Sunday, March 19, 2017

Reasons for Optimism. No, Really.

Sometimes you just need someone to tell you everything's going to be okay. That's why I just read (and loved) Ruy Teixeira's The Optimist Leftist: Why the 21st Century Will Be Better Than You Think. As reporter and author E.J. Dionne, Jr., said, "Beware: This is the rare political book than could force you to smile."

Teixeira makes a compelling case that the best is yet to come for progressive policies. And the book was published just a few weeks ago, so yes, it takes into account the Trump administration and all of the threats it brings.

The Problem with Pessimism

As Teixeira puts it, "pessimism dramatically undermines the appeal of the left. Why on earth would anyone sign up with a movement that believes the situation is so hopeless? What's so inspiring about that?...Pessimism makes people less likely to believe in positive change, not more likely."

During the Obama administration, we saw a lot of policy successes that will not be reversed, he writes, but "when the left was winning, it often acted as if it was losing." Instead of telling people how bad things have become, he argues, we need to spotlight what's working and build on it. The left needs a positive vision, compelling arguments, and leaders who can embody them.

Reasons for Optimism

Progress has slowed down, but it hasn't stopped. "What's correct is that people want to move up from their current life, not that they believe there is nothing good about their current life....Today, we live in freer, more democratic, less violent, and more prosperous world than we ever have before."

Things are good, and they will get better. "The problems we face today are solvable and, moreover, are likely to be solved in the coming decades. Life for ordinary citizens should improve dramatically over the course of the 21st century."

Demographic changes favor the progressive movement. We're witnessing a societal shift from manufacturing toward a postindustrial, knowledge-based society that's part of a global economy, and that is not going to reverse. Conservatives are clinging to shrinking populations to win elections, and the math just doesn't add up to future success. At the same time, progressives must recognize that emerging constituencies -- including immigrants and minorities, professionals, the highly educated, women, singles, non-religious, Millennials -- "by and large are not the chief beneficiaries of existing welfare states and need a 21st-century version of progressive state action to enable their future."

The Piketty Problem

In Capital in the 21st Century, French economist Thomas Piketty notes that by its very nature, capitalism tends to lead to inequality, concentration of wealth among a few, and lower living standards for the masses. And the way the left and right approach "the Piketty problem," Teixeira says, is very different. "The left sees this as a real problem that can't be solved but the market alone. The right is defined by its defense of market outcomes, no matter how dismal." And that disconnect works in the favor of the left: "The right's view is out of touch with current and future economic reality and will be increasingly unpopular with voters."

We're seeing a real example of that now. Many lower- and middle-class voters bought into the criticisms of Obamacare -- and in fact didn't realize that "Obamacare" (which they hated and wanted repealed) was the same thing as the Affordable Care Act (which they supported because it gave them access to health care). But many of the people who love the rhetoric about making the government smaller, building a wall, and repealing Obamacare will be seriously hurt by the Trump administration's health care and budget proposals. The Republicans' game -- tricking people to get elected (Trump), lying to them about the consequences of cuts (Ryan), and disregarding the human impact of these decisions (Mulvaney) -- just isn't sustainable. In the short term, rich people will get richer and many poor and disadvantaged people will be hurt, but over time, our system will hold these officials accountable. Maybe as soon as the mid-term elections.

Teixeira argues that progressives will be more successful if they embrace the fact that in a capitalist society, good economic times will lead to upward mobility and personal optimism, which in turn will promote social generosity, tolerance, and a sense of shared purpose. So instead of whining about injustice, he says, progressives should point out that high inequality is an obstacle to growth -- for everyone. "Capitalism must be actively pointed in a different direction by adopting a new approach that pushes back against inequality and promotes the economic health of the middle and working classes as the key driver of growth." And the left needs to talk about inequality not just as a problem because it's unfair, but as an obstacle for growth -- for all.

The Opportunity Today

As I read The Optimist Leftist, I often found myself thinking, "Yeah, but..." -- because the challenges we face today are real. We can't ignore those threats, and while we embrace an optimistic view for long-term justice and equality, we have to fight to defend the progress we've made, and push back on bad policy. At the same time, Teixeira's advice is that we see this as a time for defense as we prepare to be on offense. "It is absolutely necessary to agitate for progress during bad times -- to defend progressive gains, to push reforms forward when they are possible, and, of course, to develop the strength of the left. But the strategic imperative of bad times should be to prepare for good times and help make those good times happen."

With a more optimistic view of the long term, I'm going to keep doing what I've been doing. Instead of just telling my elected officials why I oppose cuts to programs I support, I'm telling them how those programs have helped my family and people I know and care about. I'm not just calling the people I oppose, but also thanking my representatives who are supportive and reasonable -- and giving them the information they need to keep fighting.

We're moving in the right direction, and Trump's election does not change who we are -- and will be -- as a country and society. And in the meantime, we can't sit by and wait for things to get better.

Friday, March 17, 2017

Who's the Most Heartless of These Heartless Bastards?

During the campaign, Donald Trump offered a populist message that resonated with just enough people to get him elected. He promised he wouldn't cut Medicaid. He told people their health insurance would be better and more affordable. Well, it turns out he either lied or changed his mind about improving people's lives, because his proposed health plan and budget would devastate millions of people while benefitting the wealthiest Americans.

According to the Congressional Budget Office, his health plan would leave 14 million more people without health insurance in 2018, which will rise to 21 million in 2020 and then 24 million in 2026. But his billionaire friend need not worry. Repeal of taxes in the Affordable Care Act will largely be passed on to the wealthiest Americans. People in the top 0.1 percent (earning at least $3.9 million per year) will get a tax cut of $207,000.

After Trump got elected, I told friends I was worried about a lot of things. But my overarching concern was that Trump and the people he was surrounding himself with simply don't care about other people (or at least haven't demonstrated any interest in improving the lives of average citizens).

That matters, because you have to be pretty heartless to support these devastating policies and budget cuts. In addition to taking away health coverage from millions of people, Trump and his team are pushing to cut funding for medical research, mental health care, the Centers for Disease Control and Prevention, energy assistance for poor families, and after-school programs -- and that's just a few examples. It also eliminates Community Development Block Grants, which help fund programs like Meals on Wheels, a program that provides meals to 2.4 million poor senior citizens.

Let's play a game called "Which Bastard is Most Heartless?"

Nominee: Paul Ryan, Speaker of the House
Nominated for: Says taking away people's health care is an "act of mercy." I'll let Representative Joe Kennedy III respond:

Nominee: Mick Mulvaney, Office of Management and Budget
Nominated for: Says there's no evidence that providing food to poor children helps them do better in school.

Nominee: Tom Price, Secretary of Health and Human Services
Nominated for: Tells a cancer survivor who's alive because of Medicaid expansion that he should settle for a small tax cut instead of getting heath coverage.

Nominee: Donald Trump, President of the United States
Nominated for: Lies, broken promises, and actions that hurt poor people and make millionaires and billionaires richer. Do you remember his campaign promise to not cut Medicaid? What about these assurances? "We're going to have insurance for everybody." "I am going to take care of everybody. Everybody's going to be taken care of much better than they're taking care of now.""It'll be another plan. But they'll be beautifully covered."
Read "President Trump's False Promises on Healthcare," from The Hill, March 2, 2017.

Tuesday, March 14, 2017

Medicaid Cuts: "A War on Disabled People"

For families affected by disabilities, the threat to Medicaid is one of the greatest concerns about the proposed American Health Care Act. I don't need to rewrite all the information about this, but if you want to understand the risk and how it may affect people with disabilities, here's some recommended reading.

During the campaign, candidate Trump promised he would not cut Medicaid. But boy, has he backed off of that, as shown by the budget estimates from the bipartisan Congressional Budget Office.
Read "Trump Promised Not to Cut Medicaid. His Health Bill Will Cut $880 Billion From It," Vox, March 13, 2017

This headline from Forbes speaks for itself. Citing a column in the New England Journal of Medicine, this article shows that shifting Medicaid to a block-grant program will let states decide who gets services and which services they get. For example, they could choose to deny behavioral health services, which is what people with autism and other developmental disabilities depend on.
Read "A Shift to Medicaid Block Grants is a Threat to People with Disabilities," Forbes, March 9, 2017

This isn't really about the Affordable Care Act (ACA). Do you realize that Medicaid covers 57 million people, six times the number covered by the marketplaces created through the ACA?
Read "Sleeper Issue of Medicaid's Future Could Prove Health-Care Plans' Stumbling Block," The Washington Post, March 12, 2017

In the Post article, Bob Kafka, a Texas leader of the national disability rights group ADAPT says he is concerned that cuts to Medicaid would lead to the elimination of home- and community-based services that allow people to live independently -- and force them into nursing homes. "What the Republicans are doing," Kafka says, "is basically a war on disabled people."

Proposed Health Changes "Would Fail My Disabled Brother"

Please read and share stories like this. Writing in the Denver Post this week, Alyssa Roberts expressed concern about how severe cuts to Medicaid would affect her 19-year-old brother, who has physical, intellectual, and developmental disabilities. 

"Overlooked in the Republican bill to repeal the Affordable Care Act is a drastic change to traditional Medicaid funding that threatens services for more than 10 million people with disabilities," she writes. "For decades, Medicaid has been their lifeline — providing everything from specialized therapies to support for daily living. Medicaid keeps people with disabilities out of institutions. It pays for caretakers so their parents can go to work. And it’s more efficient than private insurance."

Capping the federal share of Medicaid funding "leaves two options," she says. "Either shift costs to already stretched state budgets or cut services drastically." And those cuts will likely include "hearing aids, at-home care, physical therapy, and some people denied coverage altogether." Other likely consequences? Pay cuts for low-paid providers and more institutionalization when people can't access in-home care. Yeah, it's bad.

Read "Republicans' Plan for Medicaid Would Fail My Disabled Brother."

Wednesday, March 8, 2017

When is School Choice Not Really a Choice? Insights from the National Association of State Directors of Special Education

This morning I attended a panel discussion at the Center for American Progress called "What's at Stake for Americans with Disabilities in the Trump Era." Advocates, families, and people with disabilities covered a wide range of issues, including Medicaid, Social Security, civil rights, and education. You can watch the hour-long event here.

In the next few days, I'll report on some of the health topics that were discussed, but I want to start with the topic of vouchers and special education, which was addressed very well by Valerie Williams, director of government relations for the National Association of State Directors of Special Education.

"What's come up a lot lately is the word 'voucher.' Don't get hung up on the word voucher," she said. "When someone talks to you about vouchers, education savings accounts, or scholarships, it's all the same thing. The problem is not the voucher, but the effort to privatize the public school system. Anything that will allow public tax dollars to be diverted to a private school that your child may not be able to attend, that's problematic. Students may be turned away based on disability, sexual orientation, past disciplinary records, or religion."

She offered a realistic scenario of a family with a disabled child that gets a $10,000 to send their child to the school of their choice. First, the parents must sign away their rights under the Individuals with Disabilities Education Act (IDEA), which include required services, legal protections, and reporting on outcomes. A few things can happen:
  • The school may be a good fit for the child, but the cost may be $20,000, only half of which is covered by the voucher. Or the voucher may not cover the costs of books, uniforms, or transportation, which can be thousands of dollars. "So when you're discussing a middle- or low-income family, they can't make that leap, which means it's not accessible to them, and they honestly don't have a choice."
  • The school may tell them in the first few months that they can't offer the specialized services or equipment that their child needs, in which case the family will have to forego those needs or return to the public system, which is mandated to provide those services.
"If you're in a rural area," Williams explained, "the problem is even bigger. Because funds are diverted outside the public school system, and the only school is the public school, so you literally have no other option, and they have less money to work with."

In closing, Williams said, "We need to make decisions as taxpayers and legislators that will benefit the masses, not a few students. I'm concerned that children and adults with disabilities are going to be sicker, less independent, and not educated to the fullest extent they could be, based on some of the ideas that are floating around right now."

She encouraged the attendees to contact their state and federal elected officials and explain not just what they're against, but also how existing programs benefit them and their families.

Is Vaccine Debate Diverting Attention from the Real Risks to People with Autism?

When you hear "Trump" and "autism," you may first think about the president's support for debunked myths that vaccines cause autism. But the uproar over that issue maybe detracting from the real concern -- the harm that will be caused by repealing protection in the Affordable Care Act (ACA) and Individuals with Disabilities Education Act (IDEA), according to health policy experts at the Johns Hopkins Bloomberg School of Public Health and the Center for Mental Health Policy and Services at the University of Pennsylvania.

In a column posted today in the New England Journal of Medicine, the authors point out that the ACA has expanded access to health insurance for low-income people in 31 states and the District of Columbia by expanding the Medicaid program -- the largest health care payer for people with autism and developmental disabilities.

One of the authors, Colleen Barry of the Bloomberg School of Public Health, said, "These rollbacks could be devastating for children and adults with autism and other disabilities. It is important not to let the controversy over the debunked link between vaccines and autism distract from what is at stake in terms of the potential loss of critical benefits this vulnerable group relies on."

The authors are also concerned about threats to the rights of students with disabilities. Barry said, "People who care about preserving and expanding services for children and adults with autism need to pay attention to the conversations in Washington around the ACA repeal and threats to IDEA to make sure important protections and guarantees are not lost."

Read "Care for Autism and Other Disabilities -- A Future in Jeopardy."

New Analysis: 5 Ways Trump Agenda is Disastrous for People with Disabilities

More than 15 million people with disabilities, including children and seniors, would be at risk under the Medicaid cuts proposed by House Republicans and endorsed by President Trump, according to a new study by the Center for American Progress. I'm going to address some of these points in future posts, but for now, here's the short version:
1. Trump's health care plan would push millions with disabilities into institutions.
2. Trump's policies would make it harder for people with disabilities to work.
3. Trump's education plan would harm students with disabilities.
4. Trump would slash programs that provide basic living standards.
5. Trump's administration would weaken disability rights and protections.

The analysis concludes: "If Trump were serious about helping the workers and families who've been left behind -- including millions of Americans with disabilities and their families -- he would reject policies that undermine health care, education, and other basic living standards; push people put of the labor force as well as from their homes into institutions; and erode enforcement of disability rights in favor of a policy agenda that gives people with disabilities and their families a fair shot."

Read more at "5 Ways President Trump's Agenda is a Disaster for People with Disabilities."

This is a great article to share with your friends and family members who support the Republicans' proposal. If you have a personal connection to disability issues, you have a powerful voice -- this is a short, powerful analysis that can change minds and inspire action.

SHARE THIS VIDEO: How Medicaid Cuts will Harm People with Disabilities

Just released today, this video by the Center for American Progress shows three perspectives on how proposed cuts to Medicaid will threaten the health, independence, and lives of people with disabilities. Watch and share.

Use this link to share on your Facebook and Twitter accounts:

Tuesday, March 7, 2017

As Budget Cuts Loom, No One's in Charge of Special Education

Christina Samuels, who writes the "On Special Education" blog for Education Week, continues her good reporting on issues related to students with disabilities. Today she asks, "When Will We Have a New Federal Special Education Chief? (And Why It Matters)." Interestingly, she points out that four assistant secretaries for the Office of Special Education and Rehabilitative Services (OSERS) have been appointed during a president's first term. Those four were nominated during April to June and confirmed as early as June and as late as October.

The advocates who Christina has interviewed aren't concerned about the non-political staff who are involved in special education policy and operations. But with a proposed increase in defense spending and likely cuts in other areas, this vacancy could put special education programs in jeopardy. Katherine Beh Neas, vice president for government relations for Easterseals, told Samuels, "If you don't have a political person in place advocating for the political part of the functions of that department, it leaves the department at risk."

Read the EdWeek article, which also addresses potentially harmful changes to the Every Student Succeeds Act (ESSA). And take a look at Christina's blog, On Special Education.

Sunday, March 5, 2017

Vouchers and Special Education: A Primer

Thanks to Education Week for this graphic illustration of how special education money gets to local schools. As Secretary Betsy DeVos shifts the focus of the public education conversation toward school choice and vouchers, it's important to understand how the current system works. There are a bunch of articles and analyses about this, but here's what I think is important to know.

1. Special education is already underfunded. When the Individuals with Disabilities Education Act (IDEA) was passed in 1975, Congress authorized funding for special education up to 40 percent of average per-pupil spending in public schools. But the current federal contribution is just about 16 percent. Read more details about this at EdCentral from the New America.

Rising spending for special education over the past 15 years is mostly the result of more children being identified as "disabled," not a disproportionate increase in the cost of special education services.

2. Investing in private schools takes resources away from public schools. Read this account by Bonnie Kandel, a parent in Indiana, "Civil Rights Crisis Unfolding: Most Needy Children in America at Risk." She's concerned about the impact that voucher systems and Education Savings Accounts would have on her son, who has autism is attending first grade in a public school (after being asked to leave two private preschools). "Options for students with special needs, like my son, are worse than abysmal. Voucher programs are programs where schools choose the child. He is expensive to educate. Not only does he need special interventions that cost money directly, but he also needs teachers with experience and higher education specializing in autism." Kandel points out that Indiana public schools have already lost $485 million because of the push for "school choice." And she's worried about what will happen with more cuts in more states.

3. Students in private schools often forfeit protections and rights. Voucher programs are risky for families because students who attend private schools aren't guaranteed the same rights and protections as students in public schools are. Many states require parents to sign away some or all of their protections under IDEA, Section 504, and the Americans with Disabilities Act to participate in voucher programs. If a private school determines that a student needs support services like occupational or speech therapy, parents often have to cover those services when they exceed the value of the voucher. And if parents are not satisfied with the education at a private school, they have no legal recourse -- their only choice may be to remove their child and find a new school.

4. Voucher programs have not been shown to improve academic performance -- and have actually worsened academic outcomes in Louisiana, Ohio, Indiana, and other states. As Kevin Carey reports in The New York Times, the latest studies are "very unusual." He writes: "When people try to improve education, sometimes they succeed and sometimes they fail. The successes usually register as modest improvements, while the failures generally have no effect at all. It’s rare to see efforts to improve test scores having the opposite result. Martin West, a professor at the Harvard Graduate School of Education, calls the negative effects in Louisiana 'as large as any I’ve seen in the literature' — not just compared with other voucher studies, but in the history of American education research." Read Carey's column, "Dismal Results from Vouchers Surprise Researchers as DeVos Era Begins."

Learn more from these recent reports from the Center for American Progress:

Thursday, March 2, 2017

Reaction from Guest at Congressional Address: "We all left feeling expendable and disposable."

Jeannine Chartier, Executive and Artistic Director, VSA Arts Rhode Island
Jeannine Chartier had a unique vantage point for President Trump's address to Congress on Tuesday night. As a guest of Congressman David Cicilline (D-RI), the disability advocate and director of VSA Arts Rhode Island watched in the gallery with other invited guests. She shared some reflections with me yesterday as she waited to board her flight back to Rhode Island.

What was it like to watch the speech in person?
It was an honor to be invited by Congressman Cicilline, and he graciously pushed my wheelchair through the long and winding underground "accessible" pathway over to the Capitol. It was an incredible experience, even if it was sometimes horrifying to hear the president's vision for our country.

Who were you seated with?
I was with other guests who had been invited by Democratic members of Congress, and our seating was scattered throughout many Republican guests. Mixed into my corner of the gallery: a woman who told me she had had a heart transplant, women wearing headscarves, several Native Americans in traditional dress, and people of difference races, ethnicities, and sexual orientation -- some wearing buttons promoting causes or simply #resist.

What was it like to be sitting with such a diverse group while President Trump presented his policy proposals?
During much of the speech, we sat stoic while enthusiastic Republicans leaped to their feet applauding his calls to dismantle laws regarding the Dakota Access Pipeline, EPA, health care, and education, while ignoring the rights of minorities (race, gender,  LGBTQ, etc.). While the speech started out on a positive note acknowledging disapproval of anti-Semitism and racism, his words still ultimately seemed to promote stigma and fear, and I feel we all left feeling expendable and disposable.

The president did acknowledge Rare Disease Day.
Yes, the individuals and their stories in the later part of the speech -- a parade of "victims" overcoming hardships. It just seemed to be exploitation and pandering, and completely disconnected from his previous speeches and actions. Sorry if I sound cynical or jaded, but the young woman in the wheelchair and how she was referenced reminded me of the old Jerry Lewis telethon days. No disrespect to the individuals, but his stated plans to dismantle policies and regulations that protect many of us who are minorities to have access to education and health care will only increase our struggles.

What other moments stand out?
A few come to mind. The shock and groan that went out from our side of the aisle about VOICE (Victims Of Immigration Crime Enforcement) was palpable. I don't know if that translated on TV, because the cheers from Republicans may have overwhelmed it, but it was obviously scary to a LOT of people in the room -- people looked at each other in eyes-wide-open shock. And my side of the room couldn't contain WTF laughter over the line, "The time for trivial fights is over." Did he really say that? Oh Lordy...and he pointed to Democrats like they are the ones tweeting at 3:00am.

Are you happy you went?
Yes. It was exhausting physically, but more so emotionally – it was a long speech full of disturbing rhetoric outlining a dark path we are heading down in this Trump presidency. It was a powerful reminder that there's so much to fight for -- and fight against. But I keep reminding myself, it's a marathon and not a sprint.

Disability Scoop

Special Ed News (Education Week)

Special Education Law