Late Night Horrorshow Open Thread: What News of Maine’s “Human Bowling Jacket” Governor?

I have a mild case of the spindizzies, and it’s making me even crankier than usual. But I’m still about 80 IQ points and some head trauma away from “cranky like Paul LePage.”

I will also point out, for any Purity Ponies lurking, that LePage is what happens when the “True Progressive” becomes the enemy of the “at least he’s not Paul LePage” mere Democratic machine candidate.

To quote Mr. Charles P. Pierce, Paul LePage always brings dignity to the office.”

GOTV optimization

This evening, my wife and I were door knocked for the first time this election cycle. A very earnest paid canvasser from a union backed entity asked us half a dozen questions, got our contact information and engaged in small chit chat. He stayed on our porch for ten minutes as a nasty but brief squall ripped through the neighborhood and took down a pair of branches from the walnut tree across the street. As we were talking, I mentioned that I had been a data geek for a similar 527 organization a while back. I understood that this was an initial data canvas and not a mobilization nor a persuasion canvas. Neither my wife nor I need persuasion nor mobilization. We have not missed an election in ten years, and the latest either of us have voted is three hours and seventeen minutes after the polls opened (this year as I was working from home and had to get the kids to school and coffee in me before casting a ballot for Hillary Clinton).

Any resources devoted to either persuade or mobilize my wife or I are wasted resources. We’re going to vote, and we’re going to vote for the most plausibly electable liberal that we can whenever we can. And this is a problem that calls for a solution. We’re going to get hit up with at least four different liberal GOTV ground campaigns (Clinton, joint/coordinated Federal and State Dem victory campaign, an environmental organization and a union backed 527 that we just talked to). Each of these groups will call us, they will mail us, and they will door knock us. If we only answer ten canvassers at the door this fall, I will be surprised. All of that effort is wasted effort that should be deployed on either getting a sure liberal but unsure voter out to vote, or a sure voter but squishy persuasion target out to vote for Democrats.

Is there a solution where my wife and I can register with a data vendor to say that we are 100% sure of voting and we are non-persuadable in the general election cycle so send resources three doors down to the new couple that moved into the neighborhood from out of state and have just registered to vote for the first time? If that is a third party entity, then both the campaigns that are allowed to coordinate with candidates and independent entities can buy the same cleansing lists to clean and narrow their actual target universe.

Reminder: Mike Pence Is Every Bit As Dangerous As Donald Trump

There are two wings in the modern Republican party: the “I Got Mine, Fvck You” (‘business’) clan, represented this presidential year by Donald Trump; and the “We Hate All the Same People You Hate” (‘religious’) group, now ably seconded by Mike Pence. Of course the overlap between the two is large — the main difference between Trump’s career and Pence’s is that when Pence threw other peoples’ money around, he was to some degree subject to the wrath of his victims, the voters. (Despite his best efforts to keep them from hearing about it.) He’s also, per Think Progress, a longtime shill for the tobacco industry. Truly the Swiss army knife of RWNJs!

From Jezebel‘s political sub-blog The Slot, “Get to Know Mike Pence and All of the Very Bad Legislation He’s Signed”:

Pence is a bit of a darling among anti-choice groups. As a member of Congress, Pence sponsored a 2007 bill to defund Planned Parenthood, the first of its kind, the legislation set off a now nearly decade old congressional battle to defund the organization. Pence reintroduced the legislation multiple times until he left the House in 2011. “Let the abortion providers provide for themselves,” Pence told Politico in 2007. “I’d like to continue to be a persistent, respectful voice for the sanctity of life.”

It was a template and an indicator of how he would treat women’s health as governor of Indiana. As governor, Pence signed virtually every anti-choice bill that was put on his desk, including HB 1337, an omnibus abortion bill that a federal court blocked from taking effect in June of this year.

Pence described the law “a comprehensive pro-life measure that affirms the value of all human life.” In reality, it is a deeply invasive law lacking both empathy and reason (unsurprising, perhaps, from the state that jailed Purvi Patel). HB 1337 bans women from seeking abortions based on race, gender or fetal anomaly; it also mandates that women be required to bury or cremate the fetus post-termination. In addition, it required that abortion doctors have admitting privileges in order to practice, a restriction that the Supreme Court recently struck down in Whole Woman’s Health vs. Hellerstedt

In 2015, Pence also signed the Religious Freedom Restoration Act (RFRA). The controversial law prohibits the passage of state laws that “substantially burden” the religious beliefs of individuals. According to the Associated Press, the definition of an “individual” originally included churches and religious institutions, as well as businesses and other entities (RIP Memories Pizza who played themselves all the way to closing).

The law and its passage were a mess. LGBTQ activists argued that the bill would effectively allow business owners to discriminate and deny customers service if they were LGBTQ (or merely if the owner of the business perceived them to be). After numerous companies and organizations, including Angie’s List and the NCAA, announced that they would boycott the state, the Indiana legislature amended the bill, clarifying that it could not be used to discriminate against LGTBQ people.

Pence handled the passage of the bill poorly. He acknowledged that the bill was discriminatory, yet signed it anyway and, in the process, lost quite a bit of cash for Indiana businesses…

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Math has a well known liberal bias.


That is the Oklahoma House passing a Medicaid expansion bill.

The state is heavily dependent on cyclical resource extraction taxes (oil and gas) for a significant chunk of their state budget. The state is facing a a massive deficit and Expansion is a good way to solve a decent chunk of the problem while not destroying the public health system:

a huge $1.3 billion hole in the budget that threatens to do widespread damage to the state’s health care system.

So, in what would be the grandest about-face among rightward leaning states, Oklahoma is now moving toward a plan to expand its Medicaid program to bring in billions of federal dollars from Obama’s new health care system.

What’s more, GOP leaders are considering a tax hike to cover the state’s share of the costs.

“We’re to the point where the provider rates are going to be cut so much that providers won’t be able to survive, particularly the nursing homes,” said Republican state Rep. Doug Cox, referring to possible cuts in state funds for indigent care that could cause some hospitals and nursing homes to close.

The law still needs to go through the Senate and get signed by the Republican governor. After that the state will need to negotiate with the Center for Medicare and Medicaid Services for a waiver as Oklahoma wants to adapt the Arkansas model. Arkansas buys private exchange plans and then tops up their cost sharing assistance for people to minimize the deductible.

From a cash flow perspective this is interesting. Private exchange plans tend to pay providers significantly higher rates than Medicaid. It allows Oklahoma to send their rural providers a decent income stream that should allow the state to hold steady or even decrease their Legacy Medicaid provider rates. That is one source of state cash savings. The other is it moves a lot of people from Legacy Medicaid with a high state share to Expansion Medicaid with a low state share of the costs.

Over the long run, state budget math has an expansionary bias. Expansion solves several big problems without allowing too many hard choices to be made (as well as make the residents of the state better off). It is a one way ratchet. This is why national Democrats have been proposing to give every state three years of 100% funding, and I wish that they would propose bumping up Legacy Medicaid federal shares by several points contingent on expansion being in place. Those policies are big bribes to get the hold-out states on board because sooner or later every state budget will need some relief. Federal Medicaid money is relief.
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Evil Infests Augusta

John Brunner said it exactly right in The Shockwave Rider:  “If there is such a phenomenon as absolute evil it consists in treating another human being as a thing.”

With that in mind, let me give you the latest from Maine’s governor, the utterly odious Paul LePage:

Gov. Paul LePage vetoed a bill Wednesday that would allow pharmacists to dispense an anti-overdose drug without a prescription, saying that allowing addicts to keep naloxone on hand “serves only to perpetuate the cycle of addiction.” [via Kerry Eleved at GOS]

That’s nonsense on its own terms, as the deeply valuable Maia Szalavitz — herself a former addict — has argued over and over again:

As with needle exchange, opposition to Naloxone distribution has mainly come from those who fear that reducing drug-related harm will lead to increased drug use.   Fortunately, also similarly to the data on needle exchange, the research doesn’t find this occurring.

But don’t let any actual experience bother you, LePage!

“Naloxone does not truly save lives; it merely extends them until the next overdose,” LePage wrote, repeating a contention that has caused controversy before. “Creating a situation where an addict has a heroin needle in one hand and a shot of naloxone in the other produces a sense of normalcy and security around heroin use that serves only to perpetuate the cycle of addiction.”

It’s a strong word to use, I know.  But this is evil.


In LePage’s telling the addict isn’t a person.  He or she is rather just the worthless meat sack that locally reverses entropy between one overdose and the next.  He’s rather let those suffering an overdose die than live because, as he frames it here, the state of addiction robs the user of all other human attributes.

This is how a monster thinks.

I won’t say that this is the view that infects all of your modern Republican party, because on this issue it’s not. But it remains a perfectly mainstream one for the GOP — and this is a case of words (and inactions) that kill.

If you needed any more reason to go all yellow-dog Democrat on every line of your ballot, Governor (sic!) Paul LePage is exhibit (n)*

Last, to help wash the taste of tiny-minded misery out of your mouth, here’s Szalavitz again:

…one of the biggest misunderstandings we have about addiction is that tough love—is that being kind will fail and tough love will work. What really helps and why harm reduction, which is this idea that we will meet you where you’re at and we’ll help you whether you’re ready to stop or not—why that works is because when you have addiction, you tend to be very marginalized, self-hating. You might be homeless. You feel like a criminal. Nobody has any respect for you. And when somebody just hands you a clean needle or gives you access to naloxone and says, “I believe you deserve to live, regardless of whether you do what I want,” that’s a really powerful message of kindness.

And here a plug (full disclosure: she’s a friend) — here’s Maia’s new book on addiction.

*Where n is an arbitrary large number.

Image: Rembrandt van Rijn, Christ Preaching (The Hundred Guilder Print) c. 1649.

Saturday Morning Cartoon Open Thread: Potty Talk

toilet gender identity danziger

(Jeff Danziger’s website)

I’m so old, I can remember when No unisex toilets!!! was Phyllis Schlafly’s rallying cry against the Equal Rights Amendment, back in the early 1970s. Between NC Gov. McCrory and the news this week about Ted Cruz’s anti-dildo proclamation, it’s clear the Repubs — individually and as a party — have some strange ideas about other peoples’ swimsuit-covered bits…

Apart from stocking up on brain bleach, what’s on the agenda for the day?

toilet biz in nc toles

(Tom Toles via

toilet for guv mccrory ohman

(Jack Ohman via

toilets small gubmint sheneman

(Drew Sheneman via

toilets men women other anderson

(Nick Anderson via

Federalizing Medicaid funding

And another story from Oklahoma:

Facing a $1.3 billion budget hole, the Oklahoma House has passed legislation that would cut 111,000 Oklahomans from Medicaid.

House members on Wednesday passed the bill 65-34 mostly along partisan lines and sent it to the state Senate for action.

The measure would instruct the Oklahoma Health Care Authority to seek a federal waiver allowing the state to exclude from Medicaid all able-bodied adults under 65 with dependents.

That bill failed in the Oklahoma Senate.

Oklahoma is heavily dependent on oil revenue to make their budget work. Oil prices have cratered so state revenues have crashed. At the same time as oil prices have collapsed, economic activity in the state is decreasing which means more people don’t have jobs, more people don’t have employer sponsored insurance, and more people have become Medicaid eligible. The Medicaid eligible pool is counter-cyclical. As the economy does well, the eligible pool shrinks, and as the economy does poorly, the pool grows. So the number of people who are eligible for Legacy Medicaid grows just as the state revenue needed to pay for Medicaid services drops.  This is a problem.

Legacy Medicaid is financed by the state and the Feds splitting the bill.  Oklahoma pays 41% of the cost of the medical services component of the program.  The Feds pick up 59% of the medical side and a bit more on the administrative side.  Oklahoma has a balanced budget constraint.  the Federal government does not.  That means the Feds are willing and able to spend money to meet increased Legacy Medicaid demand in a downturn but the state can not.  Instead, the state needs to cut expenses to meet its balanced budget constraint and Medicaid is a very large line item in every state budget, so that means Medicaid is often one of the major areas of cut-backs in either eligibility, services allowed or provider payments.

So what is the solution?

The long term solution is that the Federal government should take on more and more of the cost of Legacy Medicaid.  The Feds can spend in a downturn when the states have to be 50 mini-Hoovers who have to cut during a recession.  This does three things.  The first it makes sure that people can get the medical care that they need and that the continuity of care is maintained.  Continuous care is usually better and cheaper  than people getting dropped and then added back to insurance months or years later.  Secondly, it transforms Medicaid financing from a pro-cyclical activity into a counter-cyclical macro-economic stability policy.  One of the major components of the stimulus in 2009 was a Federal Match rate bump.  This moved $87 billion in Medicaid expenses from the states’ books to the Federal books.

The Stimulus bump was a short term solution that required massive supermajorities from a party that believes that the federal government faces a different budget constraint than a typical household.  The long term solution is to have the Feds continually increase their share of the costs until Legacy Medicaid is funded on the same bases as Medicaid Expansion. The Feds pick up 90% of the tab and the states pay 10%.  This will still allow for state control  which allows Massachusetts to cover different services than Mississippi but it allows for a much stronger counter-cyclical automatic stabilizer to be in place.

The attraction this should have to a significant number of Republican state level elites is that by taking Medicaid off of their books, it frees up a lot of money for easy to justify tax cuts.