Hearst Connecticut Media. March 16, 2023.
Editorial: The wrong way forward on health insurance
The Connecticut General Assembly is working toward a laudatory goal on health care, which is to reduce the cost of insurance and thereby open care to more people. It doesn’t work to have a great health care system if people are unable to avail themselves of it. When it comes to increasing access, everyone is on the same page — rhetorically, anyway.
How to get there is another story.
The current debate is over what are known as Association Health Plans, which are a form of group medical insurance for employers that allow smaller companies and nonprofits to access the health insurance savings associated with large group coverage. It’s all about economies of scale; what wouldn’t be available to a person or small group is possible for a larger group because the numbers balance out.
That’s the theory, at least, and the plan has earned bipartisan support. Rep. Kerry Wood, a Democrat and co-chair of the Insurance and Real Estate Committee, is supporting the plan, as are Republicans such as Sen. Tony Hwang and Rep. Cara Pavlock-D’Amato. This would seem to be a good way forward in a legislature where large-scale reforms have been stymied by the governor and the influence of the insurance lobby.
But it’s not so simple.
Testifying against the proposal for Association Health Plans this week was Sen. Matt Lesser , who was previously chair of the committee and has worked hard in recent years for more robust insurance reform. Lesser made the point, backed up by the state’s health care advocate, Ted Doolittle, that the plans in question would not contain many of the protections that customers have come to expect in insurance.
Specifically, Lesser said, Association Health Plans could conceivably discriminate against older workers or women by charging higher premiums depending on a workplace’s profile. These are the kind of fluctuations that were supposed to be eliminated under the Affordable Care Act, but that could come back into play were the bill to pass. That would have the effect of putting people back on the open market.
The bottom line is that the plans would be more affordable because they wouldn’t be as good. They wouldn’t do what we’d expect of health insurance, and it would be by design.
There is nothing simple about this issue, but it’s also not necessary to make it quite so hard. We want people to have access to health care, both for moral reasons, because it’s the right thing to do, and for economic reasons, because it’s cheaper to get people care they need regularly rather than deal with major problems that have gone untreated.
Getting people access to health care requires insurance. We could make this easy — we could guarantee coverage for anyone, or for large groups, and ensure regulations are in place to protect people in their time of need from surprise expenses or denial of service.
We don’t do this because it’s not in the best financial interest of powerful people, including in the state capital. The General Assembly needs to put aside overly complicated half-measures and work toward better coverage for all, regardless of whose bottom line is affected.
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Portland Press Herald. March 15, 2023.
Editorial: Kids living on the street; a problem demanding immediate attention
About 2,000 Maine young people are homeless – that’s a number we should be able to handle.
It’s the kind of story you’d hope would make everyone stop, put everything else aside, and work tirelessly until something is done.
The number of Maine kids living alone on the streets is on the rise. As Vanessa Paolella of the Sun Journal reported March 5, they struggle to get by day to day, and have little hope for a better future.
But youth homelessness is a symptom of some of Maine’s most difficult challenges – poverty, substance abuse, the lack of affordable housing – and while people are working every day to overcome them, solutions to those big problems seem far away.
So let’s make them smaller.
Just as military veterans can access programs tailored to their specific needs, so too should homeless young people, particularly those estranged from their families.
As Paolella reports, most homeless kids live with their families, often in hotels, shelters, or with friends or relatives.
But about 17% of them are on their own, having left their parents or foster care, experts say.
Those teenagers often have little choice but to leave. Their families are steeped in poverty, and many struggle with alcohol and drug abuse. They are victims of the housing crisis and the lack of mental health care, both of which contribute to family instability.
It’s particularly bad for teens whose gender or sexual identity doesn’t fit family expectations; they are less likely to have other forms of community support, and far more likely to end up homeless.
Things aren’t likely to get better once they leave. Most homeless young people report being assaulted on the street, and many are exploited in exchange for money, food or shelter. They are more likely to turn to alcohol and drugs to cope. They are far less likely to graduate from high school.
Those kids never get a chance to get going. It is such a waste, and one that echoes over time – today’s homeless kids often become tomorrow’s unstable parents, perpetuating the cycle.
That’s the bad part.
The good part is that the number of homeless youth in Maine – about 2,000 total – is small enough to wrap our hands around. The number of unaccompanied homeless young people is even smaller.
By focusing on that population, Maine can make a real difference for these kids and their communities.
People and institutions are already working to help homeless youth, but all agree it’s not enough.
Maine needs more shelter options for teens. Many homeless teens, because of past trauma, have trouble adhering to rules and structure; that must be taken into account so they aren’t driven away from help.
There is also not enough short-term housing to help teens transition from homelessness, nor is there enough help available in areas they need it most: transportation, counseling, education and job training.
Additional help should be steered toward kids in foster care, as well. More than half of Maine’s unaccompanied homeless young people were in the foster system, which regularly leaves kids without familial support or a place to live once they turn 18.
Lawmakers should seriously consider a bill this session that would extend MaineCare coverage to foster kids up to age 27, ensuring they have health insurance. Another bill would waive higher education tuition for children in foster care.
Both would help Maine teens age out of foster care with more support, and help them avoid homelessness in the first place.
The bills are also a good opportunity for legislators to discuss the problem and see what other gaps may exist.
Not too long ago, people decided that every veteran should have a home. It became an intense focus for housing advocates, and it worked, cutting veteran homelessness in half over six years.
We should do the same for homeless young people, so they have a chance at the kind of future we all want.
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Bangor Daily News. March 16, 2023.
Editorial: Naloxone should be immediately accessible in all Maine correctional facilities
Corrections officers in the Cumberland County Jail, the state’s largest, are now carrying the opioid overdose-reversing drug naloxone. All counties across the state should be making the same move, if they haven’t already, to try to prevent any more overdose deaths in Maine jails.
Not long ago, Maine corrections officers couldn’t even administer naloxone, also known by the brand name Narcan. It took a 2017 state law, and lawmakers overriding a veto from then-Gov. Paul LePage, to allow corrections officers to administer naloxone like a police officer or medical provider already could. Allowing jail guards to do so was the right move. Now that they can, jail leaders must also make sure this life-saving intervention is immediately available if needed.
“If I’m up in one of the areas farthest from the officer’s station and I find an issue, I can immediately act on it,” Cumberland County’s Lt. Dan Haskell explained to News Center Maine about the recent change. “It can be the difference between life or death.”
According to the National Commission on Correctional Health Care, drug and alcohol overdoses are the third leading cause of death in jails behind illness and suicide. Overdose deaths have occurred in Maine jails.
Last year set another grim record, with 716 people confirmed or suspected to have died from an overdose across Maine. The tragic loss of life last year would have been even worse if not for access to naloxone. According to a December overdose report, which included statewide numbers for all of 2022, there were nearly 2,300 overdose reversals with naloxone last year.
Naloxone access is a good and necessary thing. This should be especially obvious with the increased prevalence of fentanyl. As a state, hopefully we have moved past the debate about naloxone access and agree that keeping people alive is always a good thing. Naloxone can help keep people alive, both in and out of jail, and give them a chance (or chances) to access more long term recovery services.
As reported in the BDN by Troy Bennett, other Maine counties where corrections officers carry naloxone include Androscogggin, Kennebec, Penobscot and Waldo. Piscataquis County Jail officers are encouraged but not required to carry the drug.
According to Penobscot County Administrator Scott Adkins, Penobscot County issues naloxone to all corrections and patrol staff along with jail medical staff. This broad access among staff should be standard practice in all correctional facilities. Naloxone might not be used frequently, but it should always be available.
“In all of last year, it was given maybe twice,” Bill Prout, the jail administrator executive assistant in Cumberland County, told Bennett. “Though we stop an awful lot of fentanyl trying to come in here, so it’s a smart thing to have.”
With people trying to get fentanyl into the jails, naloxone obviously needs to be there too — and it needs to be immediately accessible should an overdose occur.
Cumberland County jail officials recently took the appropriate step by adding naloxone to their corrections officers’ belts. Hopefully they will never have to use it, but we’re glad it is there. All other Maine correctional facilities should be taking this same approach.
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Boston Globe. March 13, 2023.
Editorial: Locking in tuition at state universities needs to offer affordability, not just predictability
Governor Healey’s $59 million proposal is good in theory but could lead to higher tuition and fees if not carefully implemented.
There is a lot to like about Governor Maura Healey’s $59 million budget proposal to lock-in tuition rates for four years for Massachusetts students attending state universities. It provides predictability in budgeting for students, and colleges are being reimbursed by taxpayers, so they do not lose money.
Healey, speaking to The Boston Globe editorial board, suggested that having cost certainty will help more students stay in school. “It’s going to allow students and families some certainty, transparency. They’ll be able to plan,” she said.
But in considering the idea, lawmakers must avoid confusing predictability with affordability. They have an obligation to students to make sure that any plan addresses both aspects. It’s not clear that Healey’s plan does.
The $59 million would be divided among the three public higher education segments. The University of Massachusetts would agree to freeze tuition for the incoming fall 2023 class at the same rate for all four years of college. Other state universities, which make the bulk of their money in fees, would freeze both tuition and fees at the same rate for all four years for the incoming class. At community colleges, where students often attend part-time and pay per credit, tuition and fees would freeze for one year.
The tuition lock would provide predictability in budgeting for students. It would also be a marketing tool to help public colleges recruit students with the promise of flat fees. It might even incentivize students to graduate in four years, because tuition would rise after the four-year lock.
State Senator Jo Comerford, who cochairs the Joint Committee on Higher Education, praised Healey for “removing a lot of the opacity of the cost.” “There’s nothing hidden, there’s nothing unexpected,” she said.
But the plan is more complicated than it appears. While the Healey administration envisions a multiyear lock, that is not guaranteed. Because of the nature of state budgeting, this year’s budget would lock in rates for next year’s class only. The Legislature would have to decide each year whether to approve additional funding for another year’s tuition lock, and each school’s board of trustees would have to agree.
A bigger question is what rates would be locked in, who sets the rates, and, perhaps most importantly, whether having a fixed rate would in the long run reduce the price of college. Healey budget officials say appropriating $59 million a year for four years will be enough to lock in a tuition and fee rate that increases by 2.5% a year for the next four years. So the class entering in 2024 would pay 2.5% more than the class entering in 2023, with their rate locked in for all four years, and the class entering in 2025 would pay 2.5% more than that.
It’s hard to say whether the total amount of money paid for higher education would increase or decrease at that level, because tuition increases vary widely by year and by campus. The tuition and fee increases this year were 3% at UMass and ranged from zero to 4% at other state universities, depending on the campus. State officials say 2.5% was chosen because it reflects modest annual growth, recognizing that campus costs increase with inflation.
Further complicating matters is that while the Legislature decides how much money to appropriate, each campus sets its own tuition and fees. If lawmakers are committed to affordability and agree that a 2.5% annual increase is the right amount, they could write into the law that campuses will only be reimbursed for a tuition lock if they raise tuition and fees by no more than 2.5%.
But the current language of the budget bill says explicitly that “tuition and fees will continue to be set by each respective board.” If a campus board decides that due to inflation or other costs it needs to raise tuition and fees by 5% for an incoming class, there is nothing to stop the board from taking that vote and lobbying the Legislature to increase appropriation before the campus agrees to a tuition lock. It is unclear what would happen in that case.
Both UMass President Marty Meehan and Vincent Pedone, executive director of the State Universities of Massachusetts Council of Presidents, made clear that the campuses are only committed to locking in tuition costs for as long as the Legislature fully funds the added expense.
“If you give us a certain amount of money up front, we’ll guarantee a price lock for incoming students,” Meehan said.
Neither official appears willing to defer to the Legislature to cap the size of inflationary tuition and fee increases.
Pedone said it is up to each campus’s board to set tuition and fees, and there are costs that need to be paid, like collective bargaining agreements, employee benefits, maintenance and capital spending, and student support services.
Illinois imposed the nation’s first state-level guaranteed tuition law in 2004, requiring universities to lock in freshman tuition rates for four years. Other states like Oklahoma and Texas gave students the option to have a guaranteed tuition plan, but at an additional cost. Some private colleges have imposed tuition locks at particular times, such as after the 2008 Great Recession.
Academic studies of guaranteed tuition programs were done in 2015-2016 by Jennifer Delaney and Tyler Kearney of the University of Illinois. The researchers concluded that guaranteed tuition there actually led to higher tuition rates, since campuses tended to overestimate the effect of inflation over the four years of the lock so they made tuition higher up front. Ultimately, students ended up paying more with guaranteed tuition than if the campuses had imposed annual increases.
Another potential pitfall is campuses may seek to raise more money through fees that are not covered by the freeze, like course fees, student activity fees, or health service fees. The schools could also hike tuition and fees for out-of-state students.
Bahar Akman Imboden, managing director of the Hildreth Institute, a Boston-based higher education research institute, said the trade-off of providing predictability to students is that colleges become limited in their ability to respond to financial hits, like enrollment declines or unanticipated expenses. That can lead to policies like hiking fees on future students or trying to enroll more out-of-state students.
“It will provide predictability to students,” Imboden said. “But the impact of these on tuition and fees themselves is quite complex.”
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Barre-Montpelier Times Argus. March 15, 2023.
Editorial: Sunshine Laws
Too many times each year, our journalists have to call out elected officials for being in violation of the state’s open meeting and open records laws. On a few of those occasions, we have had to educate the violators with letters citing statute, and even reaching out to town attorneys to underscore our concerns about lack of transparency and shadow government decision-making. It is far too common an exercise.
Fortunately, Vermont had a strong advocate in former Secretary of State Jim Condos, who, as a longtime elected official at the local level, had incorporated open government and public records into the mission of his ongoing work with the state’s 246 municipalities. Secretary of State Sarah Copeland Hanzas has promised to keep it a priority.
This week is Sunshine Week, which was launched in 2005 by the American Society of News Editors — now News Leaders Association — and has grown into an enduring initiative to promote open government.
It is designed to promote a dialogue about the importance of open government and freedom of information. Participants usually include news media, civic groups, libraries, nonprofit organizations, schools and individuals concerned about the public’s right to know.
March 16 gets an added moniker as Freedom of Information Day.
According to the American Presidency Project, Proclamation 5447: Freedom of Information Day, 1986, “March 16 is the anniversary of the birth of James Madison, our fourth president and one of the principal figures in the Constitutional Convention. Madison eloquently expressed the guarantees in the Bill of Rights, in particular in the freedoms of religion, speech and of the press protected by the First Amendment. He understood the value of information in a democratic society, as well as the importance of its free and open dissemination. He believed that through the interaction of the government and its citizens, facilitated by a free press and open access to information, the government could be most responsive to the people it serves. Surely the American experience has proved him right.”
The Freedom of Information Act was enacted in 1966. It has been a valuable tool for all journalists, whether it has been covering The White House or our local select boards.
It’s our duty as journalists “to shine light into the dark recesses of government secrecy,” as the Society of Professional Journalists notes on its website.
As watchdogs for the community, journalists for The Times Argus and Rutland Herald track the laborious process of public meetings: ensuring meetings were warned correctly; making sure those running the meetings are not excluding the public from discussions; making sure our elected and appointed leaders are not abusing executive sessions in order to have private conversations that should be happening in open session; and following up by making sure the minutes of the meetings are posted within the constructs of Vermont law.
Considering how many public meetings are held across the state every week, that is a heavy lift, but an important one, especially when journalists start to identify patterns and certain boards that are bold enough to be making public decisions outside the public, either to assert power, or to avoid process. Either motive is why we need Sunshine Laws to protect the process and the public.
Mining public documents — including emails, text messages and correspondences — also falls under the purview of public access to information. Any citizen has the right to ask to see public documents. The process requires a level of specificity, and there is a documented timeline for requests being accepted or denied, and it sets guidelines (and cost parameters if the request is for a lot of documents requiring copying and staff time) for the timely release of public documents.
Knowing that process — and the potential pitfalls — usually gives journalists a better chance of asking for information than a member of the public who might not know where a document was created or from where it was distributed. That is the luxury of having a responsible local newspaper doing that work, seeking out those trouble spots, and calling out our civic leaders.
Bottom line: Public officials conduct themselves on behalf of the public. They do so in public, and their meetings are warned publicly, and their minutes are posted publicly. Except from notable exceptions, we all have a right to know.
Every citizen benefits from open government. Everyone deserves access to public information and what it means to you and your community.
It’s your right to know. It’s our privilege to keep an eye on it.
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