The Contrarian

They came by the hundreds to honor and remember Bernard Rapoport on Wednesday.

B, as his friends called him, passed away late last week at age 94. The son of Russian Jewish immigrants, B made his fortune in the insurance business and then set about giving away millions to causes he believed in: the University of Texas, scholarship funds, numerous nonprofits, many Democratic politicians, and the Observer.

Several hundred came to his public memorial service Wednesday at the cavernous Grand Mason Lodge of Texas in Waco to hear seven speakers offer touching tributes to B.

“He had unshakable confidence that he could change the world,” said his granddaughter Abby, a former Observer staff writer. She was joined on stage by her sister, Emily, who read a poem dedicated to B.

Abby recalled that B always kept up with what his granddaughters were learning and always had advice for what they should be reading. During her freshman year of college, Abby said her grandfather asked to look at her syllabi and, as the year went along, kept up with the reading himself. “His confidence and his big ideas made me think he could change the world,” she said.

And in many ways, he did. The number of people whose lives were touched or changed by B Rapoport is far too numerous to list. His donations to Democratic candidates made him a well-known political figure and welcome in many Democratic congressional offices in Washington. And Wednesday’s memorial was filled with anecdotes of B’s proximity to power. In their eulogies, both Ben Barnes and Bill Cunningham, a former UT chancellor, told of visiting the Clinton White House with B. (Politics never came before family, though. Former Congressman Chet Edwards remembered sitting in B’s office while Rapoport talked on the phone with President Clinton. Then another call came in, and B said, “Mr. President, I have to go. My granddaughter just called me.”)

His political donations helped make him famous, but B’s philanthropy likely effected many more lives.

“If you were in need, he was there for you,” said Lyndon Olson, a former ambassador to Sweden and B’s long-time friend, in his eulogy. “How many of us present here today did he help in some way? Big and small ways! He did that for the people here in Waco, Texas… in the State of Texas… in the nation… and around the world.

“Those who were less fortunate, who were in poverty, who were the victims of injustice, or were just in need due to some personal calamity had a champion in B.”

The Rapoport family has generously requested that donations be made in B’s memory to The Texas Observer, or to the Rapoport Scholars Program at the University of Texas.

Everyone at the Observer was tremendously saddened to learn of the passing late last night of Bernard Rapoport—our board member, great friend and supporter—at age 94.

A public memorial service for B will be held at noon on Wednesday, April 11, at the Masonic Grand Lodge of Texas (715 Columbus Ave.) in Waco. The family has asked that in lieu of flowers, you make a donation to the Rapoport Scholars Program at the University of Texas, or to The Texas Observer.

B supported the Observer for decades and helped it through some lean years. Put simply, this magazine probably wouldn’t exist without his long-time financial contributions.

Of course, he didn’t just support the Observer. It would be impossible to compile a comprehensive list of all the political campaigns and good causes B supported, and all the lives he changed. To understand what this great man was about and why he did what he did, I suggest you read former Observer editor Lou Dubose’s wonderful appreciation.

As Lou writes—and a long line of Observer editors, myself included, will confirm— B never tried to influence the Observer’s editorial content, despite his generous contributions.

B explained his support for this cantankerous, investigative publication in a 1979 op-ed that we’ve unearthed from our archives and posted on our website here: “As one who has been deeply involved with the paper, I love it because I can’t tell anybody on the Observer what to do or say. This makes me know positively that no one else can. That’s why I am so supportive and shall continue to be in the future… .

“What I like best about The Texas Observer is that it is the most unpolluted institution in Texas. John Dewey once mentioned that one of his favorite quotations was ‘Every government needs a minister of irritance.’ The Texas Observer has fulfilled that need for many years in Texas, and what I hope is that it will continue to do so in the years to come.”

Indeed it has. We’ll be posting more tributes to B in the coming days. But perhaps the best tribute we can offer is our very existence. All the great journalism the Observer has done (and will do) would never have been possible without B Rapoport.

The debate over President Obama’s health care reform law, argued before the U.S. Supreme Court this week, touches all kinds of complex concepts and fancy jargon: a mandate, a severability clause (or lack thereof) and the Commerce Clause, health care exchanges, over-taxation and underinsured, and even a donut hole.

But the central issue is this: Should the government, under threat of monetary fines, force Americans to buy health care from private companies?

The health care reform bill famously requires all Americans to obtain health insurance either through their employer or purchase it on their own. Anyone who refuses to follow the mandate would face government fines. 

It would, I believe, be the first time in American history that the government required all citizens to buy a product from the private sector. (The often-cited car insurance and home insurance analogies don’t fit. More on that further down.)

Politicians on both sides are complaining about many of the other provisions too. Republicans don’t like the Medicaid expansion to cover more poor families. And many Democrats wanted a government-run insurance plan.

But, generally speaking, your opinion of the health care law generally hinges on whether you can accept the health insurance mandate.

There seem to be two camps. Some look at the prospect of providing health care to 30 million currently uninsured Americans, including millions in Texas, and at the success the system has had in Massachusetts, and conclude the mandate is worth it.  Others see government overreach—an unprecedented intrusion on individual liberties that can’t be justified no matter how many more people gain health insurance as a result.

No matter what you think of it, the mandate does set a dangerous precedent. As I wrote more than two years ago when Congress was debating the mandate:

“What items in your life does the government require you to purchase from a private company?

“I’ll venture a guess at the answer: Nothing.

“Car insurance, you say? Not really. You’re required to buy it only if you have a car. You still have the choice whether to buy a car. No car, no insurance. Same with home insurance. You’re still choosing to buy a home.

“In other cases, the government mandates something but provides the means. For instance, you’re required to educate your child, but the government provides a system of free, public schools.

“Nowhere in our lives does the government mandate that — no matter what — we must buy a product from the private sector.”

That may be about to change, depending on how the Supreme Court rules. The justices heard arguments over the mandate for two hours this morning—the second of the High Court’s three days of oral arguments on the law. As the New York Times reports, the conservative justices posed probing questions about the health care mandate.

“’Can you create commerce in order to regulate it?’” Justice Anthony M. Kennedy asked the lawyer, Solicitor General Donald B. Verrilli Jr., only minutes into the argument.”

“Chief Justice John G. Roberts Jr. asked if the government could compel the purchase of cellphones. And Justice Samuel A. Alito Jr. asked about forcing people to buy burial insurance,” according to the Times.

I won’t venture a guess on whether the mandate is constitutional or how the court will rule.

But if the court does strike down the mandate, we also may lose the most popular provisions in the law such as the ban on denying coverage due to pre-existing conditions and allowing dependents to remain on their parents’ plans up to age 26.

The insurance industry accepted these provisions in exchange for the mandate. The industry claims it can’t afford to insure people with pre-existing conditions without the added revenue from the many new customers the mandate would deliver. If the mandate is struck down, then perhaps insurance companies will again deny coverage because of pre-existing conditions.

Is that worth it?

Unfortunately, we’ve been forced into this choice by the bill that Congress and the White House designed. By maintaining the private insurance system and by refusing to implement a public option, the designers of the law had little choice but to require all Americans to buy insurance.

We’ve been forced to decide which principle is more important: basic civil liberties and freedom from government telling you what to buy or providing health care to tens of millions.

It’s a tough call, and it’s what made today’s Supreme Court argument so fascinating.

Like many journalists in the state, I was saddened to learn this week that Scott Braddock had lost his job with News 92.1-FM in Houston.

Braddock, who previously worked as a radio reporter in Houston, Dallas and Austin,  has a well-earned reputation around the state for high-quality, fair journalism. He returned to Houston last November to help launch the city’s new FM news station, News 92. His three-hour morning show tackled some of the most controversial and important issues facing Texas, from immigration and border issues to energy and the environment.

Last Friday morning, he broadcast an interview with Austin writer Carolyn Jones about her first-person account in the Observer of her ordeal with Texas’ new pre-abortion sonogram law. Jones’ powerful piece raises questions about whether politicians should be meddling in one of the most personal decisions a woman can make.

On Tuesday—two business days after the Jones interview aired—Braddock was called into his boss’s office and fired.

The timing has led to speculation that abortion politics contributed to Braddock’s firing.

The president of Texans for Life, Kyleen Wright, emailed the station to protest Braddock’s firing. “[H]he is one of the few news guys I always make time for—he does his own homework and works very hard to be fair to both sides, a rare commodity in broadcasting today,” Wright wrote.  Quorum Report, Dallas Morning News and Houston Chronicle posted stories suggesting that abortion politics may have led to Braddock’s firing.

I certainly hope that Braddock wasn’t fired for simply practicing good journalism—airing a good interview on an important subject for public debate.

The reasons for Braddock’s firing aren’t clear. The station managers, who work for the national company Radio One, have refused to comment on his termination.

Braddock says he can’t be sure why he was let go, but he says the  stated reason—that he guest-hosted a friend’s radio show on another station—doesn’t make sense. “There’s been no explanation for it that’s been given that adds up,” he told me.

Last Friday night, Braddock hosted a show on KPFT, the listener-supported Pacifica station in Houston and aired the Jones interview that he had conducted earlier in the day for News 92.

As Quorum Report noted, Braddock didn’t obtain permission, but didn’t think he had to. Braddock says it’s not unusual for radio hosts to fill in on other stations.

He suspects that his bosses weren’t pleased with the content of his show, By taking on controversial issues, Braddock’s show differed from the  rest of News 92’s content, which Braddock terms “fires and shootings…crime blotter type of stuff” and other local items. Braddock says that media outlets must have the courage to cover complex, controversial topics—like abortion, immigration, education, and the environment—from all sides. Otherwise, “It doesn’t give anybody any perspective on decisions they’re going to have to make. Who they’re going to vote for. Do they need to contact their congressman? Do they need to show up at their school board meeting tonight?”

I called Doug Abernethy, the regional vice president for Radio One, which owns News 92, for his side of the story. Abernethy refused again to comment on Braddock’s firing. But he did stress he thinks “Scott is a very talented reporter.”

Abernethy said he was pleased with the quality and content of Braddock’s show; it was what managers expected when they heavily recruited Braddock to join the station last fall.

Asked if the sonogram interview contributed to Braddock’s firing, Abernethy said, “I don’t think he got reprimanded for any content he had on the air last week. … There wasn’t even a discussion [among station managers] about any of his shows last week.”

I don’t know what the truth is here. But what is clear is that one of the state’s best radio journalists is now off the air. I hope it doesn’t stay that way for long.

Until recently most Texans had probably never heard of the Women’s Health Program. It was one of those out-of-the-way, good-government programs that consumes a relatively small amount of money (about $40 million) but does copious social good: paying for health screenings and birth control for 130,000 low-income, uninsured Texas women.

Yet despite the obvious benefits, the program’s future has been in doubt for nearly a year. As early as last spring, some Republicans in the Texas Legislature made clear their desire to do away with it. Most Texas media outlets—the Observer included—have been covering the effort to preserve the Women’s Health Program for many months.

But in the past few weeks, this once little-known program has become the issue in Texas politics—bandied about like a beach ball between Texas Gov. Rick Perry and the federal government. Here’s the short version in case you haven’t been following along: Texas had to ask the federal government to renew the Women’s Health Program, which typically would be pro forma. Except this time Perry’s administration announced it would apply to renew the program only if it could bar Planned Parenthood. The Obama administration said Texas couldn’t do that. Texas did it anyway. The feds responded by essentially saying they wouldn’t renew money for the program—and they pay for 90 percent of it— unless Planned Parenthood was included. Texas said nuts to that.

And there you have it: The Women’s Health Program is expiring in a flurry of finger-pointing, with the feds announcing the program’s end yesterday. Democrats are calling its demise part of the Republican “war on women” (war on Planned Parenthood would be more accurate). Meanwhile, conservatives are shouting about the Obama administration favoring abortion and Planned Parenthood over women’s health (it would be more accurate to say the feds are favoring federal law).

Amid all the political posturing and spinning, it’s difficult to discern what’s actually going on here. Quite a few Texans, even those reading the headlines, still don’t really know what it is, including some folks in my office.

So let’s clear up some misconceptions with a few FAQs that might help you see through the political rhetoric.

 

1. Women’s Health Program—sounds like a fitness regimen at the Y. What the hell is this thing?

The goal of the program is to prevent unplanned pregnancies. Oh sure, there’s a lot more to it—it’s a Medicaid waiver program with strict eligibility rules and provides health screenings for a long list of ailments and so on. But at its core the Women’s Health Program exists to provide poor uninsured women with the birth control and family planning services they need to avoid unintended pregnancies. Simple as that.

 

 

2. OK, but why is that necessary?

The program came about to fill a gap in the health care system. Lower-income women who become pregnant are usually eligible for Medicaid, which will provide health insurance during their pregnancies, deliveries, and for a short time after they give birth. Medicaid pays for more than half the births in Texas. So that’s covered. The child will likely be eligible for Medicaid. So that’s covered. But what about the mother? A couple of months, after giving birth, the mother could well be uninsured. Medicaid’s eligibility is much stricter for adults who aren’t pregnant. You have to be really poor to qualify for Medicaid as an adult. So even though her child may be on Medicaid, the mother may have no health insurance—that means no access to preventive health care or birth control.

 

If the mother soon becomes pregnant again and it’s an unplanned pregnancy, then not only will Medicaid have to pay for another birth, but more importantly, the mother will have another child she can’t afford to care for. That can lead to all kinds of ugly outcomes—from child abuse to neglect to placing the child in the foster care system. None of that benefits the child or taxpayers.

 

So providing uninsured women with family planning services seems like a good idea. And that’s how the program started. States began by asking the federal government for a Medicaid waiver—essentially permission to spend Medicaid dollars outside the program’s traditional rules—to provide birth control to uninsured, non-pregnant women.

 

More than two-dozen states have done this, including Texas in 2005. The Texas Women’s Health Program is narrowly focused: women ages 18-44 (child bearing age) who earn less than about $1,700 a month on their own and who aren’t pregnant. If you become pregnant, you’re off the program. It will pay for women to be sterilized—cause that’s a pretty effective way to prevent pregnancies—but once a woman is sterilized, she’s booted off the program (cause she’s no longer a risk to become pregnant).

 

 

 

3. Ok, we get it—the goal is to prevent unplanned pregnancies. Yeesh. But how come we keep hearing about abortion and Planned Parenthood? What does the Women’s Health Program have to do with abortion?

Nothing. Except that by preventing unplanned pregnancies, the Women’s Health Program might reduce the number of abortions. But, otherwise, nothing.

 

 

4. Doesn’t the Women’s Health Program pay Planned Parenthood to do abortions?

No. Taxpayer money can’t pay for abortions.

 

5. But Texas Comptroller Susan Combs sent out a statement last week in which she said excluding Planned Parenthood from the Women’s Health Program was good because, “As Comptroller, I have consistently opposed using taxpayer dollars to fund abortion services.”

This is a highly misleading statement. Taxpayer dollars don’t fund abortions (or whatever an “abortion service” is). There are very strict rules to prevent it. And Susan Combs knows it.

 

 

6. OK, that’s the official story. But Planned Parenthood is probably shifting money around under the table to pay for all kinds of things. The Women’s Health Program money may be intended for birth control, but once Planned Parenthood gets it, the money probably supports abortion some how, right? Wink, wink.

It’s basically impossible for Women’s Health Program money to contribute to abortion in any way. Remember, no pregnant women can even be on the program. And even if Planned Parenthood wanted to game the system, that would be difficult. Medicaid (the Women’s Health Program included) is a fee-for-service system. That means a woman who has signed up for the Women’s Health Program goes to an approved medical provider (a hospital or, until recently, Planned Parenthood) and receives a screening or birth control or other family planning service. The hospital or clinic then bills the state and gets reimbursed.

 

But—and here’s the key part—if the patient wasn’t eligible or the medical service provided wasn’t on the approved list, then the state won’t pay the bill. In other words, the government controls what services the program pays for. If Planned Parenthood tried to game the system, it wouldn’t get paid.

 

And Medicaid rates being what they are—which are incredibly low—hospitals and clinics aren’t making money off the deal. The Women’s Health Program money can pay only for screenings and family planning and nothing else. No abortion anywhere in sight.

 

But don’t take my word for it. I asked Stephanie Goodman, spokesperson for Texas’ Health and Human Services Commission, “If patients can’t be pregnant on the program, and it’s fee for service, and government money can’t pay for abortions anyway—then am I right in assuming that WHP funds couldn’t ever pay for an abortion?”

Her answer: “Correct.”

 

7. Then what was Susan Combs talking about?

 

Good question. We called her spokesperson to ask. He hasn’t responded.

 

 

8. So is this really about attacking Planned Parenthood?

Seems so. In late February, the state implemented a rule that technically forbids any entity (or its affiliates) that provides abortions from participating in the Women’s Health Program. That could leave hospitals in a tough spot. Many hospitals provide abortions.

 

But state officials didn’t want any part of taking on the hospitals, so the hospitals were specifically exempted. That pretty much leaves Planned Parenthood as the target. Perry has said as much.

 

 

9. And what’s wrong with excluding Planned Parenthood?

Well, it provides more than 40 percent of services in the Women’s Health Program. It’s not clear who or what would step in to provide that care if Planned Parenthood is excluded.

 

But there’s a larger legal question. The Obama administration contends that Planned Parenthood is a qualified Medicaid provider, and the state can’t simply exclude qualified providers simply cause it doesn’t like them. The feds say that violates federal law. Texas AG Greg Abbott disagrees and argues that Texas can exclude whoever it wants.

 

10. Didn’t the Legislature already cut family planning funding last spring?

Yes, but that’s a different program. The Legislature cut funding for the state family planning program by two-thirds. That’s an entirely different program that provides family planning services, though a lot fewer than it used to. The two programs offer similar services, but they’re two different pools of money.

 

11. Rick Perry says that Texas will create its own version of the Women’s Health Program without the federal money. Can Texas do it?

We’ll find out. Goodman, the HHSC spokesperson, says the state intends to cover all the women who were eligible for the Women’s Health Program. It doesn’t cost that much. Texas could easily make up the loss of $40 million in federal funding. But the state has to set up a new system. As part of Medicaid, the Women’s Health Program had everything all ready to go—established providers, rates, payment system. Texas will have to do all that now outside the Medicaid system and without any authority from the Legislature, which doesn’t meet till next year. State officials told the Austin American Statesman yesterday that the details aren’t that complicated. We’ll see. It’s possible the new state system won’t be ready when the Women’s Health Program expires.

 

If Texas does succeed with its go-it-alone strategy and excludes Planned Parenthood, then you have to suspect that other conservative states will try it too.