TIME Health Care

11 Numbers to Explain Obamacare on its Fifth Anniversary

Marketplace guide Jim Prim works on the Healthcare.gov federal enrollment website as he helps a resident sign up for a health insurance plan under the Affordable Care Act at an enrollment event in Milford, Delaware on March 27, 2014.
Andrew Harrer—Bloomberg/Getty Images Marketplace guide Jim Prim works on the Healthcare.gov federal enrollment website as he helps a resident sign up for a health insurance plan under the Affordable Care Act at an enrollment event in Milford, Del. on March 27, 2014.

The Affordable Care Act turned five years old Saturday, but that’s not the most important number you need to know about President Obama’s controversial health care law.

To mark the law’s anniversary, here are 11 numbers you need to know to understand the law:

$142 billion: What the Congressional Budget Office projects the law will cost over the next decade

16.4 million: Number of previously uninsured Americans who have gotten coverage under the law

2.3 million: Number of previously uninsured young adults, ages 19-25, who have gained health insurance through the under 26 provision, which allows them to stay on their parents’ plan

29: Current number of states that accepted the law’s Medicaid expansion (including Washington, D.C.)

24,000: High-end estimate of how many lives the law could save per year by increasing the number of insured Americans

50+ : Number of times the GOP-controlled House has voted to repeal the law, in whole or in part

30: Number of Democratic senators who voted for the law who are no longer in office

25: Number of states that signed on to a Supreme Court challenge to the law in 2012

7: Number of states that signed on to a Supreme Court challenge to the law in 2015

2% of annual household income or $325 per person: The fine for not having coverage in 2015

43%: Percentage of Americans who don’t support the law (41% support it)

TIME White House

Obama Administration Unveils New Fracking Rules

Mody Torres (L) and Josh Anderson of Select Energy Services connect hoses between a pipeline and water tanks at a Hess fracking site near Williston, North Dakota Nov. 12, 2014.
Andrew Cullen — Reuters Mody Torres (L) and Josh Anderson of Select Energy Services connect hoses between a pipeline and water tanks at a Hess fracking site near Williston, North Dakota Nov. 12, 2014.

Tightens use of chemicals on federal land

The Obama Administration announced Friday the first major nationwide hydraulic fracturing safety rules since the technology sparked an energy boom in the U.S.

Under the rules, companies drilling on federal land must publicly disclose what chemicals they use in “fracking” — a mining technique by which rocks are fractured by pumping a liquid compound deep underground — within 30 days of operations. The regulations also tighten standards for collecting wastewater and keeping the groundwater protected.

The Interior Department said that meeting the new regulations would cost companies less than one-fourth of 1 percent of the estimated cost of drilling a well.

The new rules apply to the over 100,000 oil and gas wells on federal government and American Indian lands and exclude some major drilling areas with their own ordinances. Only around 11 percent of U.S. natural gas production and 5 percent of oil production is produced on public lands, according to Bloomberg.

The Republican-led Senate has already introduced a bill to stop the regulations from coming into force, arguing that states alone should have the right to regulate hydraulic fracturing. Some environmental groups also oppose the regulations, arguing they don’t go far enough. The League of Conservation Voters (LCV) legislative rep, Madeleine Foote, said the proposal was a “missed opportunity.”

 

 

 

TIME Drugs

New Senate Bill Could Solve Medical Marijuana’s Tax Problems

Katy Steinmetz / TIME Bryan and Lanette Davies pose for a portrait at their "Christian-based" medical marijuana dispensary in Sacramento in February 2014.

The bill aimed at healing the sick could save dispensary owners lots of money

When Bryan and Lanette Davies got an $875,000 bill from the Internal Revenue Service, they didn’t pay it. Instead, they took the IRS to court, arguing that a 1982 law meant to prevent drug traffickers from deducting business expenses should not apply to Canna Care, their small “Christian-based” medical marijuana dispensary in Sacramento—or any other medical marijuana dispensary legal under state law.

The couple is in the midst of a years-long legal battle over these expenses, arguing that marijuana dispensaries should be treated like most other small businesses and be allowed to deduct payroll, rent and health benefits from their taxable income.

But a new bill introduced in the Senate could help bring their trial to a conclusion.

On March 10, three Senators introduced a historic bill called the CARERS Act that would end the federal ban on medical marijuana, clearing up the discrepancy between federal law that considers pot an illegal drug and the 23 state laws that sanction the use of medical weed. The bill explicitly does several things: It would reschedule marijuana as a drug with known medical uses to allow for research. It would allow banks to work with dispensaries—both medical and recreational—without fear of being prosecuted for money laundering. And it would create an exception in the Controlled Substances Act that essentially says it doesn’t apply to medical marijuana in states where that substance has been legalized. That last part may help solve legal pot’s tax problem.

An obscure bit of the tax code known as 280E states that businesses in violation of the Controlled Substances Act can’t take a tax deduction or receive any credits for any expenses connected with their trafficking of illegal drugs, which is what medical marijuana dispensaries are currently doing in the eyes of the federal government. (Due to a tax court ruling, the one deduction they can take is for the cost of goods sold). The costs can be crippling, and politicians have joined dispensary owners in saying that prohibiting cocaine dealers from writing off the boats they bought to ship the drug, as one lawyer put it, is not the same as businesses deducting quotidian operating costs while on the right side of the law in their state.

In 2010, a group of Congress members, including Colorado Rep. Jared Polis and former Massachusetts Rep. Barney Frank, sent letters to the IRS asking the agency to interpret the tax code in a way that would allow medical marijuana businesses to be taxed on net income instead of gross income. This is what the IRS told those members of Congress in response:

Because neither section 280E nor the Controlled Substances Act makes exception for medically necessary marijuana, we lack the authority to publish the guidance that you request. The result you seek would require the Congress to amend either the Internal Revenue Code or the Controlled Substances Act.

Legal experts have said that the IRS’ hands are essentially tied. If this bill passes, University of Denver’s Sam Kamin says that may be enough for the IRS to loosen the rope and issue that guidance. “It definitely puts marijuana on much sounder footing and makes much clearer what the legal rights of marijuana businesses are,” he says.

Dan Riffle, director of federal policies for the Marijuana Policy Project, who worked with the Senators’ offices on the Hill to craft the bill, is more absolute in his interpretation: “It resolves the 280E issue.”

Both of them agree that the bill has the potential to affect other areas of life too, in states where medical marijuana is legal. It may prevent people from being fired for using marijuana as medicine. Parents may no longer lose custody of their kids for having medical marijuana in the house. Known medical-marijuana users could be allowed to legally own a firearm; if a drug user or addict currently possesses a firearm, that’s punishable by up to 10 years of jail time.

Malik Burnett, policy manager at the Drug Policy Alliance—which also had a hand in crafting the bill—cautions that these are only potential interpretations of a potential law and that separate, explicit legislation should be passed if reform advocates want to definitively solve these issues. But he says the bill would enable lawyers to make stronger arguments to protect clients who use medical marijuana. “You would certainly have more solid ground to stand on,” he says.

Since being introduced, the bill has gained two cosponsors: Republican Sen. Dean Heller of Nevada and, as of Monday, Democratic Sen. Barbara Boxer of California. Despite bipartisan support for the bill, it remains unclear whether it will be taken up in the Republican-controlled Senate.

The Davieses, in an interview for a previous article on their legal battle, said that they not only see themselves as a legitimate business but as a force of positive change in society. Lanette Davis said she felt they were being unfairly punished. “It has to do with taking care of the sick and ill. Jesus Christ made a statement that all people should care for one another, and this is our way of taking that to our community,” Lanette said. “What we try very hard to provide is a way for people to get well.”

TIME Innovation

Five Best Ideas of the Day: March 19

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. Instead of fighting about the Iran nuclear talks, Congress and the White House should be planning smart sanctions in case a deal falls through.

By Elizabeth Rosenberg and Richard Nephew in Roll Call

2. DARPA thinks it has a solution to Ebola — and lots of other infectious diseases.

By Alexis C. Madrigal at Fusion

3. A stand-out rookie’s retirement after one year in the NFL over fears of brain injury should be a wake-up call for all of football.

By Ben Kercheval in Bleacher Report

4. When patients are urged to get involved in their course of treatment, they’re more confident and satisfied with their care.

By Anna Gorman in Kaiser Health News

5. We don’t need “diversity” on television. We need television to reflect the world around us.

By Shonda Rhimes in Medium

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Health Care

Support for Obamacare Highest in Years, Poll Says

The country is almost evenly divided.

The gap between Americans who support and oppose President Obama’s controversial health care law shrank to its narrowest margin in more than two years, according to a new poll.

A Kaiser Health Tracking Poll conducted in March found that 41% of respondents had a favorable view of the Affordable Care Act—up from 1% in January—and 43% had an unfavorable view. The numbers are a marked increase from July 2014, when the same poll found 53% of respondents viewed the law unfavorably, and they come just ahead of the five-year anniversary of the law’s enactment this weekend. Kaiser has tracked opinion on the health care law regularly.

Support largely fell along party lines, with 74% of Republicans expressing an unfavorable opinion and 65% of Democrats expressing a favorable view. While most people said the law had no direct impact on them, Republicans were far more likely to say it had hurt them than Democrats.

In total, 30% of respondents said that Congress should repeal the law, including 11% of Democrats and 61% of Republicans, while 46% of respondents said the law should remain as is or be expanded, including 72% of Democrats and 16% of Republicans.

Most respondents—53%—also said they were not aware of the Supreme Court case underway that threatens to roll back a key feature of the law.

The poll of 1,503 adults, conducted March 6-12, has a margin of error of three percentage points.

TIME White House

Obama Comes Out Swinging Against House Republican Budget

President Obama
Brendan Smialowski—AFP/Getty Images President Barack Obama speaks at the City Club of Cleveland on March 18, 2015.

He criticized the budget proposal during an event in Cleveland

President Obama took his trash talking on Republicans’ 2016 budget proposal on the road Wednesday, telling a Cleveland audience it offers a “path to prosperity [for] those who are already prospering.”

During a speech to the City Club of Cleveland, the President said though the success of his plan to expand “middle-class economics” proves that “trickle-down economics” don’t work, Republicans’ budget proposal—which would balance the budget within 10 years—doesn’t reflect that.

“We know now that the doom and gloom predictions that justified this [type of] budget in the past were wrong,” Obama said. “Despite the new evidence, their approach hasn’t changed. “

Since the House budget was released on Tuesday the Obama administration has come out swinging, using it as a convenient foil against his own budget ideas. Republicans suggest cutting $5.5 trillion from the budget over the next ten years, mainly by pulling back investments in domestic programs. Defense spending under the budget would increase, about $36 billion over Obama’s budget. The budget also calls for repealing Obama’s signature health care law.

The President was particularly critical of the tax proposals in the Republican budget, which he said would benefit the wealthiest Americans and leave middle class Americans out to dry. “Those at the top aren’t asked to sacrifice a single dime,” Obama said.

House Speaker John Boehner, a Republican from Ohio, hit back at the President’s appearance in his home state. “Sadly this is just the latest example of President Obama putting campaign-style events and partisan politics above governing. And it’s all a ruse designed to distract from the president’s own problems, “ a post on the Speaker’s website reads.

TIME Congress

Senate Democrats Block Anti-Trafficking Bill, Again

Senate Minority Whip Richard Durbin, D-Ill., speaks to reporters on Capitol Hill in Washington on March 17, 2015. From left are, Sen. Patty Murray, D-Wash., Sen. Charles Schumer, D-N.Y. Durbin, and Senate Minority Leader Harry Reid of Nev.
Molly Riley—AP Senate Minority Whip Richard Durbin, D-Ill., speaks to reporters on Capitol Hill in Washington on March 17, 2015. From left are, Sen. Patty Murray, D-Wash., Sen. Charles Schumer, D-N.Y. Durbin, and Senate Minority Leader Harry Reid of Nev.

Senate Democrats again blocked a bill Wednesday that would create a fund to help victims of human trafficking over concerns about an abortion provision.

Even Democratic co-sponsors of the bill have backed off of it in the past week, claiming that they did not notice a provision that would bar the fees raised from perpetrators to build the fund to pay for abortions. After failing to nab the necessary 60 votes on Tuesday, Republicans failed to clear a procedural hurdle again Wednesday. Illinois Sen. Dick Durbin, a member of the Democratic leadership, says “there’s only one way” to now break the impasse.

“They’ve got to take the offensive language out or take the bill off the floor,” he told TIME.

Republicans have blasted Democrats for blocking a bipartisan bill once expected to pass easily. Senate Majority Leader Mitch McConnell said before the vote Wednesday that Democrats had made a “historic mistake.”

“Democrats actually filibustered a bill to help victims of modern slavery, apparently because left-wing lobbyists told them to,” he said.

The bill’s delay has pushed back the confirmation vote of President Obama’s Attorney General nominee, Loretta Lynch, who has had to wait around 130 days, longer than the past five nominees combined. McConnell has said that her vote will occur once the sex-trafficking bill is passed.

TIME Congress

Senate Democrat Says Nominee Told to ‘Sit in the Back of the Bus’

Justice Department Officials Announce Charges Against HSBC
Ramin Talaie—Getty Images U.S. Attorney for the Eastern District of New York Loretta Lynch arrives for a news conference to announce money laundering charges against HSBC on Dec. 11, 2012 in the Brooklyn borough of New York City.

The White House has avoided making similar arguments

Senate Democrats are turning up the heat on Republicans for delaying a vote on Attorney General nominee Loretta Lynch, implying that it’s tied to her race.

Sen. Dick Durbin, the No. 2 Democrat in the upper chamber, argued that the four-month delay of Lynch, the first African-American woman nominated for the post, may be related to her race. Using wording suggestive of the days of segregation, he said that Lynch had been told to “sit in the back of the bus.”

Durbin said that there was “no substantive reason” for delaying Lynch’s confirmation process, which has been the longest for an Attorney General nominee in 30 years and longer than the past five nominees combined.

“This is the first African-American woman in the history of the United States to be nominated to serve as attorney general. It is a civil rights milestone,” said Durbin. “Why has the Senate Republican leadership decided to target this good woman and to stop her from serving as the first African-American attorney general of the United States of America? There is no good reason. There is no substantive reason.”

“Loretta Lynch, the first African-American woman nominated to be attorney general, is asked to sit in the back of the bus when it comes to the Senate calendar,” he added. “That is unfair, it’s unjust, it is beneath the decorum and dignity of the United States Senate. This woman deserves fairness.”

Durbin’s comments echoed those of Democratic Rep. G.K. Butterfield, the chairman of the Congressional Black Caucus, who said Tuesday that race “certainly can be considered a major factor” in her delay.

But Durbin’s rhetoric Wednesday is a clear escalation from those of his Democratic colleagues. White House spokesman Josh Earnest reiterated Tuesday that Lynch is well qualified for the post but did not remark on her race.

“Well, let me just say that if Ms. Lynch were not confirmed by the United States Senate, it would be an astonishing display of partisanship,” said Earnest. “Particularly given the fact that not a single member of the United States Senate has raised a legitimate concern about her aptitude for that office.”

Senate Majority Leader Mitch McConnell has said that the Lynch vote won’t occur until after the Senate passes a bill that would help victims of sex trafficking, which Democrats have been filibustering recently over abortion provisions. McConnell spokesman Don Stewart said that the Lynch nomination is next on the schedule and would occur as soon as Democrats lifted their obstruction.

“The only thing holding up that vote is the Democrats’ filibuster of a bill that would help prevent kids from being sold into sex slavery,” said Stewart. “The sooner they allow the Senate to pass that bipartisan bill, the sooner the Senate can move to the Lynch nomination.”

With reporting by Maya Rhodan/Washington

TIME Military

Pentagon and Its Allies Begin the Budget Death Watch

House Armed Services hearing with Joint Chiefs of Staff for FY2016
Yuri Gripas / REUTERS General Raymond Odierno, the Army's chief of staff, testifies before the House Armed Services Committee on Tuesday.

Bottom Line: 'The only way to save lives is to boost spending'

War is a nasty business. Soldiers and civilians die. It has been ever thus.

That’s what makes Tuesday’s hearing before the House Armed Services Committee distressing. Unless the Pentagon gets more money next year, a senior member of the House Armed Services Committee and the Army’s top general agreed, more U.S. soldiers will die.

Rep. Michael Turner, R-Ohio, pressed Army General Ray Odierno on the declining readiness rates of his 32 brigade combat teams. Only one in three of the 5,000-troop units is ready to go to war today, short of the Army’s two-in-three target.

“Doesn’t this mean that more people will get injured or killed?” Turner asked the Army chief of staff. “It’s not just an issue of readiness, risk, capability or mission. It’s that more people will get injured or killed. Is that correct?”

“That’s absolutely right, Congressman,” Odierno responded. “It means it’ll take us longer to do our mission. It’ll cost us in lives. It’ll cost us in injuries. And it potentially could cost us in achieving the goals that we’re attempting to achieve, as well.”

House Oversight Committee Hearing On Obamacare Transparency
Andrew Harrer / Bloomberg via Getty ImagesRep. Mike Turner. R-Ohio, member of the armed services committee

“So, the translation we need is, we can lose, people will die, and people will be injured?” Turner asked again.

“That is correct, sir,” Odierno confirmed.

It became something of a refrain. “Let me now do my plain speaking,” Air Force Secretary Deborah James added. The capped, congressionally-mandated military budget “is going to place American lives at greater risk, both at home and abroad, if we are forced to live with it.”

It’s a craven way to beg. If the nation doesn’t want soldiers to die, it should shelve its military. The question isn’t will soldiers die, but how many deaths is the nation willing to pay for its national defense?

Every pound of armor not added to a tank, every ounce of ceramic plate not added to body armor, means troops could die. So does every compromise baked into the design of aircraft ejection seats, landing craft used by the Marines, and the hull thickness of Navy warships. Decisions like this are made every day inside the Pentagon bureaucracy.

The job of the military and Congress isn’t to reduce the risk of military deaths to zero. It’s to calibrate the threats and set the death rate at what the nation concludes is an acceptable level.

Some lawmakers at the hearing made clear tradeoffs are required. Rep. Martha McSally, R-Ariz., a former Air Force A-10 pilot, warned that the Air Force’s plan to retire its A-10 ground-attack plane seems shortsighted when, sometimes, “only the A-10 can save lives.” General Mark Welsh, the Air Force chief of staff, conceded that there “are circumstances where you would prefer to have an A-10.” But the cost of a warplane like the A-10 that can only do a single mission is unaffordable. “We have priced ourselves out of that game,” he said.

“So it’s a budget issue,” McSally declared—and an added cost that, in her eyes, troops on the ground might have to pay in blood, yet one the Air Force is willing to pay.

Lawmakers’ efforts to save pet programs and bases can have a similar impact, Rep. Seth Moulton, D-Mass., a former Marine, added. “Sometimes when we’re protecting jobs back here at home, we’re putting lives at risk overseas,” he said. Then the four-tour Iraq vet stated the obvious to the military brass arrayed before the panel: “It’s really your decision to make those tradeoffs.”

The military always says one death is one too many. But the troops know that sending young men and women to train, never mind fight, among heavy, fast-moving equipment, often punctuated by explosions and heat, makes death inevitable. There have been many examples of military hardware found to be unduly dangerous, and fixes were made. Not to eliminate death, but to reduce it.

Tough training makes better troops. “The more you sweat in peace,” Army General George S. Patton said, “the less you bleed in war.”

Military training is dangerous. Just ask the families of the 11 soldiers and Marines who died when their UH-60 Black Hawk helicopter crashed Mar. 10 in Florida amid dense fog. They died not because they weren’t ready, but because the U.S. military had the money to pay for their training.

Hundreds of troops perish, largely unnoticed, in such training accidents every year.

Training also costs money. If budget cuts reduce training, it’s likely that fewer troops will die in training accidents. But that’s no reason to cut training; the nation wants its fighting forces honed to a sharp edge.

So the Pentagon funds drills, exercises and war games designed to prime the nation for war. Just because some troops will be killed in such training is no reason to curtail it.

The same holds for fitting the nation’s military strategy to what the nation has decided to allocate for defense. Hawks argue that you shouldn’t fit strategy to budgets, but that has always been the reality. The public will fund the Pentagon to the degree it thinks is necessary, but no more.

Of course, if money were no object, ready is always better. But the smarter question isn’t about the prospect of additional deaths if only one of every three brigade combat teams is ready for war. The smarter question is why is the target two out of every three?

And that leads to another question, even for the math-challenged among us: the nation, through its messy political process, has decided the Army need to get smaller. That will drive up the readiness rate of the surviving brigade combat teams. If the military had faced reality and adjusted its spending to accommodate the cuts contained in 2011’s Budget Control Act—instead of spending the last four years pretending they were never going to happen—it would be well down that road already.

Neither generals nor lawmakers should use the threat of dead soldiers to bolster their budget arguments. The nation can afford whatever military its leaders decide it requires. Blaming prospective future deaths on budget cuts demeans those now wearing the uniform, as well as those who are dying in peacetime, readying for war.

Those troops are doing their jobs. It’s long past time for Congress and senior military officers to do theirs.

TIME Congress

Illinois Congressman to Resign After Reports of Extravagant Spending

Aaron Schock
Seth Perlman—AP Representative Aaron Schock speaks to reporters in Peoria, Ill., on Feb. 6, 2015

Illinois Congressman Aaron Schock, once heralded as a rising Republican star, resigned Tuesday after reports of wild spending on everything from a Buenos Aires duty-free shopping spree to redecorating his Capitol Hill office in trappings representative of Downton Abbey.

Multiple reports founds that Schock had failed to disclose trips abroad and that he spent lavishly on both his employees — taking his interns to a Katy Perry concert and staffers to a weekend in New York — and himself, hiring a photographer to document the travels of “the Ripped Representative,” as Men’s Health magazine once called him.

“The constant questions over the last six weeks have proven a great distraction that has made it too difficult for me to serve the people of the 18th District with the high standards that they deserve and which I have set for myself,” he said in a statement.

The controversy started after a Washington Post report on his extravagant office decorations, which led Schock to say he would personally pay the interior designer tens of thousands of dollars.

But it quickly grew more serious amid numerous reports delving into his home and auto payments. The Associated Press reported Tuesday that political donors “built, sold and financed” a Schock-owned home in Illinois. A Chicago Sun Times investigation also found that Schock had purchased a nearly $74,000 Chevy Tahoe with campaign funds and then put the vehicle in his name and charged taxpayers for over $1,200 of mileage reimbursements.

And he billed the federal government and his campaign for roughly 170,000 miles for his previous car, according to Politico. The Office of Congressional Ethics had begun to reach out to Schock’s political affiliates, according to Politico, which asked the Congressman last week if he had broken any ethics rules or federal laws.

“I certainly hope not,” he replied. “I’m not an attorney.”

Schock’s fall from power will hit the GOP’s purse strings. Schock gave the House Republicans campaign arm over a million dollars last cycle while his GOP Generation Y Fund racked up hundreds of thousands of dollars.

Your browser is out of date. Please update your browser at http://update.microsoft.com