Author: John Burbank

We are approaching the Fourth of July, when we celebrate American independence and the success of the colonists’ desire to be self-ruling. The United States was the first of England’s many colonies to gain its independence, something that would not be repeated until Canada broke away nearly a century later. It’s a testament to Americans’ individualistic, rugged, bold ways.

But we didn’t do it alone. We couldn’t do it alone. Despite George Washington’s exceptional instincts, the Continental Army simply didn’t have the money, men, training or ships needed to defeat the British. So they were lucky to have the French, who were fuming after losing almost all their territory to the British in the French and Indian War. The French pummeled the British at sea, gave the Americans weapons, and sent soldiers to fight on American soil. It’s no coincidence the treaty ending that war was signed in Paris.

These facts are often lost in the myth of America’s origin. We like to talk of “self-made” individualists who pulled themselves up by their bootstraps. We’re told it’s a place where anyone can be president, and we can achieve anything if we work hard enough. It’s something like Garrison Keillor’s fictional Lake Wobegon, where every child is above average. But of course, the truth is a little different.

All wealthy Americans achieved their status with the help of other people. It may have been parents who paid for their education, allowing them to start out without student loans. Or a grandmother who offers free childcare during work hours. Or a credit union that offered a favorable first business loan. Or taxpayers who help fund the transportation networks that allow them to get to work and ship products. At the root, it’s the productivity of thousands of workers who generate wealth and ultimately make possible a person’s “individual” advancement.

Last year, Forbes listed Bill Gates as the top self-made billionaire. That’s partially true in that he’s the wealthiest, by far. But he’s not entirely self-made. His father was able to become a lawyer through the federal (taxpayer-funded) GI Bill, which helped make it possible for Bill to attend an expensive private school. Bill Gates and Paul Allen first explored computing through the (also taxpayer-financed) University of Washington’s computer lab. His wife, Melinda, stayed home to take care of their children while Microsoft was a young company. Taxpayer-funded research created the internet and built phone lines and other infrastructure, laying the groundwork for the personal computer revolution that made Microsoft huge.

Don’t get me wrong — I’m not saying Bill Gates isn’t a genius, or that he didn’t work hard for this success. But put a genius in the desert, alone, and what do you have? Society helped make Bill Gates rich. He and other wealthy individuals are the product of intergenerational and societal investments designed to build the common good.

That’s why it’s extremely dangerous when these societal investments are cut back and withdrawn. We can see it now with the prolonged debate over just how much the government is going to gut Medicaid and Medicare, or the long-overdue upgrades needed to our transportation networks; or the state Legislature’s unwillingness to fully-fund K-12 schools per the state Supreme Court’s order. We’re cutting up the social contract that creates an America where anyone can succeed.

You can’t get rich if you’re in bankruptcy from cancer treatments. You can’t succeed in business if your employees and customers can’t reach you. You can’t be a great employee — or come up with the next big business idea — if you don’t get a shot at a great education.

If we’re serious about keeping the promise of America, where upward mobility is available to everyone, we have to provide for education, transportation, health care, utilities and a myriad of other public good projects for the economy to thrive. And yes, that means paying taxes to fund those investments through our democratic institutions. Otherwise, it doesn’t matter how good the cause is, it will fail without a support system.

So this Fourth of July, as you celebrate our Independence Day, take a moment to recognize and remember that our community is what gives us the tools to succeed. Every day is Interdependence Day.

Originally posted at Herald.net

It’s day 23 of a second special session in Olympia, since legislators couldn’t agree to a state budget before the end of the regular session. Now they have only 16 days left until the new two-year fiscal term. It will be hard to start that without a budget!

The cause for delay is a disagreement over how to increase funding for the state’s paramount duty: public education. Republicans have proposed increasing property taxes in cities; Democrats have talked about a carbon tax or a capital gains tax. Gov. Jay Inslee suggests a sales tax on goods purchased online. But none of those measure has enough support to pass.

That leaves us with the status quo — which is convenient for avoiding tough political decisions, but atrocious for our kids and schools. The state Supreme Court ruled in 2012 that the state was guilty of underfunding education. Two years later, the court found the Legislature in contempt for failing to remedy this constitutional violation. And in 2015 the Court imposed a $100,000 per day fine on the Legislature for their failure to act, which now totals $67.1 million.

The Legislature has already put a plan for fully funding education into law, but they haven’t given themselves the tools to fund it. Unable — or rather, unwilling — to remedy that fundamental problem, some are now trying to pretend it no longer exists. Both parties have touted the improvements to education funding in the last few years. But it’s like having a house with a leaky roof, then patting yourself in the back for putting on a new coat of paint: the reality contrasts with the rhetoric.

In terms of quality, Washington’s K-12 schools lag behind 19 states, according to the Education Week Research Center: Massachusetts, New Jersey, Vermont, New Hampshire, Maryland, Connecticut, Wyoming, Pennsylvania, New York, Rhode Island, Minnesota, Wisconsin, Maine, Virginia, Illinois, North Dakota, Iowa, Delaware, and Nebraska. Part of those states’ success is their ability to maintain smaller student-teacher ratios: an average of 13 to 14 students per teacher. Washington has the seventh-worst ratio in the nation, at 19 students per teacher.

The only way to fix that is to hire more teachers. And that requires money. What would it take for our state to have class sizes like the states ahead of us? About $1.35 billion a year — but only if we could attract more teachers at current salaries!

Washington teachers are paid about 10 percent less than the national average, so we’re not attracting new talent. A beginning educator now earns only $35,700, even though the Legislature’s own technical working group recommended a starting salary of $54,000 next year. Raising teachers’ salaries to competitive levels would mean $2 billion a year in new public investments.

The Legislature is not even close to reaching those levels of funding. The core problem is that Washington state relies too much on regressive sales and property taxes, which mean poor and middle-class households pay four to seven times more of their income than those at the top. We can’t generate the revenue we need for public education with an upside-down tax system.

There are some options on the table. State law currently allows the very wealthy to accrue profit through stocks and bonds with no contribution to public good. A person pays no state tax when selling high-end financial assets. A capital gains tax — 92 percent of which would be paid by those with incomes over $600,000 a year — would generate about $700 million per year.

It’s nowhere near enough to cover the more than $3 billion we need to truly build a strong K-12 education system. But it’s a step in the right direction.

In the long run, the only realistic way we’re going to ensure educational opportunity is really a right for all children in Washington — and not a privilege for the lucky few — is with broad-based progressive tax reform that reduces taxes on low- and middle-income families, and increases them on the rich.

So far, our legislators have been loath to tax the wealthy. So we are left with this inconvenient truth: The wealthy are protected while the education of our children is undermined. The kids are not all right!

Original: Everett Herald »

As a young girl, my daughter had a fear of flying. She overcame this through a thorough study of airplanes and landed on the 737 as her preferred means of transportation in the air. So naturally, she asked for a Boeing T-shirt for a present. It says, “If it’s not Boeing, I’m not going!”

So let’s talk about Boeing. You might expect that Boeing would treat Everett as the jewel in the crown of its operations. That is certainly what the Boeing management led legislators and the governor to believe when the company demanded first a $3.2 billion tax concession from the state, and then another $8.7 billion.

But what did this recent tax giveaway to Boeing get us? A loss of close to 12,000 jobs, 15% of the total Boeing workforce in our state. That means that the state gave Boeing about $138,000 for every single job they took away!

Boeing just heralded its new 787-10, built in South Carolina. This was the first Boeing jet to make its first flight outside of Puget Sound. The company is forecasting that production of the earlier 787 models may slow down. Where will the planes not be built? Well, naturally, not in Boeing’s old home of Washington. That tax money we gave them? It just finances outsourcing of jobs and investment to other states and countries.

Boeing is spending billions of dollars in South Carolina and not in our state just to stick it to the unionized workers, the machinists and the engineers, in our state. There is no other reason, financial or otherwise, to forsake decades of investment in plant and workers. Remember how all this got started: Boeing took over McDonnell Douglas in 1997, but actually the McDonnell Douglas management took over Boeing. Right away, they went looking for a new Boeing corporate headquarters, not in Seattle.

The guy who oversaw this flight from and fleecing of our state was Harry Stonecipher. He dreamed up outsourcing the 787 to Japan, Italy, South Carolina and other places, which resulted in billions of dollars of cost overruns when the quality of this outsourcing was not good enough to fly safely in the new airplane.

As Jim Albaugh, chief of Commercial Airplanes at Boeing, explained in January 2011, “We spent a lot more money in trying to recover than we ever would have spent if we’d tried to keep the key technologies closer to home.” But Stonecipher was not fired for his mismanagement of Boeing, he was fired for his mismanagement of his personal life after it came out he was having an affair with another Boeing manager.

Washington has not only given billions to Boeing in tax breaks, it has invested in workers’ education to insure a pipeline of skilled employees for Boeing. At Edmonds Community College, the Washington Aerospace Training and Research Center teaches manufacturing assembly, electrical assembly, quality assurance, aerospace tooling and aerospace composites. Everett Community College has both the Center of Excellence for Aerospace and Advanced Manufacturing and an aviation maintenance technology program. In 2012, the Legislature established the Aerospace and Advanced Manufacturing Pipeline Advisory Committee.

However, with Boeing’s job drain, we do not need a pipeline. These workers are picked off by companies in other states, with no investment by those states. Recently SPEEA, the Boeing engineers union, sent out a notice to its members about Lockheed Martin holding a Seattle job fair to hire for positions in California and Texas. So now aerospace companies are poaching Boeing workers from our state. These workers have been educated thanks to our public investments in K-12 and higher education to supply Boeing with a skilled workforce. Now Boeing does not need or want these workers.

Boeing is indeed going. There is no reason why the state of Washington must pay them to go. The Legislature should immediately close that $8.7 billion tax loophole, and put that money into education from pre-kindergarten through college. Then we would have workers ready for Washington companies, including aerospace companies, who are committed to our state. Boeing is not one of those.

Originally published a the Everett Herald

(April 20, 2017) — The Legislature is wrapped up in discussions about how to fund (or not fund) K-12 education. But if you look under the covers, you will see that these very same elected representatives and senators are intent on defunding Sound Transit 3. Instead of simply abiding by the voters’ approval of the tax increases necessary to fund mass transit in the Puget Sound area, they are engaging in a bipartisan attack on the election results.

Last November, we approved Sound Transit 3, with more than 54 percent support for the taxes necessary to build out our light rail system. To finance this, voters ratified Sound Transit’s financing plan, which increases property taxes by $25 per $100,000 in assessed value, hikes sales taxes by one half of one percent, and increases annual car-tab fees by about $80 for a vehicle valued at $10,000.

That money will enable Sound Transit to complete a 108-mile light rail network from Everett to Tacoma. By 2040, Sound Transit and its regional transit partners, including Community Transit, will carry more than 200 million passengers, with seven out of 10 trips made by rail, most of those by light rail. That is the key, because light rail is dependable, doesn’t get stuck in traffic, and takes you to where you want to go, or at least close by!

During the campaign, Sound Transit was completely transparent about the taxes. We all knew that our car tabs would increase a lot in 2017 to help fund Sound Transit. So when the first invoices arrived, the vast majority of people just paid their tabs. But a vocal minority, with big tabs from expensive cars, took their displeasure to Olympia, hoping that the Legislature would listen to their stories and disregard the will of the people.

Now we have a bipartisan attack on Sound Transit, with both Republicans and Democrats offering proposals for defunding.  The Republicans in the Senate are straightforward. One bill, sponsored by Sen. Dino Rossi (R-Sammamish), would allow cities and counties to opt out of all Sound Transit taxes. With this one bill, the Republicans enable any city to pull itself out of Sound Transit, regardless of how its citizens benefit. Free rides for all! This bill also appears to be a moneymaker for Tim Eyman, as it enables local initiatives to void all taxes paying for Sound Transit.

In this context, the Democrats’ proposal in the House of Representatives doesn’t look so bad. But it is not good. It, too, undermines the vote of the people last year and the financing necessary for building out Sound Transit.  Twenty Democrats in the House of Representatives endorsed the Sound Transit 3 ballot initiative. Now they are proposing to lower car tabs for motorists who have bought cars recently, and especially for those who have bought the most expensive cars. This is what is considered “providing fair tax relief for motorists.”

Do Democrats think they can win votes from the complainers who do not want to pay their car tabs for Sound Transit? The Democratic proposal does not roll back car tabs to where they were last year. So if you are going to complain, you will complain about your car tab increase whether it is $100 or $200 or $300.

One owner stated that he was billed three times as much as what he paid last year. His total bill was $406. Under the Democrats’ bill, it will be around $275. He won’t like that either.

But let’s stick with the law as approved by the voters. $406 sounds like a lot. Now consider his vehicle: a 2010 Range Rover, with a sticker price of more than $76,000. If he can afford a car that is valued at twice the total annual earnings of typical workers in our state, then he can afford his car tabs. They cost him $1.11 a day.

Under the Democrats’ bill, if passed, car tabs for this fellow would be 75 cents a day. He would save 36 cents a day and Sound Transit would lose 36 cents a day. That’s not much, but you add together all these reductions, and Sound Transit loses $780 million in car tab fees. This will result in a total loss of $2 billion over 25 years, a loss of 4 percent of the total budget for Sound Transit 3, worth about four miles of light rail track.

Perhaps the light rail to Everett would end at Paine Field. You could take a taxi to downtown!

 

Originally published at The Stand.

Here’s a headline that should make us happy: “Trump, Battered in Washington, Is Buoyed at Boeing Rally.” That was from the New York Times, last Friday.

But the funny thing is, there was no Boeing rally in our state, where the vast majority of Boeing workers live and work, making the vast majority of Boeing’s airplanes. And it wasn’t “fake news.” Trump just decamped to Charleston, South Carolina, to have a love fest with Boeing management. Those are the same people who funded and masterminded an all-out multi-million-dollar anti-union campaign to blackmail workers in South Carolina not to join the Machinists union.

The backdrop for this love fest between the billionaire and the mere millionaires of Boeing’s management was the latest new Boeing 787-10 Dreamliner in production in South Carolina. South Carolina wasn’t even called out in Boeing’s employment statistics in 2012. Now it is touted as the jewel in the crown. Is something wrong with this picture? A lot of things.

How did Boeing get all the billions of dollars to invest in South Carolina? Well, it could be seen as a direct transfer of tax money from our state, to Boeing, to South Carolina. Just in 2014 and 2015, Boeing got more than $521 million in tax breaks from the state of Washington. Did that go to ramping up Boeing employment in our state? No, employment has actually fallen, from 87,000 in October 2012 to 71,000 now. That is a loss of 16,000 jobs, or almost 1 out of 5 jobs disappeared.

Adding up the tax exemptions that Boeing rammed through the Legislature in 2003 ($3.2 billion) and 2013 ($8.7 billion) and even a top executive can figure out that’s how to invest in South Carolina. Which Boeing has done, to the tune of at least $2 billion, so far. These tax breaks have also enabled Boeing to pay over $41 million in fines in 2014 and 2015 for falsifying claims for the maintenance of military aircraft. No skin off Boeing’s profits!

Why is Boeing so anxious to rob the state of Washington and starve education funding, with these tax breaks? Is it because the workers in Washington, organized together in the Machinists Union and SPEEA, saved Boeing from its disastrous outsourcing of initial production of the 787 to other state, countries and companies? Is it because the 737 plant is going full-tilt as Boeing’s cash cow in Renton? Is it because we have the biggest concentration of aerospace-related production, manufacturing, and brain power in the world right here. Is it because the state of Washington has invested in community college workforce training and degrees tailored specifically to “supply” skilled workers for Boeing?

OK, so none of these reasons makes sense. How about this one: Washington workers are organized into unions at Boeing. Because of this, they don’t have to forfeit their constitutional rights when they walk into the plant. They get some respect from the company. They have some power to negotiate with the company to determine their wages and benefits. They cannot be fired at the arbitrary whim of a supervisor. They cannot be fired by Donald Trump, like he loved to do on “The Apprentice.”

Are there ways to stop the hemorrhaging of Boeing jobs from our state? Last year, state Rep. June Robinson, D-Everett, proposed a simple equation: Boeing, if you want your tax break, you keep jobs in Washington; if you reduce employment by 5,000 jobs or more, you lose your tax break and that money goes into education funding.

Really, what do we have to lose? Our state is just getting played by Boeing. We give Boeing tax breaks, they invest in other states and countries. We don’t, and Boeing invests in other states and countries, but they will have less money to do so. And of course, whenever these Boeing off-sites like the joint Boeing-Russian operation for titanium machining in the Ural Mountains of Russia, or the Charleston, South Carolina, site for the 787-E or the Boeing technology center in Moscow, whenever any one of them fail the exact quality assurance we all need for aircraft, Boeing will always fall back on the workers, the machinists, the engineers and the aerospace infrastructure of Washington state. So rather than encouraging Boeing to go, let’s just tell them they should stay!

Originally published at HeraldNet.com

I am a lucky person. My jaw is broken, but that is not why I am lucky.

I have good health and dental insurance. So when my jaw was fractured last month, I didn’t have to worry about how I could afford to fix it. Sure, I will pay some significant cost-sharing, but it will not make me poor. And this final fact overrides all the inconveniences of having my teeth wired and banded so the jaw can heal.

That’s why I am lucky.

Before the Affordable Care Act, millions of people in our state did have to worry about the cost of health care. If they had “pre-existing conditions” they were forced to get their coverage through the state’s high-risk pool, which was very expensive. If they had insurance, their premiums or their share of premiums went up and up every year. The deductibles and out-of-pocket costs went up as well. If they didn’t have insurance, they lived in fear of being sick or getting hurt, or they simply played the odds and thought they could get by. Some did. Others didn’t. They were saddled with tens of thousands of dollars of costs for their care. And the hospitals to which they went for emergency care accrued hundreds of millions of dollars in costs for uncompensated care.

The proportion of people without insurance in our state has fallen by 10 percent between 2010 and 2015. That’s means that about 700,000 people now have health coverage that they did not have before passage of the Affordable Care Act. Our rate of uninsured is at an all-time low – 5.8 percent in 2015. It has fallen further since then. This is an equal opportunity benefit. The uninsured rate for whites fell 7.5 percent between 2013 and 2015. For blacks it fell 10.2 percent. For Hispanics it fell 13.2 percent. For Native Americans it fell 14.3 percent.

How did this happen? The Affordable Care Act enabled coverage of young adults under their parents’ employer-provided health insurance until age 26. The act disallowed insurance companies from denying coverage on the basis of pre-existing conditions.

The act expanded our state’s Apple Health coverage up the income ladder, so that all citizens with incomes below 138 percent of the federal poverty level could get health coverage. (That’s $16,400 for a single person and $33,500 for a family of four.) The act created the individual health insurance exchange and enabled immediate tax credits for people with income up to 400 percent of the federal poverty level who purchased their coverage through the exchange. That comes out to subsidize coverage for individuals with incomes up to $47,500. The act created subsidies for out-of-pocket costs for people up to 250 percent of federal poverty level — $29,700 for a single person and $60,750 for a family of four.

Today 1,838,000 people get their health coverage through Apple Health and another 173,000 get their coverage through the health benefit exchange. Apple Health now covers over 136,000 people in Snohomish County. The individual exchange covers another 16,500. So in Snohomish County, as is true for the entire state, 1 out of every 4 people get their health coverage through the Washington Benefit Exchange.

We all know the Affordable Care Act is not perfect. Out of pocket costs can be up to $6,000 per person. When your income goes up from $16,000 to $20,000, you have to go from Apple Health, with zero cost, into the exchange, which, even at that income, will cost you almost $1,000 for your share of the premium and up to $2,500 more if you get sick and need care. As your income further increases, your health care costs get more out of whack.

So, the Affordable Care Act could and should be improved. But it does work. Millions of people in our state alone have health coverage that they did not have before.

What we need to do now is to decrease health care costs and eliminate wasteful unnecessary care. That means driving down the costs of pharmaceuticals, hospitalization and specialty care. But that would mean taking on the “swamp” of special interests in Washington, D.C. Donald Trump and the Republican-controlled Congress swim in that swamp. They want to repeal the Affordable Care Act. They don’t have a replacement. That’s their plan for making America great again. But that’s not our America.

Original: Everett Herald »

This week we witnessed another 21st century virtual coup in America.

Hillary Clinton won the popular vote by well over 600,000 votes and by the time all the ballots are counted, it will be a margin in excess of 1.5 million nationwide. Hillary lost the electoral college vote, an archaic institution fashioned by the founders to insulate the making of a president from the democratic will of the voters.

On top of this, the intervention of the FBI in the election just 10 days before voting, and then the finding by the FBI that there was nothing new, announced two days before the election, had a significant dampening effect on voting for Hillary Clinton.

Just 16 years ago, Al Gore won the popular vote for president by a margin of more than half a million votes, and lost the electoral college vote to George Bush. What did that bring us: war, privatization, money for the already monied, stagnation of wages and income, the pulling apart of America. But America survived and we survived. We will survive the Trump years, and rise again.

Most likely, only bad things will happen at the federal level, from health coverage to environmental protection to corporate regulation and accelerated privatization to trampling on workers’ rights and their organization into unions.

What this means for us is that we can progress, we must progress, and we will progress at the state and local level. Election results from Tuesday underscore this. Our minimum wage and statewide paid sick days initiative in Washington won with 59% support.

We must look forward, and we must realize our responsibility to the people of our several states. So already in Washington we have a host of proposals for the coming year. Family leave insurance is of highest priority for the state legislature. We will also be working on compensation for early learning teachers and caregivers, progressive tax reform, higher education affordability and accessibility, health coverage, and a state supplemental social security system to add to federal social security as private retirement plans wither.

Then we have a host of openings and opportunities at the city level, especially in Seattle, including a family allowance and local tax reform.

We don’t have much of a choice, do we? We must go forward, or we must go forward. I would suggest we go forward, for the well-being of our people and our democracy.

When your ballot arrives later this week, take a pause and before you vote, consider, what does it mean to be an American? As Americans, we are all in this election together. We are in this country, this economy, this culture, and this government together.

What is government? It is the comprehensive delivery of services upon which we all depend, including emergency responders to the wind storms last week, schools for our kids, health care for retired people and low-income citizens, protection from violence and terrorism, road maintenance, public utilities, food safety, the court system to protect private property and enforce contracts, and the regulation of the financial underpinnings of our economy. Literally every part of our daily lives, and of the private capitalist economy, is dependent on government services.

We don’t get these services for nothing. We pay for them, with our taxes. So let’s talk about taxes. According to the New York Times, pollsters have been asking Americans whether “it is every American’s civic duty to pay their fair share of taxes.” Every year, about nine in 10 Americans agree they should.

It is not just people’s opinions. It is their actions. Paying federal income taxes is done through a system of voluntary compliance. Sure, you might be caught by the IRS if you don’t submit your 1040. But the actual likelihood of this is so slim that some economists, weighing costs and benefits, claim that it makes sense for a “rational” person to evade taxes altogether. But we are rational people and 140 million of American households, that is, us, file our federal income taxes every year. Over four-fifths of total tax liabilities are paid on time. We do this because we all understand, intuitively, that if we want public services, we have to pay for them.

What people don’t like is tax avoidance. You pay no federal taxes, and you reap all the benefits of living in America. That’s what appears to be Donald Trump’s situation, which he terms as “smart” and we all know is just selfish.

It is also the habit of some of Washington’s largest companies. Microsoft has stashed away $124 billion in Ireland, Luxembourg, and Singapore. This maneuver enables Microsoft to avoid $39 billion in what the corporation should have contributed in federal taxes. Microsoft is joined by Pfizer, GE, and Apple as those corporations that have hidden over $100 billion each in tax havens, avoiding taxes in our country.

Compare that legal maneuvering to avoid taxes to the voting habits of Americans. Even in the face of the anti-tax rhetoric which politicians like to preach, Americans have increasingly supported taxation for government services. Thirty-five years ago, only about one in five state ballot measures to raise taxes passed. In the past decade, voters have approved half of tax-increasing measures on state ballots.

This public support for taxation increases at the local level. Last April, voters in the Everett School District approved both a levy and a bond for capital projects and technology. Last February, voters in Arlington, Edmonds, Lake Stevens, Lakewood, Mukilteo and Stanwood all approved school levies. Less than a year ago, voters in Gold Bar, Stanwood, Arlington and Warm Beach voted for property taxes to finance fire and police services, renovate fire stations, purchase equipment and fund EMS. Across the county, voters approved an increase in the sales tax to enhance Community Transit services.

These are our neighbors, our families and ourselves voting to tax ourselves so that our local governments, school districts, and fire districts can provide the fundamental services needed as foundations for our quality of life. We as citizens make the immediate connections to our shared local well-being – hence, we support schools, EMS, and fire protection.

We make the same connection with the federal government. We understand that taxes provide safety, security, education financing, regulation of food and drugs, environmental protection, disaster relief, national parks, Social Security, Medicare and Medicaid, occupational safety, negotiations with other countries, and the list goes on and on.

We get that. We as taxpayers pay for that. We are the patriotic ones. Not so for the people who avoid their taxes, or who applaud those who avoid their taxes, or the corporations which hide their money in tax-free havens in other countries. They are not patriotic. They are free riders.

Originallly published: a the Everett Herald

King County residents, especially those with U.S. citizenship, have benefitted greatly from the expansion of health coverage via the Affordable Care Act. Between April 2014 and March 2016, the number of residents covered through Apple Health (Medicaid) and the Qualified Health Plans offered through the Washington Health Benefit Exchange grew by 55%, from 256,000 to 396,000.[i] As a result, one out of five King County residents now has health insurance through Apple Health or Qualified Health Plans.[ii]

These expansions have driven a noteworthy decrease in the number of uninsured residents in King County. Data from the Washington State Office of Financial Management (OFM) and Public Health – Seattle & King County shows a systemic decline in the number of uninsured across the board: by ethnicity, age, employment status, citizenship and income level between 2013 and 2014[iii] (prior to the 140,000 person increase in health coverage through the Health Benefit Exchange in 2016.)

Between 2013 and 2014, King County realized a 38% proportional decrease in the number of uninsured, as the number of people without health insurance decreased by 82,000. Compared to a 35% drop in the uninsured across the state, and a 20% drop in the uninsured nationally, this makes King County a high performer relative to other jurisdictions.[iv]

Of particular note: disproportionate drops in the rate of uninsured occurred among African Americans, Asian Americans, people with incomes below 138% of federal poverty level, the unemployed, and naturalized citizens. These numbers indicate the success of the Affordable Care Act across all population cohorts, while highlighting those cohorts which still disproportionately lack health coverage.

Who Doesn’t Have Coverage in King County

In spite of the advances in coverage made possible through the Affordable Care Act, 139,000 residents of King County still did not have health insurance as of 2014.[v] These individuals are particularly concentrated among adults not in the labor force (35,546), non-citizens, those who with incomes below the median income (112,040), Hispanics (35,785), and people between the ages of 25 and 45 (75,233). These are overlapping cohorts. For example, thousands of Hispanics reside and work in Washington state are both poor and do not yet have citizenship status.

It is important to note that since 2014, over 140,000 additional people have gained health coverage through Apple Health or the Health Benefit Exchange (an additional 60% on top of 2014’s totals). At the same time, King County’s overall population has grown by 89,000 people. Without knowing the numbers of employees who have been switched from employer health coverage to coverage through the Health Benefit Exchange, we can only imprecisely estimate the number of residents who remain uninsured in King County. Our estimate is that of the 2.1 million residents of King County, fewer than 80,000 people, or less than 4% of the County’s population, lack health coverage.

Price Walls and Affordability

A decrease in the number of uninsured does not mean the Affordable Care Act has “solved” problems with the nation’s health insurance coverage. Current coverage rates still don’t match the levels found in other developed countries around the world. And even King County residents who have health insurance remain vulnerable to losing coverage or being financially unable to meet their “cost-share” for health coverage.

The price wall people encounter when their income exceeds 138% of federal poverty level is another significant problem. With an annual income of $16,284 or less, an adult is covered by Apple Health, with minimal, if any, cost to the individual.[vi] But if that same person gets a wage increase and thereby earns $20,650 (175% of federal poverty level), the combined premium and out-of-pocket costs can exceed $2,300 – more than 12% of their income – even after receiving federal subsidies. For a person earning $23,600 (200% of federal poverty level), the combined premium and out-of-pocket costs can exceed $2,800.[vii]

The Price Wall Problem

Imagine a hypothetical community college student named Brenda, who is working 32 hours a week at the minimum wage in Burien. At $9.47/hour, her income is $14,773 and she qualifies for Apple Health (i.e. no-cost health insurance.) The following year, she takes a job in Seattle that pays $12.50/hour. Her income goes up to $20,800, a bit above 175% of federal poverty level.

Brenda now no longer qualifies for Apple Health, and so moves into the commercial health benefit exchange. While premiums and out-of-pocket costs are subsidized by the federal government, they can still be sizeable. If she gets ill and needs care, she can lose 40% of the increase in her wages – over $2,300 – to payments for her health insurance coverage. If her income increases to $29,500, she could pay as much as $6,152 for health care in premiums and out-of-pockets costs – more than 20% of her total income.

Solutions for Advancing Health Coverage in King County

King County can improve health insurance coverage by paying particular attention to those populations with continued high rates of uninsurance and underinsurance – that is, individuals below 138% of federal poverty level (who qualify for Apple Health but may have difficulty accessing it), and those between 138% and 199% of federal poverty level.

For people in the former category, that corresponds to: less than $16,284 for a single person; less than $22,107 for a two-person family; less than $27,820 for a three-person family; less than $33,534 for a four-person family; and less than $39,247 for a five-person family. The county should make every effort to expedite coverage for this population through Apple Health, while recognizing that many residents and workers at this income level will still not be able to gain coverage due to citizenship status.

For those with incomes between 138% and 300% of federal poverty level, there is not a straightforward solution regarding affordability – particularly for premiums and out-of-pocket costs that challenge family budgets. One avenue is for the county to explore re-instituting Washington state’s Basic Health Plan at the county level, using the same parameters for cost-sharing that were in place when the people passed Initiative 773 in 2001 to expand Basic Health coverage.

The county could also work with the state and federal government to increase the threshold for coverage under Apple Health from 138% to 150% of federal poverty level. If this were to happen, about 13,000 people currently in the commercial exchange could move into Apple Health.[viii] Another possibility is for the county to work with the state in developing a federal Basic Health option, as provided by the Affordable Care Act’s section 1331.

The county could also continue to dedicate and increase resources to providing care for those excluded from coverage under the Affordable Care Act, particularly recent immigrants. King County has already laid out an agenda for action, outlined in the July 2015 report, “Access to Health Care After the Affordable Care Act”[ix] and the October 2015 report, “Affordable Care Act Enrollment in King County: Early General Population Impacts.”[x]

King County, Washington state, and the United States have embarked upon systemic and significant advances toward achieving health coverage for all. While progress has been made, there is much more to do. This work will take innovative and creative policy development, increased public funding, and, most importantly, the political will to meet the health needs of and establish health security for all residents.

Notes:

[i]     Washington Health Benefit Exchange Enrollment Reports: http://www.wahbexchange.org/wp-content/uploads/2016/02/HBE_EN_140422_April_Enrollment_Report.pdf, http://www.wahbexchange.org/wp-content/uploads/2015/12/HBE_EN_160607_March_Enrollment_Report.pdf

[ii]     Population grew in King County from 1,981,900 to 2,052,800 between 2013 and 2015, an increase of 70,900, or 3.58%. See http://www.ofm.wa.gov/pop/asr/default.asp Washington state Office of Financial Management, Population, Estimates of April 1st population, county data tables.

[iii]    The OFM data is for the total population (that is, including Medicare recipients 65 and older, and children under 18 years old, whose coverage is very high, thanks in large part to Apple Health. The King County data focuses on the 18-64 age population. Further, OFM adjusted data to take in account an undercount of Apple Health enrollment in the 2014 American Community Survey (ACS). These differing methodologies and populations account for the difference in the rates of uninsured.

[iv]    Affordable Care Act Enrollment in King County, presentation by Public Health – Seattle & King County, http://www.kingcounty.gov/healthservices/health/%7e/media/health/publichealth/documents/data/affordable-care-act-enrollment-king-county.ashx, p. 10 and 11.

[v]     American Community Survey 1-Year Estimates on the American FactFinder; Wei Yen, OFM Forecasting and Research Division

[vi]    Washington State Health Care Authority: Apple Health Federal Poverty Level (FPL) Chart – Find out if you’re eligible http://www.hca.wa.gov/medicaid/publications/Documents/19_031.pdf

[vii]    Washington Health Plan Finder: https://www.wahealthplanfinder.org/HBEWeb/Annon_ShowIndividualFamilyPlans

[viii]   Washington Health Benefit Exchange, March 2015, Health Coverage Enrollment Report, page 8: http://wahbexchange.org/wp-content/uploads/2015/08/991427407310_2015_Enrollment_Report_2_032615.pdf

[ix]    Access to Health Care After the Affordable Care Act, presentation by Public Health – Seattle & King County, http://www.kingcounty.gov/healthservices/health/%7e/media/health/publichealth/documents/data/Access-Health-Care-After-ACA.ashx

[x]     http://www.kingcounty.gov/healthservices/health/%7e/media/health/publichealth/documents/data/affordable-care-act-enrollment-king-county.ashx

Originally published at EOI Online