Obama vs. Romney: The Bottom Line

All things considered, the 2012 presidential election comes down to one issue for people who care about people with disabilities -- and that's health coverage. Put aside the misleading attack ads and confusing statistics, and consider the following facts.

• Fact 1: The Affordable Care Act prevents insurance companies from denying coverage based on pre-existing conditions or disabilities.
• Fact 2: The Affordable Care Act expands Medicaid coverage for people with disabilities.
• Fact 3: Governor Romney has vowed to repeal the Affordable Care Act on his first day in office.

From the Arc of the United States, read "How the Affordable Care Act Helps People with Disabilities."

Having a major health need, or a chronic health need like a disability, can easily lead to bankruptcy even for working Americans. In Massachusetts, Governor Romney implemented a plan very similar to the Affordable Care Act. Now he wants to deny coverage to 45 million Americans, including veterans, families living in poverty, and people with disabilities. Is that the America we want?

Scary Statistics: Romney's Plan Would Deny Coverage for 30-37 Million Americans

Governor Romney has said several times that he wants to turning Medicaid into a block grant program to the states. A good idea? Sure, if the goal is to take health insurance away from tens of millions of poor people, which is what a new report says it will do. Oh -- and it will also reduce benefits for other Medicaid recipients. And if Romney keeps his promise to repeal the Affordable Care Act, even more people will lose their insurance.

The study comes from the nonpartisan Kaiser Family Foundation's Commission on Medicaid and the Uninsured. By cutting Medicaid spending by $1.7 trillion between 2013 and 2022, the plan would save $810 billion -- by kicking tens of millions of poor people out of the program. And estimated 14.3 million to 20 million Americans would no longer be eligible. By repealing the Affordable Care Act, another 17 million people would not be able to get health insurance, according to the Congressional Budget Office.

The report says it could be much worse. "If there are no requirements that federal payments be matched by state contributions, states could reduce state spending more than federal spending and these enrollment estimates would be understated.” And state payments to hospitals and nursing homes could fall by more than 20 percent, likely resulting in reduced services for seniors in long-term care facilities. So in other words, the people most affected by these cuts would be people with disabilities, poor people, and seniors.

Read the MSNBC article.

Download the 21-page white paper from the Kaiser Family Foundation.

Truth-O-Meter Agrees with Biden: Not One Democrat Supports Romney-Ryan "Bipartisan" Plan for Medicare

If you watched the vice presidential debate, you may remember this exchange:

Ryan: "This is a [Medicare] plan that's bipartisan. It's a plan I put together with a prominent Democrat senator from Oregon."

Biden: "There's not one Democrat who endorses it."

Ryan: "Our partner is a Democrat from Oregon."

Biden: "And he said he does no longer support [it]."

They can't both be right. And politifact.com's Truth-O-Meter says Biden was exactly correct. Here's the explanation. That's not exactly an example of reaching across the aisle and building bipartisan consensus, as Ryan tried to suggest.

What Romney's Not Telling You About His Economic Plan

No politician wants to run a campaign on a message of "I want to cut programs that a lot of people depend on, and tough times are ahead for children and people who are poor, disabled, veterans, students, uninsured, etc." But as President Clinton said at the Democratic Convention, Governor Romney's numbers don't add up. "It's simple arithmetic," he said.

If you want to take a close look at what the reality of Romney's plan is -- what he's not telling you -- read this report from the Center on Budget and Policy Priorities.

Romney says:
1. He wants to cap total federal spending at 20 percent of gross domestic product (GDP).
2. He wants to increase defense spending to 4 percent of GDP.
3. He wants to repeal the Affordable Care Act and exempt Social Security from cuts.
4. He wants to cut Medicare, Medicaid, and all other entitlement and discretionary programs by the same percentage.

To do those four things, he would have to cut non-defense programs other than Social Security by 22 percent in 2016 and by 34 percent in 2022. "If they exempted Medicare from cuts for this period," the report says, "the cuts in other programs would have to be even more dramatic -- 32 percent in 2016 and 53 percent in 2022."

But wait, there's more. "If they applied these cuts proportionately, the cuts in programs such as veterans’ disability compensation, Supplemental Security Income (SSI) for poor elderly and disabled individuals, the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps), school lunches and other child nutrition programs, and unemployment compensation would cause the incomes of large numbers of households to fall below the poverty line.  Many who already are poor would become poorer." The cuts for non-defense discretionary programs would hit public services like elementary and secondary education, law enforcement, veterans' health care, environmental protection, and biomedical research."

Read the report and see the numbers for yourself.

Mom: "Medicare Saved My Family"

Special thanks to Monique Ruffin -- a mother, author, life coach, and advocate for her son, who has Down syndrome -- for today's post. I spotted her emotional post on the Mom.me website, where she and another mother wrote about "What Health Care Policy Means for Moms." Click to read a counter-argument from a mother who does not support the Affordable Care Act. Monique writes:

"When my son was born with Down syndrome, I was shocked by all the new concerns our family faced. Our hearts were happy and heavy at the same time. We were new parents to a beautiful baby boy whose future was uncertain. After spending the first week of his life in the neonatal unit of the hospital, we brought our son home to begin our journey of loving and supporting him as he grows into his greatest potential.

"We quickly learned to take advantage of the support available from various state and federal agencies. Within weeks we were pointed to our local Regional Center, a federally and state funded organization designed to support children and families caring for people with special needs. By the time my son was 4 weeks old, there was someone visiting my home weekly to assist me and teach me how I can support my son’s development. I was directed to an occupational therapist, a speech and communication therapist, a behavioral therapist, and an eating specialist to help me understand and overcome my son’s challenges. The center also offers classes for parents, including how to potty train children with special needs and how to teach special needs kids to read. The information and resources are invaluable and come at no cost to the families of the children.

"My entire life revolves around my ability to receive the services and tools to support my son, who at 5 years old is thriving—largely because of the assistance and guidance of the Regional Center’s staff and services.

"If the Romney/Ryan ticket wins this upcoming election and we suffer more cuts to the services that like those of the Regional Center and Medicare, what will happen to families like mine? The Ryan cuts—between 50 percent and 75 percent—to Medicaid would drastically decrease the federal dollars. These federal cuts would likely force the states to pick up the cost or drop nearly 19 million Medicaid recipients, including the very poor, seniors, and pregnant mothers. Putting millions of families like mine, who are not able to absorb the high cost of medication and treatments, in dire straits. On the other hand, the Obama plan works with health care providers and hospitals to cut their cost. Obama’s plan also creates a health care mandate for all citizens bringing more people into the health care pool.

"It was my family’s need for support and my connection with other families in far more severe conditions—like a single mother with four autistic children—that inspired me to start writing and getting involved in politics like health care reform. Unless you have a child or close family member with special needs, and have faced the onslaught of medical treatments and therapies he or she requires, you don’t understand how these programs help us stay afloat emotionally, mentally, and physically.

"My heart nearly jumps out of my chest when I consider what will likely happen to our babies if the Medicare proposals of the Romney/Ryan ticket are implemented. I am asking myself, 'Are we are nation that wants to stand by as millions of children are denied access to services that not only create possibilities for them, but also actually save their lives?' It is in situations like this that government is needed to assure that all our citizens have access to services that their lives depend on. Such resources would otherwise go only to those with financial means. Is this who we are? I know firsthand of what President Clinton spoke of, but I also know firsthand the progress of a child whose life has an abundance of possibilities, created directly by the love and the care we receive from these life-saving social services."

Follow Monique on Twitter at @moniqueruffin and read her other posts on Mom.me and the Huffington Post.

"Disastrous Educational Agenda"? Voucher Lessons from Milwaukee

One way I collect content for my blog is through Google Alerts for the policy issues that affect people with disabilities. Alerts for Medicaid, Medicare, and health care reform would overwhelm my inbox, and I want to be specifically focused on disabilities -- so I search for the candidates names connected with terms like special education, disability, and disabilities. I've been noticing a distinct trend that my Google Alerts are increasingly critical of the Romney-Ryan agenda in terms of their impact on people with disabilities.

While many (most) in the disability community recognize that more needs to be done to give all citizens equal opportunities, including health care, education, training, and other areas, there is real concern about what a Romney presidency would mean for people with disabilities.

As an example, read award-winning journalist Barbara Miner's latest op-ed, "Romney's Disastrous Educational Agenda: Lessons from Milwaukee" in the Milwaukee Journal Sentinel. Based on her reporting experience in Milwaukee, she writes that "in essence, vouchers are a mechanism to funnel public dollars into private schools. They are an abandonment of both public education and our country's democratic ideals."

In the Milwaukee voucher program, once held up as a national model, only 17.5 percent of students remained in voucher schools after five years, compared with a rate of 43.5 percent for public schools. States tests in math were significantly lower in private schools; reading was about equal.

Miner writes, "Every state constitution in the country enshrines the right to a free and public education for all children—an honor that is not bestowed on other requisites for life, liberty, and the pursuit of happiness, whether housing or employment or healthcare.

"In the current debates on vouchers, there is strikingly little discussion of the relationship between democratic values, civic responsibility, and public education. Instead, education is treated as a mere commodity, with parents and children reduced to mere consumers."

Important to families whose children require special education, in Milwaukee the percentage of special education students in private voucher schools is just less than 2 percent, while it's about 20 percent in public schools. If you are a parent of a child with special needs and think vouchers are the way to go, imagine if you lived in Milwaukee. Do you really think schools with just 2 percent of their students in special ed are investing in the training, staffing, and specialized services that our students require?
Read Barbara's blog, View from the Heartland.

Romney's Voucher Plan: "Disaster for Special Education Students"

Charles Fox, an attorney and parent who writes the excellent Special Education Law blog, provides one of the clearest arguments against Governor Romney's plan to make special education a voucher program. In a post titled "Romney's Educational Vouchers a Disaster for Special Education Students," Fox writes that while choice sounds good in theory, we can't trust the profit-driven market to ensure protections for students with disabilities.

"Charter schools and private schools operate very differently and have different philosophies," he says. "As public schools, charter schools are bound by all of the federal laws pertaining to special education.  It is entirely unclear under this voucher system how many special education students will be accepted to either charter or private schools and what legal protections will follow them. Given Mr. Romney’s hands-off philosophy and market-oriented approach, the likely answer is few if any protections, or as he states derisively, 'regulations' would apply to protect students who opt to use a voucher.

"Congress is authorized to fund up to 40 percent of the cost to educate special education students, bu tin reality, the amount Congress contributes is approximately 16 percent, or $1,950, of the average expenditure per student.The cost to educate a special education student tends to be higher than a regular education student, so profit-maximizing driven private schools will have no incentive to take special education students. The whole premise of better outcomes through competition is very much an illusion for these students."

Some states have experimented with vouchers already -- most notably, Florida under then-Governor Jeb Bush. As Fox explains, "In the McKay Scholarship Program, special education students are given vouchers equal to the lesser amount of the cost of the child’s education in his home school or the tuition charged by the private school he is attending....The amount of vouchers given to these students in 2011-12 ranged from $4,280 up to $18,529; the average voucher was for $6,849." In many areas, this amount would not begin to pay for specialized education for children with disabilities.

And then there's this: "An investigative report by the Miami New Times revealed a 'cottage industry' rife with 'fraud and chaos.' The award-winning author of the report wrote the McKay program was 'like a perverse science experiment, using disabled school kids as lab rats.'" Fraud was reported in 25 of 38 schools. "What came out of these reports and what is particularly troubling is the realization that there is no requirement for McKay schools to be accredited. And because these schools are private, the Department of Education can neither monitor curriculum nor prohibit use of corporal punishment. And finally, because these schools are private, there is no system of assessments to overall gauge the progress of their students."

Many charter schools cater to students with mild disabilities. The Council of Parent Attorneys and Advocates (COPAA) has reported that students who have more significant disabilities are excluded from charter schools through a process of “selectivity, controlled outreach, counseling out, and other push-out practices.” 

Fox asks, "So what happens to the more profoundly disabled special education students or those that cannot or choose to not take the voucher if the special needs students with more mild disabilities (and their dollars) are siphoned out to charter or private schools? Will the school districts be left with the resources to educate these students? Are there really other options for these students?  The clear answer is 'no.' There will be few other options, and the prospect for special education students left in the public schools is dismal at best.

Fox concludes, "Sorry, Mr. Romney, but your education policy seems to be poorly thought out. We cannot put our children at risk and subject them to the tender mercies of the market place. Special education students need more, not less, from the education system....Let’s make the current education system stronger and more accountable. We cannot take a leap of faith that the market will provide for students with special needs when we know the economics, the current data, and common sense all strongly prove otherwise."

Vouchers: What Would They Mean for Special Education?

Last night, Education Week sponsored a debate at Teachers College at Columbia University on education between education advisers for President Obama and Governor Romney. I'll post the video and transcript when it's available soon. If you care about education, especially special education and Title I funding for families in poverty, I strongly encourage you to watch the debate. I guarantee it will give you more substantive information on education policy than you'll get in tonight's presidential debate.

In the debate, much time was devoted to the candidates' differing strategies to improve education and choice for students and parents. Romney has advocated turning Title I and the Individuals with Disabilities Education Act (IDEA) into a voucher program. Next to health care reform and Medicaid, this may be the most important issue in this election for people with disabilities. The Romney camp argues that vouchers will give families more choice and reward good schools; the Obama camp agrees with the concept of choice, but are concerned about removing the protections that the federal law currently provide.

As background, I recommend these two articles by Nirvi Shah, who does a great job reporting on special education issues for Education Week. Keep up on this and other special ed issues by following her "On Special Education" blog.

Read "Details of Romney's School Choice Plan Emerge," May 24, 2012. Excerpt:

"Many advocacy groups warn parents against using vouchers for students with disabilities because, in doing so, they give up their rights outlined in federal education and disability laws. And they may not know that.

" 'We have to remember that a family with a child who has a disability never really has the same choice as others. By virtue of having a disability that qualifies them for an Individualized Education Program, a private school for instance, would never guarantee via a voucher that they would provide a free appropriate public education and the services outlined in the IEP,' said Laura Kaloi of the National Center for Learning Disabilities.

"In addition, the Council for Exceptional Children's Lindsay Jones says that it's the wrong time to consider siphoning special education funding from public schools.

" 'This proposal's potential to take money out of our public school system and place it in the hands of private business is also especially concerning at this point in time,' Jones said. 'School districts around the nation have seen deep cuts in funding over the last few years as our nation confronts a recession, increased needs, and declining revenues. These cuts have impacted districts' ability to provide services to children in need—further cuts won't help.' "

Read "Would Romney Voucher Plan Equalize Special Ed. Opportunities?" June 8, 2012.

Shah cites an article from the Atlantic by a parent and attorney who says "there's already a system of vouchers built in: Schools that believe they can't provide the right educational services and environment a student needs can choose to send that student to a private school, at the public school's expense. It's called private placement."

Shah reports, the author "goes on to say that for Romney's plan to work, state and local special education dollars would also have to become portable, something I can't imagine every state and school board agreeing to. Many special education advocates oppose vouchers, however, because unlike private placements, students lose their protections under federal law—the very law that would be paying for their private schooling under Romney's proposal—IDEA."

Will Romney Cut Funds for Autism Program He Supported in Massachusetts?

As explained in this article, "Would President Romney Cut Medicaid Funds for Program Governor Romeny Asked For?," in 2008 "Governor Romney signed a law directing the state to ask the federal government for more Medicaid money for home and community support services for autistic children who, without that support, would be classified as at risk of being placed in an institution....Today the program is helping 160 children and their families get services at home."

In three years, the state will need to ask the federal government to renew those funds. What would a President Romney do with that request? As President Clinton warned in his Democratic Convention speech, "They also want to block-grant Medicaid, and cut it by a third over the coming 10 years. And a lot of that [Medicaid] money is…spent to help people with disabilities, including a lot of middle-class families whose kids have Down syndrome or autism or other severe conditions. And honestly, let’s think about it, if that happens, I don’t know what those families are going to do."

The Republicans went after Senator Kerrey as a flip-flopper in 2004, and I realized at the time that any elected official with a record could be charged with the same thing. In that election, it seemed to stick, and it leaves me wondering why Romney's not being pinned with the same label.

As Governor, Romney passed one of the most progressive health care reform laws in the nation, which has increased the number of residents covered by health insurance from 90 percent to 98 percent. The program ended discrimination by insurance companies, mandated coverage, and provided government subsidies to make the mandate feasible. The program closely resembled President Obama's Affordable Care Act.

And that's what's so interesting. Romneycare was a model for Obamacare. MIT economist Jonathan Gruber advised both Romney and Obama on their plans. And now Romney's number 1 issue is repealing the Affordable Care Act, which he says he'll do on his first day in office.

With that in mind, it's hard to know who the real Romney is, and what he's likely to do as president. He hasn't laid out clear plans, so you have to read between the lines of his speeches, look at his running mate's record and plans, and look at his record as governor. And even then, you just don't know.

The Candidates on Health Care: A Detailed Review

Kaiser Health News analyzes the health records and plans of President Obama, Governor Romney, and Congressman Ryan. Review them for yourself -- these are very detailed documents.

Obama on Health Care

Romney on Health Care

Ryan on Health Care

Easter Seals on Campaign Issues: Exclusive Interview

I'd like to thank Katherine (Katy) Beh Neas, senior vice president for government relations at Easter Seals, for taking the time to talk with me about critical disability issues as we approach the 2012 presidential election. Katy has been focused on these issues since the late 1980s, when she worked in the Senate on legislation including the Americans with Disabilities Act and the Individuals with Disabilities Education Act. In her current role, she monitors and analyzes federal legislation and regulations affecting children with disabilities and their families, particularly in the areas of autism, early intervention, early childhood education, special education and budget and appropriations.

We discussed the record of the Obama Administration, health care reform, special education, and key differences between the candidates' positions.

Q: When you consider the issues that are important to people with disabilities, how would you assess the commitment and the actions of the Obama Administration? What has been done well, and what requires more attention?

A: First, what's been done well: Easter Seals launched a major initiative in 2011 – Make the First Five Count – to reduce the number of young children who enter kindergarten with a disability or developmental delay that hasn’t been identified or addressed. Our research shows that approximately 1 million kids fall into this category. An element of the MFFC campaign is advocacy to increase funding for the federal early intervention program, Part C of the Individuals with Disabilities Education Act. President Obama’s budgets have called for increases in Part C over the past two years. We are very pleased with his leadership in this area. In addition, the President has championed health care for people with disabilities in the Affordable Care Act, Medicaid and Medicare.

What needs more attention? Easter Seals was disappointed that the Administration is not working on implementation of the CLASS Act – the Community Living Assistance Services and Supports Act – this policy was adopted as part of the Affordable Care Act and would establish a voluntary long-term care assistance policy.

Q: The Easter Seals strongly supported the Supreme Court's decision to uphold the major portions of the Affordable Care Act. How could the ACA be strengthened to meet the needs of people with disabilities. What are the biggest benefits?

A: While there are many benefits within the ACA, some of the insurance market reforms are truly transformational. The elimination of pre-existing condition exclusions for kids and extending coverage to dependent children are huge first steps. Families with kids with disabilities no longer have to worry about whether their child will be dropped from coverage because of a chronic condition or disability. We are also working to shape how the rehabilitation and habilitation benefits are designed so that people with disabilities of all ages can get the appropriate habilitation services that can help a child gain a skill he or she never had or help an adult slow down the regression of a disability. The bulk of the ACA comes online in 2014. Our hope is that the law stands and that states will continue to work to meet this important deadline.

Q: Governor Romney has vowed to repeal the ACA on his first day in office, if he's elected. Would that have any immediate impact on families living with disabilities?

A: Prior to the enactment of the ACA, most people with disabilities were unable to buy health insurance on their own. Pre-existing condition exclusions made it virtually impossible for children or adults with disabilities to get coverage outside of an employer provided plan or outside of a government program like Medicaid. For many, Medicaid eligibility requires the individual to have an extremely low income. The ACA changed all of that, and today, no child with a disability can be dropped from coverage because of a pre-existing condition. For this reason alone, Easter Seals opposes repeal of the ACA.

Q: You've helped lead the Consortium for Citizens with Disabilities since its founding. Has health care reform been a contentious issue among the 50 organizations that are part of that consortium? What principles do they agree on, and where has there been debate?

A: I’ve been a member of the Consortium for Citizens with Disabilities for 21 years, and chair its Education Task Force. My colleagues at Easter Seals have been very involved in the CCD Health, Long Term Services Supports, Employment and Training and other Task Forces. This coalition has a solid track record of working across disparate groups to find areas of agreement. I believe that there was very strong support for health reform among the majority of groups. I have attached a copy of the CCD principles on health reform as well as Easter Seals’ principles.

Q: In all the talk about health care reform and Medicaid, the topic of education seems to be a much lower priority. Yet for students with disabilities, services funded by the Individuals with Disabilities Act are a daily need. What do you think of the Romney-Ryan proposal to privatize special education funding?

A: Funding for special education services is always a hot topic. The Individuals with Disabilities Education Act (IDEA) is a civil rights law that requires states to provide a free, appropriate public education to each child with a disability regardless of the nature or severity of the disability. Congress also provides billions of dollars each year to states to help them meet their obligation. The law currently provides the rights to a child to have his or her special education needs met at no cost to his or her family. Easter Seals believes that funding for quality early education and care services is the best way to decrease special education funding. We know that when kids get their special needs addressed before they enter kindergarten, they need less special education services. Our goal should be to focus on what works – to ensure that every child has a chance to succeed and with that success comes a more productive and independent life.

Q: For my readers who are studying the records and platforms of the presidential candidates, what would you say are the biggest differences between the candidates' philosophies and policies as they affect disability issues?

A: The treatment of Medicaid is among the biggest difference between President Obama and Governor Romney. President Obama is working to protect access to appropriate services to children with disabilities and long term services to adults with disabilities that are currently available under the Medicaid program. Governor Romney’s platform proposes to alter the Medicaid program from one that guarantees specific services to one that is a block grant to states that eliminates any guarantees.

Q: Is there any other information you think families should have as they prepare to vote this year?

A: This election is really important. Elected officials at all levels of government will make decisions that affect the lives of children and adults with disabilities and their families. I would urge all of your readers to educate themselves about the positions of the candidates and then vote. Elected officials need to know how their priorities either support or hinder the quality of life of children and adults with disabilities. It’s up to all of us to educate them.

If you want to learn more about these issues, Katy recommends "Principles for Health Care Reform from a Disability Perspective," prepared for the Consortium for Citizens with Disabilities, and the Easter Seals' principles for health care reform.

Visit the Easter Seals website, learn about the Make the First Five Count initiative, or read Katy's bio.

Ryan Budget: "Dangerous to People with Disabilities"

At times in his political career, Governor Romney has been known as a solid moderate. As governor of Massachusetts, he was praised by noted liberal Senator Ted Kennedy for pushing for progressive health care reform and expanding coverage for that state's residents. In fact, "Romneycare" became a model for "Obamacare," and both Romney and Obama relied on the same adviser to help shape those plans.

But as the Republican Party shifts to the right, Romney sent a strong signal to the right wing of the party when he selected Rep. Paul Ryan as his running mate. Unlike Romney, Ryan has a clear voting record at the federal level, and his proposals for the federal budget are the closest we have to a Romney-Ryan policy plan.

If you are concerned about disability issues, you don't need a crystal ball to see how disability advocates will react to a Romney-Ryan agenda. All you have to do is look back to March and see the reaction to his proposed budget as chairman of the House Budget Committee. The Consortium for Citizens with Disabilities (CCD), a group of 113 organizations representing the needs of people with disabilities, issued a strongly worded statement calling his proposal 

"dangerous for people with disabilities as it calls for deep cuts to Medicaid, deep cuts in spending for non-defense discretionary programs that support the health and well-being of people with disabilities, and would lead to tens of millions of Americans losing their health insurance or become underinsured."

 Donna Melzer, chairperson of CCD, said:

“The programs that would be cut under this bill make up the safety net of programs that people with disabilities of all ages depend upon. This Budget Resolution flies in the face of the Budget Control Act of last August, which was carefully negotiated and set already tough spending caps on both defense and non-defense programs. This budget goes much deeper than those caps. CCD urges a more balanced approach to deficit reduction.”

CCD's statement also said:

"Chairman Ryan says that these cuts to programs are necessary due to the nation’s severe fiscal situation. However, these cuts, and in some cases even wholesale elimination of programs, would surely be worse. Under Chairman Ryan’s budget many more people with and without disabilities will be in dire straits losing access toboth physical and mental health care that is urgently needed, veterans would not benefits from critical health and employment services, and children will not have access to supports and services in the education arena. This is not the America that CCD envisions for anyone."

And what did Governor Romney said about that same plan?

“I’m very supportive of the Ryan budget plan. I think it’d be marvellous if the Senate were to pick up Paul Ryan’s budget and adopt it and pass it along to the President.” [source: Ryan Lizza, "Fussbudget: How Paul Ryan Captured the GOP," The New Yorker, Aug. 6, 2012]

Pre-Existing Conditions: "Romney's Sick Joke"

In an Oct. 4 op-ed in the New York Times, Paul Krugman may have touched a nerve, considering his piece has garnered 600 comments and counting. Titled "Romney's Sick Joke," Krugman fact-checks Romney's claim in the first presidential debate that his health plan covers pre-existing conditions.

But his advisers said before and after the debate that pre-existing conditions are not covered. Krugman asks: "Was Romney lying? Well, either that or he was making what amounts to a sick joke."

The truth: Romney's plan would cover people with pre-existing conditions who 1) already have a health plan that covers their condition and 2) can afford to pay the premiums if they lose their job. Over the past decade, fewer jobs offer health insurance. And that's already in current law.

Under Romney's plan, an estimated 89 million would not have insurance, which represents a third of the population under 65 years old. Another way to look at it is that 45 million people who would have health insurance if President Obama would lose it if Romney wins. Under the Affordable Care Act, people who have insurance don't have to worry about losing it, but a repeal of the ACA would remove that security.

Politico also covered the issue in this article, "Romney's Pre-Existing Condition Plan: A Tweak and a Handoff to the States."

Krugman writes that this is "the issue that should be at the heart of this election." What do you think, and do you support Obama's or Romney's approach to health coverage?

Vouchers for Special Education? The Threat to Students

Throughout this campaign, Governor Romney has been largely silent on one of the issues that is most important to families with children with special needs -- education. Romney and Ryan have a consistent theme of downsizing government and reducing government control in almost every area, including education. While they are not saying specifically how that would affect federal programs that ensure that children with special needs receive an appropriate education, there have been suggestions that have families worried.

As a parent of a third-grader with special needs, I've learned that getting the services she's entitled to is very hard. It requires research, professional advice, and the support of parents who have been through the same challenges. And that's in a county that's supposed to be one of the best for special education. And it's with the protections that the federal government provides. Imagine if those protections were loosened.

The law that governs special education is the Individuals with Disabilities Education Act (IDEA), and the biggest issue about the program is that it has been woefully underfunded and therefore not as effective as it could be. IDEA provides about $11.6 billion to states and local education entities each year to serve roughly 6 million students, which is far less than the districts need for these specialized services.

Romney wants to turn the program into a voucher system. It makes sense from a perspective of "reduce the federal government and let the states and parents pick up the costs," but in practice, the idea poses a substantial risk to families who are already struggling with major financial needs. Read about his plan in Education Week.

In this commentary, "Romney's Radical Plan for Title I and IDEA,"a speech therapist in a public school points out the flaws in Romney's logic:

"Not all Title I or IDEA kids are the same; not all need identical services....Imagine two IDEA special education students, Abby and Ben. Abby has only a mild speech impairment, and receives 30 minutes/wk of speech therapy at school. But Ben has multiple, severe disabilities. He requires Life Skills classes; speech, physical, and occupational therapy; an orientation and mobility specialist; and an aide to help him with activities of daily living like eating and toileting. Will Abby and Ben each get the same flat voucher amount to put in their backpacks? If not, what formula will you use to determine how much each student should get?

"And of course, Title I and IDEA help pay for programs and equipment that are not student-specific. For example, my district has all kinds of equipment to help kids with disabilities participate in regular PE classes with their peers. One piece of equipment may be used throughout the day by multiple students. I'm a speech therapist, and we have test instruments and therapy materials that we share across schools, when needed. It's not always cost-effective to buy software for one student with a learning disability, but it becomes much cheaper the more site licenses you buy....Does anyone really believe that a tiny charter school is going to be able to provide all of this support on Johnny's $1,000 voucher?

"[In Romney's opinion] we cannot help each other out by pooling money for insurance so that everyone can have health care. We cannot help each other out by pooling education funds so that all kids, no matter how severe their needs, can get the education they deserve. No, Romney's going to do away with any hint of collectivity; put a random dollar value on your child's education; and give him a coupon for Voucherville instead."

Obama vs. Romney: Weigh In

After a respite, Special Needs Truth is back to report on the last few weeks of the presidential election -- as always, with a strong focus on what this election will mean for people with disabilities and the families who care for them.

In this first post on the election, I have no commentary, but a question: Do you think people with disabilities will be better off if we re-elect President Obama or elect Mitt Romney? And why? I'll share my own perspectives in the coming weeks.

Please comment and share this post with others!