care Act (ACA) is going to be the second takeaway after the first African-American presidency. Not so many weeks ago, people were talking about the collapsed Obama presidency and his limited role in history. The ACA was on its last legs. That, however, may be about to change.

Historians will surely note how many turns there were, how many debatable choices and some mistakes, mostly preventable, this White House made before the turnaround. Making health care priority No. 1 in 2009 reduced the Obama administration’s ability to fight more aggressively for a larger economic stimulus, costing his party massive losses in 2010 and resulting in Congressional gridlock that deepened the economic recession. Letting a group of Senate centrists delay passage of the health care law until the summer of 2009 allowed the Tea Party to negatively define the law, an image that only now is being challenged as Obamacare’s implementation finally takes shape.  

Of course, the utterly foreseeable catastrophe of the health care rollout in September completely squandered the Democratic gains that might have come from the government shutdown.

But through it all, the president held onto his path and has been rewarded with results that are simply stunning. His bet on a flawed, complicated half-loaf health care program that not only enraged his opponents but also demoralized many of his supporters may yet pay off in the long run. The new numbers of enrollees are concrete evidence that this has happened, and it is big both governmentally and politically.  Nearly 10 million Americans have a crucial benefit they didn’t have before, yielding virtually unlimited personal stories for political debate.  

If the law continues to expand its reach within the red states that have blocked Medicaid expansion, millions more will be added to the rolls of those with assured health care. It’s really remarkable that in most cases this law drives the cost of benefits lower rather than higher and that Democrats were not afraid of its anti-poverty elements. This will be the first broad working-class and lower-middle-class law that Democrats have implemented since the 1960s.  

In fact, this is so big that, as in the past, previous presidencies will now be seen in a new light. When LBJ signed the Medicare Act in 1965, he went to the Truman Library in Independence, Mo., so that Harry S. Truman, who had tried and failed to win such a law, could witness the signing. As we continue to revise our understanding of LBJ’s presidency, his 1965 victory on Medicare will be amplified by the success of the ACA.  And reminders of Republican opposition to Medicare are already making the rounds of the political world, to suggest to voters how history might be repeating itself.

It’s also remarkable that the long-cherished goal of widespread health coverage has taken a perhaps irreversible step at roughly the same moment that the Supreme Court decided to further open the floodgates for oligarchy in campaign spending, leading to claims that American democracy is dead. And even more oddly, the Supreme Court is also the one institution that could have stopped the ACA, and despite its right-leaning tendencies, it was the one, by a 5-4 majority, that allowed the law to survive — on Chief Justice John Roberts’ vote.  Talk about dramatic stakes. I wonder if Roberts worried that the court’s conservative majority could not do to the ACA what an earlier court did to Roosevelt’s early New Deal without setting off a political war it could not win, and that might jeopardize its other goals.  

The ACA is not out of the woods yet. In fact, the next obstacle in the long and winding story of the ACA is the potential for a Supreme Court decision to block subsidies for health care under the ACA in states that did not set up exchanges. If people already have insurance and subsidies, the court may be wary of taking them away. There may be a race against time to get those benefits locked in before the High Court rules.

If the ACA keeps going, much of Obama’s remaining time in office may focus not only on an economic agenda (minimum wage, equal pay and other measures) but also on working through the ramifications of the new health care law and fixing problems that arise. The impact of expanded health insurance is going to expand beyond health care. A new study for the Rand Corp. contends that the ACA will have the effect of lowering the cost of liability for auto insurance. Unbound from restrictions on pre-existing medical conditions, people may also feel freer to leave bad jobs and look for new ones, competition that may drive up wages and strengthen coalitions for a higher minimum wage. And the Medicaid expansion alone puts Democrats back on a path they have veered from since the days of Lyndon Johnson: directly helping low-income and lower middle-class Americans to survive and thrive. 

In theory, Democrats would be more likely to get the active votes of working people who need things that they don’t have (a belief that animated much of the Romney camp’s explanation for his defeat). But it often doesn’t work that way. Being hopeless and overwhelmed can make the act of voting seem to be a waste of time.

Latinos, working-class voters, young people and unmarried women all are widely known to be stay-at-homes in off-year elections like 2014 — and then they get hammered in public policy, including the voter suppression laws aimed at keeping them away from the polls that passed after the 2010 Republican sweep.  

 For folks who are struggling, it’s more important to gain something worth protecting than to have to dream of getting it. As Obama is discovering with Latinos with regard to deportations, Democrats are foolish to think they will win votes by saying, “Look how hard we are trying to get you what we need, while those mean Republicans keep it away from you.” 

A little security can do wonders. Having the ability to see the doctor without going bust may make enough of an impression to create a bit of that sense of “political efficacy.” What opponents of the ACA have called “dependency” on government is really something quite different — the creation of confident people who are more likely to play their role in the governance of American democracy.


Raphael J. Sonenshein is executive director of the Edmund G. “Pat” Brown Institute of Public Affairs at California State University, Los Angeles.

Why isn’t this night different?

Predictably, the 2015 House Republican budget released by House Budget Committee chairman Paul Ryan (R-Wis.) on April 1 proposes devastating and monumental cuts to programs designed to help those among us who need it most. It would slash Medicaid; it would change the funding, eligibility standards and structure of SNAP (Supplemental Nutrition Assistance Program); it would repeal the Affordable Care Act. The same harsh proposals couched in the same tired rhetoric. 

And just as predictably, progressives are wringing their hands and describing the cuts as immoral. They invoke images of the seniors, children and disabled people who have done nothing to deserve their terrible lot but will feel these cuts most deeply. They cite independently verified statistics intended to dispel persistent myths about who actually needs these programs, because, the progressives proclaim, the political tides would change if they could just get everyone to actually understand the truth. The same hitherto ineffective counterpunches couched in the same tired rhetoric.

This is the time of year when we ask a very pointed question: “Why is this night different from all others?” The Passover seder is actually replete with questions — most of them ages old. But these questions, by their very nature, challenge us to stop and think, and to consider the range of possible answers to pinpoint why this night is different from all others — those during this year, or any other year. So I’m struggling to understand how this Republican budget and this progressive response are different from all others.

The facts about the astounding prevalence of hunger have remained essentially the same since the recession began in 2008: 

• 14.5 percent of American households were food insecure in 2012. That means 45 million Americans — nearly 1 out of every 6 of us — struggled to put adequate nutritious food on the table. 

• The rate of food insecurity in California — our great state where nearly half of the nation’s fresh produce is grown — is higher than the national average (15.6 percent).

• 1.7 million Angelenos are food insecure. That means the number of people struggling to feed themselves in our county is greater than the population of twelve individual states, and larger than that of the District of Columbia.

Despite the supposed recovery of our economy, the struggle of these vulnerable Americans continues to be the same. But the sameness of their struggle does not merit the same polarizing responses.

I have always embraced the rich Jewish tradition of asking questions, a custom that seems amplified during Passover. So especially now, when I consider the recent actions of our policymakers and lobbyists in Washington, I feel compelled to demand answers to questions that too often go unasked. 

Why, today, do the rhetoric and the overblown caricatures of “left” and “right” continue to remain so predictably the same? 

Why has it become more important for one or another side to be “right” than it is to do the right thing?

Why can we not be more courageous and willing to compromise?

What would it take for us to try a new and creative approach or framework that may yield a better result? 

How can we make today different from yesterday and all the days that came before it?

Albert Einstein defined insanity as doing the same thing over and over again and expecting a different result. Today, we must stop the insanity. We cannot travel the same path and expect to reach a different destination. 

It is not in our Jewish DNA to blindly accept the status quo. We are a people that takes action to create change when we encounter injustice. And there is no greater reversible injustice than the oppressive persistence of hunger in our county, our state and our nation. That so many struggle to survive means that our policymakers are failing us. Our job is to continue to ask questions. It is their job to provide different answers.


Abby J. Leibman is president and CEO of MAZON: A Jewish Response to Hunger.

Obama needs a better job

I feel bad for President Barack Obama. Here is a decent, intelligent, articulate man who had all the qualities to be a brilliant candidate but somehow ended up in the wrong job.

As I see him running out the clock on his second term, gamely trying to appear in control but clearly in over his head, I think back to the days when my then-8-year-old daughter fell in love with Candidate Obama.

It was my daughter’s fascination with Obama that fed my own. We would sit together at night and watch his speeches, moved by his ability to inspire us. 

Because his delivery and persona were so mesmerizing, we couldn’t help but absorb his message. And what a grand message it was: Unity. Opportunity. Hope. Renewal. Optimism. A more perfect union. A more perfect world.

At a time when America was feeling down on itself, Obama came along to boost our morale, to remind us that there’s nothing we can’t do — a message he himself embodied through his remarkable rise.

But while fate dealt Obama a perfect storm of circumstances to help him shoot to the top, it also dealt him a perfect mess of crises that greeted him as soon as he walked into the Oval Office.

The magnificent candidate inherited a trifecta of disasters: Two of the dumbest wars in U.S. history in Iraq and Afghanistan (my definition of a stupid war: squandering trillions of dollars and thousands of lives on a country that doesn’t say thank you), combined with an economic and fiscal crisis the likes of which we hadn’t seen in decades.

On top of those disasters came a problem of his own making: He made us expect too much. This is the side effect of being a transcendent candidate. You make people dream. You get carried away with your promises. You don’t manage expectations.

Eventually, crummy hand or not, Obama had to own up to his record. For a while, his eloquence and self-confidence made many of us overlook his failings. But as the problems and scandals piled up, as the “jobless recovery” became the new normal and as the Obamacare launch turned into an infamous mess, the Obama magic waned.

His words were still strong and upbeat, but they could no longer cover up the failures.

From a high of 69 percent in January 2009, his Gallup approval rating sank as low as 40 percent in March 2014. 

Liberal admirers like Amy Goodman have taken him to task for promising “a new era of open Government,” which, she writes, “seems just another grand promise, cynically broken.”

Last year, another prominent admirer, New York Times columnist Maureen Dowd, wrote: “Unfortunately, he still has not learned to govern. … No one on Capitol Hill is scared of him.”

Evidently, tyrants around the world aren’t scared of him, either.

And why should they be? At heart, Obama is a dreamer, a preacher, a philosopher-king. He’s simply not wired to be a hands-on, hard-nosed leader who can leverage his power.

Sure, when circumstances suit him, he can play tough guy and take down Bin Laden or send out the drones to kill more bad guys.

But his real passion is not with hard power. It’s with soft power.

He believes more fervently in dialogue and persuasion than in credible deterrence, which is the only thing that works with bullies. After seeing him violate his own red line against the murderous bully running Syria, few allies or enemies believe he has the stomach to enforce any red lines.

His reckless predecessor may have given toughness a bad name, but Obama himself has never quite found the smart middle ground between reckless and hapless. 

As a result, Obama’s wobbling, coddling and wishful thinking have weakened America’s credibility and reduced our ability to positively influence the world — on everything from fighting global warming, to reducing the proliferation of nuclear weapons, to combating genocide in Africa, to standing up to tyrants. 

Of course, none of this would matter if Obama weren’t the leader of the free world. But he is. And while he’s certainly had his high moments, it’s clear he’s fallen far short of the greatness he evoked in 2008. The charisma that made him a star on his magic campaign ride has hardly been enough to navigate the world’s toughest job. 

But there’s hope.

As I see it, there’s one important job that would enable Obama to truly display his greatness: running the United Nations.

In this era of globalization, can you think of a more perfect role for our orator-in-chief? Every week, he’d deliver an inspiring address to the world about the most crucial issues facing humanity. 

He would initiate resolutions and proclamations, set priorities for fighting injustice and healing the planet, root out the blatant hypocrisy that too often infects the U.N. and shame the bullies while honoring the heroes.

In short, he’d be wallowing in his element, presiding over a global forum where ideas, eloquence and “soft power” matter more than anything. He’d be the inspirational leader, not just of the free world, but of the whole world.

President Obama still has 1,000 days to end his presidency on a high note, and I hope he does. But the highest note he'll reach, for him and the world, is not in Washington. It's in New York City.


David Suissa is president of TRIBE Media Corp./Jewish Journal and can be reached at davids@jewishjournal.com.

Obamacare enrollment exceeds 7 million target despite setback

President Barack Obama's national healthcare program signed up more than 7 million people by the end of March, the president said on Tuesday, notching a rare victory after a months-long, glitch-filled rollout of the law.

Appearing in the White House Rose Garden, the president said 7.1 million people had signed up for coverage under the law, known as Obamacare, and called for Republicans to end their bid to repeal it. House of Representatives Speaker John Boehner repeated his pledge to repeal the law on Monday.

[Related: Obamacare: At 29, covered and faithless]

“This law is doing what it's supposed to do. It's working,” Obama said, with Vice President Joe Biden standing at his side. “The debate over repealing this law is over. The Affordable Care Act is here to stay.”

His remarks represented a victory lap for the administration, which suffered from the botched unveiling of the program's primary website, HealthCare.gov, and wavering support from Americans some three years after the U.S. Congress passed the healthcare law over Republican objections.

Health and Human Services Secretary Kathleen Sebelius, who has taken the brunt of the criticism for the shaky rollout, sat beaming in the front row during the Rose Garden ceremony. White House chief of staff Denis McDonough gave her a hug before Obama's remarks.

Experts had predicted a last-minute surge in enrollment. The figure could give a boost to Democrats, who have suffered from the criticism of the law, ahead of November congressional elections.

Obama's party is seeking to hold on to its control of the U.S. Senate and minimize losses in the Republican-controlled House, but the problems with Obamacare have complicated congressional races and handed Republicans a key talking point for skeptical constituents.

Republicans on Tuesday were quick to highlight outstanding questions including how many of the enrollees had seen their plans canceled because of the new law; how many people saw their premiums go down, and how many people who selected plans actually completed the process and paid their premiums.

“We don't know of course, exactly what they have signed up for, we don't know how many have paid,” Senate Minority Leader Mitch McConnell told reporters on Capitol Hill, referring to the enrollees in the program.

“What we do know is that all across the country our constituents are having an unpleasant interaction with Obamacare. Whether they can sign up for a policy or not, they are discovering, of course, higher premiums, a higher deductible.”

STRONG SURGE

White House officials dismissed the Republicans' criticism. Speaking to reporters ahead of Obama's announcement, one official noted that Democrats seeking to get voters from the coalition that elected Obama to support them would not be able to do so without embracing the law.

House Democratic leader Nancy Pelosi told reporters her members were not running away from the issue.

“Our members are out there on the offensive on this issue because of what we did, and we're proud of it, and we're proud of what it means in the lives of Americans,” Pelosi said after a meeting with Obama.

Monday's deadline for initial enrollment in the program came after a surge in registrations despite the return of technical problems, including a longer-than-expected maintenance session, although nothing as serious as the issues that beset the website's launch in October.

The site on Tuesday announced that open enrollment for Obamacare had closed, but people whose applications were thwarted by technical problems would be given a chance to finish their registration.

By last week, more than 6 million people had signed up for private health coverage through the new Obamacare insurance markets, surpassing a target set after the disastrous rollout called the enrollment process into question.

Industry analysts echoed Republicans' calls for more information about those who had signed up.

“We still have a lot to learn about what underlies those numbers in terms of who signed up and how many were newly insured people versus switching from other coverage,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation.

“We have more to see … about how many of them actually completed enrollment and how much coverage expansion was accomplished.”

The healthcare law, one of Obama's key promises as a presidential candidate in 2008, was intended to expand access to healthcare coverage for millions of uninsured Americans, so having enrollment figures that reflect newly insured people is critical to the program's success.

Having a robust percentage of healthy young people to offset older enrollees is also important. White House spokesman Jay Carney said such details were yet available, but he said the demographic mix would be sufficient to ensure that the health market places that form the cornerstone of the law would function smoothly. (Additional reporting by David Morgan, Thomas Ferraro and Larry Downing; editing by G Crosse)

Reporting by Jeff Mason and David Storey; Editing by Sandra Maler

Obamacare: At 29, covered and faithless

The disappointment, like so many others, began with a promise. “If you like the plan you have,” President Barack Obama told the nation on June 6, 2009 at the nadir of the economic downturn, “You can keep it.  If you like the doctor you have, you can keep your doctor, too. The only changes you’ll see are falling costs as our reforms take hold.”  

It was a promise that provided relief to Americans, many of whom feared the side effects of Obama’s new Affordable Care Act, and were, at best, cautious about its adoption. It assured them that things would continue as usual, that while things around them changed, they could stay the same.  

The only problem was, the promise was a lie.

I’m 29. I voted for Obama, twice. I believe that national health care is important, and I would have strongly supported a single-payer system in the mold of Canada or the United Kingdom. This is to say, I am not part of the crowd that believes the Affordable Care Act was evil, or that adopting a single-payer system would inevitably turn us into godless communists. But as the March 31 deadline for signing up for Obamacare approaches, I am, however, deeply disappointed with the gap between what was promised and what’s being delivered.

I’ve always been among the more responsible of my peers when it came to having health insurance. While many of my friends went uninsured through their early- and mid-20s, I always kept at least a catastrophic plan. When I moved to California, I purchased a plan from Aetna.  It wasn’t the world’s greatest plan —  there was a significant deductible, but it had the doctors I wanted in its network, and it wasn’t expensive.  

When the Affordable Care Act’s first wave of requirements came into effect, I watched as my formerly inexpensive plan more than doubled in price. This was, I reasoned, a fair trade for obtaining godsends such as the banning of lifetime benefit caps, the elimination of pre-existing conditions as reasons for denying coverage, and mandating coverage for maternity care for women. If I was suddenly paying more than $250 per month for a plan that had once been $120, I reasoned that progress has a price. 

But in the spring of 2013, Aetna sent me a letter announcing that they would be canceling my plan, as they no longer wanted to sell insurance in California. How could this be? Obama had promised that if you liked your plan, you wouldn’t lose it.  I liked my plan, and I lost it.

I decided to give the state’s Web-based exchange, Covered California, a shot, figuring that maybe I’d at least save some money. But the site was a counterintuitive den of poor Web design and confusing language. Everything from the half-dozen required security questions to the bizarre way you had to report your income was cumbersome — and that was when the site was actually working, which it often wasn’t. Like many young people, my income varies from month to month as I don’t have a yearly salary; but Covered California didn’t provide me with an option to report my total yearly income, only my monthly income, making it nearly impossible to report what I earned.

Once I’d signed up for a plan, my work wasn’t done. I’d signed up well in advance of the deadline, but my card didn’t arrive on time. I tried calling, but I was greeted by a message saying call volumes were so heavy that they weren’t taking calls that day. Even though Covered California anticipated more than 1 million people signing up for new plans, it only hired 500 workers for its call centers, according to the Los Angeles Times, meaning one worker for every 2,000-plus customers.

My experience is hardly the worst I’ve heard about. I finally received a card in the third week of January, but my brother went uninsured until March 22, despite having signed up on time. He played by the rules, followed the government’s instructions, and yet still had to pay for medical care and antibiotics out of pocket during the first months of the year. And friends told me similar stories of impossibly long wait times on the phone, the loss of primary care physicians, cards that arrived late or not at all and, most galling, the loss of access to Cedars-Sinai Medical Center, which can only be accessed through Covered California via one “bronze-level” plan with an extremely high deductible.

I do not, like my cousin George Will, believe that the Affordable Care Act is a disaster, nor do I wish for its repeal. But I do believe I was lied to by the president and his spokespeople, who claimed on no less than 37 different occasions, according to the Tampa Bay Times’ Pulitzer Prize-winning politifact.com, that no American would lose access to their plan or to their doctor. 

I lost access, my friends have lost access, and we certainly haven’t seen falling costs. Yet I still believe health care reform is worth it. The false promises, however, made even small victories seem like defeats. The ill-timed, ill-planned, and just plain ill rollout of the health exchange system has left many young Californians wondering if aggravation, confusion and delays are all we have to look forward to. The president sold us change we could believe in, but delivered us changes that have left us faithless.


Jonathan Maseng is a frequent arts contributor for the Journal.

Letters to the editor: ACA, mitzvot, fair trade chocolate and Noble Prizes

First, Practice Mitzvot

In “No Faith, No Jewish Future” (Nov. 6), Dennis Prager has it backward. The assiduous practice of mitzvot results in recognition of their foundation, not visa versa. Halachic adherence remains the key to growth in Orthodox Judaism. A 3-year-old child learns what we do, i.e., wear tzitzit, when he puts them on and recites a bracha. A yeshiva student gains an understanding as to why we wear them, while studying talmudic tractate, Brachot. Contrary to Dennis’ suggestion, few, if any, outside Orthodoxy who “scrupulously follow halachah” reject the divinity of the Torah. The problem is not a failure to accept the divinity of the Torah; Rather, it is a failure to practice its dictates. Practice of halachah is a precursor to growth and understanding. We cannot be expected to comprehend that which is beyond our own practice and experience.

Mark Herskovitz, Los Angeles

Dennis Prager responds: 

Mr. Herskowitz and I differ. No problem. But his statement, “Contrary to Dennis’ suggestion, few, if any, outside Orthodoxy who ‘scrupulously follow halacha’ reject the divinity of the Torah,” is rarely, if ever, the case. The belief of non-Orthodox Jews who keep halacha was perfectly summarized by the past chancellor of Jewish Theological Seminary: “The Torah is the foundation text of Judaism … not because it is divine, but because it is sacred.”


More on the Affordable Care Act

David Suissa’s article “Lies and Consequences” (Nov. 15) is long on rhetoric and short on facts. Lying requires at least some degree of intent.

When President Barack Obama assured citizens they could keep their policies, he was referring to the grandfather clause included in the Affordable Care Act (ACA). That clause allowed policyholders to keep plans that were in effect as of the date the ACA was enacted in 2010.

The major reason the grandfather clause did not work is that the insurance companies kept creating plans after 2010 that they knew would not be valid after the launch of the ACA, something of which their customers were not cognizant. The insurance companies made use of that lack of sophistication among their customers. As a result, the vast majority of canceled policies were those written or amended between 2010 and 2013. For people who bought insurance plans prior to 2010 when ACA was enacted, President Obama’s statement that you can keep your plan was true and remains true. 

Is President Obama guilty of underestimating the insurance companies? Absolutely. But that does not rise to the level of a lie. It would be appropriate for the author of this column to research and write a follow-up article, this time with facts, on the real culprit, the billion-dollar, for-profit medical insurance industry.

Aaron Rubin, Los Angeles 

David Suissa responds: 

Merriam-Webster defines a lie as “to create a false or misleading impression.” In February 2010, at the health care summit with Republicans, President Obama acknowledged that 8 million to 9 million people “might have to change their coverage.” Knowing that, for three-plus years thereafter, and especially during his re-election campaign, the president promised Americans that “if you like your health care plan, you’ll be able to keep your health care plan. Period.” That’s why The Washington Post’s The Fact Checker site gave that statement its worse possible ranking — four Pinocchios.


Buy Fair Trade First

I read with great interest Deborah Prinz’s fascinating account of the role of chocolate in Jewish history (“Chocolate Freedoms of Chanukah and Thanksgiving,” Nov. 29). To really reinforce the notion that chocolate eaten at Chanukah symbolizes the freedoms won by the Maccabees, one should go one step further. Since most of the world’s chocolate is made from cocoa beans picked by children in the Ivory Coast, buying Fair Trade chocolate (certified to not involve children in the production) would really show how much we value freedom for all.

Mark Elinson, Los Angeles


A Wonderful Abundance of Nobel Laureates

The use of the term obnoxious to describe recognition of Jewish accomplishments in Nobel Prize history (“This Week in Jewish History,” Nov. 22) is regrettable. This phenomenon, a proportionally large representation of Nobel laureates attributed to the Jewish population, is a wonderful achievement that should be proudly and frequently referenced, in part to encourage our children to pursue careers in the sciences, liberal arts and engineering. It would have been preferable to have had the Jewish Journal staff edit the offending paragraph accordingly before recirculating it.

Jeff Gold, Rancho Palos Verdes

The Obamacare Apocalypse

Last week, a professor of physics and astronomy ” target=”_blank”>Koch brothers’ plan to stop them.  It’s possible that some of the Republican governors who refused Medicaid money for 8 million of their constituents will find themselves so wildly unpopular that they’ll do a 180.  It’s possible that people in the individual market stranded by the law and their insurance companies will find solutions.  Hell, it’s even possible that healthcare.gov will work.

So it’s not nuts to think that by the time Obama leaves office, the American health care system will be better in lots of ways, Obamacare will be the new normal and solid majorities will like it.  There may be no “Keep Your Hands Off My Obamacare” signs during the 2016 campaign, but it’s possible that the painful rollout of the exchanges will be forgotten.

That would ruin things for the drama queens in the media.  Their master narrative is Countdown to Armageddon.  Demagogues need end times to raise money.  News needs to shout apocalypse to get attention.

It’s not just Obamacare.  Imagine that CBS News had no reason to retract the Benghazi piece on “60 Minutes.”  If accounts of Dylan Davies’s F.B.I. interviews hadn’t made their way to the ” target=”_blank”>The Last Hours: Warming the World to Extinction,” a 10-minute movie written by Thom Hartmann and directed by Leila Conners makes terrifyingly clear, climate change is on track to cause the sixth mass extinction in geologic history. The fifth, the K-T extinction 65 million years ago, was caused by an asteroid hitting the earth off the coast of the Yucatan peninsula – and it killed the dinosaurs.  The third mass extinction – the Permean, the worst – was caused by volcanic eruptions in the Siberian Traps that warmed the oceans six degrees Celsius and melted trillions of tons of methane that had been frozen beneath the sea floor and ice sheets.  The methane this released into the atmosphere doubled the warming the volcanoes caused and killed 95 percent of all life on earth.  Today, fossil fuel burning and industrial agriculture are increasing greenhouse gases at rates never before recorded by humans, physicist Michael Mann says in the film, “far greater than any of the most rapid events that happened in the deep geological past,” including the Permean extinction. 

Talk about doomsday scenarios.  If this keeps happening, Obamacare, along with everything else we love, hate or talk about, will be irrelevant, because our species won’t be around to love, hate or talk about anything. But you would not know that things are as dire as they are from watching the news, which is just how Exxon-Mobil, Monsanto and the Koch brothers like it.

The day before the Times reported a tenfold increase in the odds of an asteroid strike, Erik Petiguara, a graduate student at the University of California, Berkeley martyk@jewishjournal.com.

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Obamacare: Glitches or death spiral?

It’s not easy to wrap your mind around a program as complex as Obamacare, which features 381,517 words in its actual bill and 11,588,500 more words in added regulations.

Thankfully and mercifully, in trying to understand this migraine-inducing puzzle, I found some relief in one simple idea: The system won’t work unless it entices enough young and healthy people to sign up.  

Right now, the big news is that the launch of the HealthCare.gov Web site has been a flop, with countless horror stories of people who haven’t been able to enroll because they were lost in a digital and bureaucratic maze.

Many liberal supporters see this initial failure (wishfully, perhaps) as a case of annoying but fixable “glitches” on the way to a more humane universal health care system.

Many conservative critics see it (wishfully, perhaps) as the kind of “disaster” that happens when Big Government bites off more than it can chew. 

As of now, the critics are on a roll. 

“With the GOP’s antics now over,” Kimberley Strassel of The Wall Street Journal writes, “the only story now is the unrivaled disaster that is the president’s health care law. Hundreds of thousands of health insurance policies cancelled. Companies dumping coverage and cutting employees’ hours. Premiums skyrocketing. And a Web site that reprises the experience of a Commodore 64.”

Even a liberal, fair-minded policy wonk like Ezra Klein of the Washington Post admits that, so far, Obamacare “is not working well at all.”

Conservative wonk Yuval Levin of National Review Online goes as far as seeing a potential “death spiral,” which he describes as follows: “The fact that it is so difficult to sign up for exchange coverage may mean that only highly motivated consumers do sign up, and those are likely to be people with high expected health costs.

“If the exchanges end up containing too many people in poor health and not enough people in good health, insurers could take massive losses in 2014 and be forced to dramatically raise premiums for 2015 plans. … Those higher premiums would cause even more healthy people to avoid getting coverage … and the cycle would continue.”

The importance of getting young, healthy people to enroll is echoed by Klein, who, after interviewing White House officials and asking “repeatedly” how they defined success, reported that “everyone in the White House shared a singular definition: Success meant setting up the exchanges and attracting enough young people [so] that premiums stayed low.”

Let’s face it — no matter where you sit, this is a scary thought: The success of Obamacare depends on getting millions of young people with short attention spans to spend hours in front of an exasperating government Web site with zero entertainment value — and trying to enroll in something they’re not sure they want.

But enroll they must, if they want to save the president’s plan. As Klein reports, the administration figured that if they got 7 million people to sign up for the exchanges in the first year, about 2.7 million needed to be young.

That’s 5.4 million jaded eyeballs to entice. 

You’d think that with the $600 million they budgeted for this Web site, the government could have splurged for a few creative types in Hollywood whose business is to keep people entertained. Put them together with the tech geniuses who built Amazon and you’d have at least the possibility of wooing these jaded eyeballs with something other than a threatened fine. 

But the user-unfriendly Web site, as bad as it is, is only a symptom of deeper issues. As Klein explains, what’s causing “deep problems” for the health care law is the mess in the infrastructure of the program, which he describes metaphorically: 

“In brick-and-mortar terms, it’s the road that leads to the store, the store itself, the payment systems between the store and the government and the manufacturers, the computer system the manufacturers use to fill the orders, the trucks that carry the product back to the store, the loading dock where the customers pick up the products, and so on.”

For the program to run smoothly, that whole infrastructure needs repair. The question is: Can the bureaucracy which created the mess do that repair work?

Many conservative critics believe that it can't, and that the program will fall under its own weight. Klein believes there’s still time to right the ship, but not much. He quotes health care experts who suggest that the Web site needs to be running smoothly by “Thanksgiving at the latest.” 

It shouldn’t shock anyone that Obamacare has been at the center of one of the nastiest partisan battles in recent memory. When a government tries to take over one sixth of the U.S. economy as it pushes through a controversial and gargantuan entitlement program on a strictly partisan vote, it can’t expect smooth sailing.

In any event, as Klein notes, the president’s program “isn't a political abstraction any longer. Its success doesn't depend on spin or solidarity. What matters for the law — and for the people who are depending on it — is how well it actually works.”

There’s something refreshing about that. After years of fighting, spinning and promising, we’re down to results.

Even a well-meaning and eloquent president has to face this reality: Ultimately, government comes down to how effectively you can solve people's problems. Either you do or you don’t.

President Obama fought tooth and nail for his 12-million-word health care legacy. Now, he needs the government he believes in and the young people who voted for him to help him deliver on that legacy. It’s far from clear that this will happen.


David Suissa is president of TRIBE Media Corp./Jewish Journal and can be reached at davids@jewishjournal.com.

Lewis Black’s ‘Rant’ is due in Thousand Oaks

It’s been a great year for Lewis Black. There was the budget sequestration, the government shutdown and the fierce debates once again over Obamacare. Politicians left and right have been acting like nitwits, and Congress has proved its incompetence over and over again.  

The amount of comedic material that can emerge from these circumstances is endless. For Black, now 65 and best known for his appearances on “The Daily Show With Jon Stewart,” the absurdity in politics, government and society is nothing more than sheer inspiration for his act. 

A stand-up comedian well-known for angry tirades against the government, religion and cultural crazes, Black is back with a new tour, “The Rant Is Due,” which he debuted in January. He will be making a stop at the Fred Kavli Theatre at the Thousand Oaks Civic Arts Plaza on Oct. 27, and his main targets this time are his contemporaries. 

In a phone interview, Black said, “My parents’ generation was a group of idiots. Now I’m watching my generation, and they are, too, especially the leaders. They are real idiots. I look at them and go, ‘Jesus, they are twice as dumb and should have known better. I look at John Boehner and think, ‘Wow! We were raised on the same planet,’ which is really astonishing. It’s just unbelievable.”

Black got his start as a playwright, and these days, he said, he performs on the road 150 days out of the year. He’s taped four “Comedy Central Presents specials; appeared in movies, including “Man of the Year” with Robin Williams and “Accepted”; and is the centerpiece of “Back in Black,” a long-running “Daily Show” segment. He’s also written three best-selling books, won two Grammys and performed to sold-out houses at Carnegie Hall and Lincoln Center. 

This latest tour has taken him across the United States, including to Ohio, Colorado, Florida, New Jersey, New York and Washington, D.C. The fall leg, which he began in Sacramento, is already extending into February 2014. 

Black said he sees his generation as stuck in the past. “There is this mentality that has gone on in my entire lifetime. People don’t acknowledge that things have evolved. They want things to be exactly the way they used to be, and it’s going to stay the way it was whether people like it or not.”

He argues in his new show that while the United States is progressing in certain respects, his generation doesn’t want to transform with the times. “There’s been this slow change, while there is this whole [other generation] coming up who has already changed,” he said. “A door got opened, and this breeze came through, and these jackasses put coats on.”

Because he’s on the road a quarter of the year, his act is always a work in progress. “I’ll take one little fact, and I’ll work on it,” he said. “If a joke doesn’t work, I’ll try to make another joke. I’ll try three times, and it if doesn’t work, then I throw it out.”

Black is such a fluid writer that sometimes he pulls out jokes that wouldn’t fit into his previous special and reworks them into his new one. “I’m doing things now that weren’t in the last two specials. I spend a portion of the act on the legalization of pot. My generation needs a legacy [like pot legalization] because otherwise people are going to say, ‘What the hell were they about?’”

Although his jokes are oftentimes extremely current, he said they can also be evergreen, because “these people don’t die. If I talk about Sarah Palin, it’s because she hasn’t gone away.”

He finds his material appeals to anyone from “ages 12 to 95.” And he first started gaining younger audience members when he began playing colleges and theaters. The “Daily Show gig probably helped, too.   

Black, who doesn’t shy away from religion in his stand-up, was raised in a Jewish home in Silver Spring, Md., a mere 20 minutes from Washington, D.C. He isn’t religious, but he does take pride in his heritage. “Today I describe myself as a ‘deli Jew,’ ” he said. “I have a certain amount of faith. I believe there is something out there. I just don’t take that kind of comfort praying in a group.” 

He said he had a bar mitzvah, celebrated the High Holy Days growing up, and went to Hebrew classes every Sunday. He even published a book, “Me of Little Faith,” which is about his relationship to Judaism and religion in general. “When I graduated from school, I was kind of done. I did try to hang in. I got a lot more of the ethical and cultural than I got the spiritual end.”

Along with perpetually writing and changing his stand-up act, Black is currently working on a new play, but he said he doesn’t “know how far it will go.” He will also be back on “The Daily Show” soon, he said, and people can catch his latest special, “Old Yeller,” on inDemand until early next month. 

Although Black appears irritated, frustrated and flustered on stage, he said he wants, above all, that his audiences have fun when they see him live: “I hope they have a good time, and I can help them get away from whatever stress and nonsense they’re dealing with.”

My lunch with a Los Angeles Tea Partier

Of the 3,977 angry e-mails I received last week, one stood out.

“I am a Jew, a member of Temple Emanuel in Los Angeles, and the founder of the largest local, grass-roots Tea Party group in Los Angeles called the Hancock Park Patriots,” Mark Sonnenklar wrote.

“I, and many of my fellow leaders in the Tea Party movement, are pretty upset about the recent ‘Tea-hadist’ cartoon published in the Jewish Journal. I would like to discuss this matter with you. Would you be open to a phone call?”

Sonnenklar was referring to the political cartoon in the Oct. 11 issue of the Jewish Journal. Our longtime cartoonist, Steve Greenberg, portrayed a Tea Party activist as a suicide bomber wearing an explosive vest labeled “Govt Shutdown.” You get the idea.

Tea Party-affiliated Web sites reposted the cartoon and urged readers to e-mail me their outrage. It worked. Overnight, my inbox filled with thousands of e-mails railing against the cartoon. The vast majority of the letter writers were not Journal readers. Many repeated the charge that the cartoon “mocked the actual victims of Islamic terror,” and I took that to heart. I issued a public apology for the cartoon’s insensitivity to terror victims. 

Many letters were vicious; some were strange. 

“May God show you the error of your wicked ways and give you the redemption you clearly do not deserve!!” Scott Walker wrote.

 “You should … use your amazing resources to find out just how many Muslim Brotherhood members are working in the White House,” Charles Walter wrote. “Did you know Obama has a ‘Sharia Czar’?”

Truthrevolt.org, an intelligent conservative site, originally flagged the cartoon. But a site named PatriotAction.com had picked up the cause, and many of the e-mails turned outright anti-Semitic.

“Jews have caused [sic] the world by stealing land instead of just paying for it in the first place, I guess I can understand the idiocy,” someone calling himself Ron Paul wrote. 

The few writers who identified themselves as Jews were not much kinder.

“This may come as a shock to you, Comrade Eshman,” Aaron Shuster wrote, “but not all Jews share in your utopian socialist agenda for Islamic hegemony.”

Amid these screeds, Sonnenklar’s civility stood out. So did his Web site. It listed seven action steps activists could take. No. 7 was, “Click here to sign up for the Koch Brothers Check Distribution” — a cheeky swipe at those who say Tea Partiers are just dupes of the 1 percent. 

I called Sonnenklar, and three hours later we met for lunch at Le Petit Greek on Larchmont.

Sonnenklar is 44, a corporate lawyer, father of three, and he bears more than a glancing resemblance to Bradley Cooper. He wore blue jeans and a trim striped dress shirt, untucked, along with the standard L.A. three-day growth of beard.

We decided not to talk about “it” — the cartoon — until at least after the grilled halloumi.

Sonnenklar told me he had established the Hancock Park Patriots in 2010, because he was “tired of not doing anything. I wanted to make a difference.”

Between 50 and 100 people from all over Los Angeles attend the Hancock Park Patriots’ monthly meetings. Sonnenklar estimates about 20 percent of them are Jewish.

“The goal is not to become a third party,” he said, “but to become more powerful within the GOP. There needs to be a Tea Party to bring the Republican Party back to its core principles.” 

Those principles: smaller government, greater individual liberty, protecting free enterprise.

The Constitution is sacred, he said — everything has to flow from that.

I asked him: Don’t many progressives want the same things? More efficient government, greater liberty, etc.? And isn’t the Supreme Court the arbiter of the Constitution, and didn’t it uphold Obamacare …

“It’s a very politicized court,” he interrupted, and then batted away my arguments.

He saw President Barack Obama’s campaign pledge to “fundamentally transform” the country as a declaration of war against America. I saw it, in the context of a boilerplate campaign speech, as a promise to the middle class.

We were like two doctors who agreed easily on what an ailing patient looked like, but not on the cure.

“I’m not a moderate,” he said, smiling. “I’m just more articulate than most.”

I asked him how that flies in his Reform Beverly Hills synagogue, which has a liberal reputation.

“I have no doubt if people found out I was a leader of a Tea Party group, I would be ostracized,” he said. “As a conservative in Los Angeles, you can’t be open. You’re going to be the one guy at the dinner party who stands out. The Tea Party is almost a support group. Now I feel I can be open about who I am and my political views.

“We are under attack by the hard-left establishment,” he went on. “They are using Alinsky-like tactics to undermine any opposing point of view. That’s why this cartoon hit such a nerve.”

Sonnenklar knew I had publicly apologized, but he pushed further. Would I run a cartoon of Obama in a Hitler mustache?

That didn’t sound very funny or clever to me, I said — and talk about insensitive. I did point out that the Journal publishes opinions from many different perspectives, because thoughtful debate is a core Jewish value. 

We reached an impasse on many points, but it was a good, long lunch — a useful outcome to an unfortunate incident. After all, thoughtful argument may be a core Jewish value. Agreement — not so much.


Rob Eshman is publisher and editor-in-chief of TRIBE Media Corp./Jewish Journal. E-mail him at robe@jewishjournal.com. You can follow him on Twitter @foodaism.

U.S. lawmakers close to deal on debt ceiling, reopening government

The U.S. Senate appeared ready to announce a last-minute deal on Wednesday to avert a historic lapse in the government's borrowing ability and a potentially damaging debt default.

But even if the Senate and House of Representatives manage to overcome procedural hurdles to seal the deal before Thursday – when the Treasury says it will exhaust its borrowing authority — it will only be a temporary solution that sets up the prospect of another showdown early next year.

Major U.S. stock indexes rose more than 1 percent on optimism that lawmakers would finally end the weeks-long fiscal impasse, but cautious investors are still wary over the final outcome. Although the cost of insuring U.S. debt hit its highest in over two years, the dollar held its ground against other currencies.

Senate Majority Leader Harry Reid and Republican leader Mitch McConnell were close to finishing a fiscal plan that could be considered by the full Senate later on Wednesday. The leaders were expected to announce a deal when the Senate convened at noon (1600 GMT).

Weeks of bitter fighting among Democrats and Republicans over President Barack Obama's signature healthcare reform law led to a two-week government shutdown, sidelining hundreds of thousands of federal workers.

The initial fight over the healthcare law turned into a bigger battle over the debt ceiling, threatening a default that would have reverberations around the world.

“If we don't get a default, it would be like Y2K. People were staying up all night worried about what would happen during that deadline. Then nothing happened,” said David Keeble, global head of interest rate strategy with Credit Agricole Corporate & Investment Bank in New York, referring to worries about the millennium computer bug in 2000.

Both Democrats and Republicans are confident that the U.S. House of Representatives will have enough votes on Wednesday to pass the bipartisan Senate plan, a top Democratic aide said.

Aides to House Speaker John Boehner, the top Republican in Congress, called senior Senate staff to say the House would vote first on the measure, the aide said, adding that it appears certain to be approved with mostly Democratic votes.

Lawmakers are racing against time. While analysts and U.S. officials say the government will still have roughly $30 billion in cash to pay many obligations for at least a few days, the financial sector may begin to seize up on Thursday if no deal is secured.

“I think folks on both sides of the aisle in the Senate are ready to get this done,” Republican Senator Saxby Chambliss of Georgia told National Public Radio on Wednesday, a day after chaotic developments frayed the nerves of many members of Congress and global financial markets.

Even if a deal is reached, it must still clear the full Senate and possible procedural snags before moving to the fractious House of Representatives, which was unable to produce its own deal on Tuesday.

“Today is definitely not the day to be conducting any serious business as traders across the globe will be hypnotized by their TVs/terminals and anxiously waiting for something to hit the news wires,” Jonathan Sudaria, a trader at Capital Spreads in London, wrote in a client note.

Fitch Ratings warned it could cut the U.S. sovereign credit rating from AAA, citing the political brinkmanship over raising the debt ceiling.