Life expectancy from another angle
Earlier in the week I wrote about life expectancy in the U.S. and how our woeful public health system negatively impacts it.
Another under-the-radar issue affecting how long we live is where we live. That is, living in a blue or red state can either add years to your life, or deprive you of a few. Significant research is bearing this out.
A report from the Population Reference Bureau, with funding support from the National Institute on Aging, concludes that life expectancy is influenced by policymaker decisions at the state level. According to the report:
Life expectancy differences among states have widened in recent years, as state policies have become more polarized. In general, states where policies have become more liberal have added years to their residents’ lives more quickly, while states where policies have veered conservative have seen slower gains in life expectancy.
This study builds on research published by Jennifer Karas Montez, et al., in the Millbank Quarterly in August 2020. Their paper, US State Policies, Politics, and Life Expectancy, found that states with more conservative marijuana policies and more liberal policies on the environment, gun safety, labor rights, economic taxes, and tobacco taxes were related to lower mortality in working-age Americans between 1999 and 2019. In particular, gun safety laws were associated with a lower suicide risk among men; labor protections like minimum wage and paid leave were tied to a lower risk of alcohol-related death; and tobacco taxes and economic taxes were linked to a lower risk of death from cardiovascular disease.
The authors estimate if all states enacted the most liberal policies, 171,030 lives might have been saved in 2019. On the other hand, enacting the most conservative policies might have cost 217,635 lives. Looking at it from another perspective, they concluded that US life expectancy would be 2.8 years longer among women and 2.1 years longer among men if all states enjoyed the health advantages of states with more liberal policies.
It would be nice if research like this persuaded politicians in red states to consider liberalizing some of their policies with an eye to making life better for their constituents. At the very least, they could read the studies (I did) and invite the researchers to discuss their findings.
Meanwhile, deep in the heart of Texas
You probably don’t know this if you don’t live there, but for months, top Republicans in the Lone Star State have coalesced into two warring camps. On one side are State Attorney General Ken Paxton and his followers. Facing off against them are Speaker of the House Dade Phelan and the House Committee on General Investigating. The Texas House has long been seen as far less far rightish than the Senate and Paxton’s base. The result is that though they have total control over the Legislature and every statewide office, Republicans have not always agreed on what to do with their power.
For some time it has been apparent the two sides don’t like each other very much.
A bit of history is in order.
There has been a cloud of scandal hovering over Attorney General Paxton for years. The ever-darkening cloud includes an extramarital affair and actions taken to benefit an Austin real estate developer who donated to Paxton’s campaign and renovated his home. Despite the scandal, and an indictment in state court for securities fraud dating back to 2015 (he has repeatedly succeeded in delaying his trial), he won re-election to a third term last year, largely by closely aligning himself with Donald Trump and his MAGA supporters.
The barely concealed disdain of the two factions for each other, brewing for months, burst into public view this past week when the Attorney General accused Speaker Phelan of performing his duties while drunk and called for the speaker’s resignation.¹
That accusation last Tuesday sent a shock wave through Austin. Then, less than an hour later, word came that Paxton might have had a personal motive for attacking the speaker: The aforementioned House Committee on General Investigating had subpoenaed records from his office, as part of an inquiry into the Attorney General’s request for $3.3 million in state money to settle corruption allegations brought against him by his own former high-ranking aides.
The House Committee met the next day, Wednesday, for several hours to discuss accusations against Paxton brought by those former aides in 2020, as well as allegations of retaliation from the same former aides.
The four top aides — turned whistleblowers — had taken their concerns about his activities to the F.B.I. and the Texas Rangers. Paxton then fired all four.
The aides — Ryan Vassar, Mark Penley, James Blake Brickman and David Maxwell — are all former Deputy Attorneys General, and Maxwell is a former director of the office’s law enforcement division. They told investigators that the Texas AG may have committed crimes including bribery and abuse of office. They have also sued Paxton.
This is where the $3.3 million comes in. Paxton wanted the state to pay that amount to settle the lawsuit brought by the former aides. Speaker Phelan has said that he did not believe there were the votes in the House needed to approve the payment; he also has said that he did not himself support doing so. If the state paid the aides the $3.3 million settlement it would be like giving Paxton a very expensive Get Out Of Jail Free card.
After hours of testimony on Wednesday from five House investigators who outlined the evidence they had collected against Paxton, the attorney general suggested on Twitter that he believed the Texas House was preparing a case to impeach him.
“It is not surprising that a committee appointed by liberal Speaker Dade Phelan would seek to disenfranchise Texas voters and sabotage my work as attorney general,” Paxton said in a statement aimed at his base of supporters, many of whom view the Speaker as aligned with Democrats.
Thursday evening, the Committee on General Investigating unanimously filed 20 articles of impeachment against the Texas AG. The Committee is composed of two Democrats and three Republicans.
And last night, despite a last minute appeal by Donald Trump, the Texas House overwhelmingly voted to impeach Attorney General Paxton, temporarily removing him from office while he undergoes trial in the Senate. The vote was 121-23. He is the first statewide office holder to be impeached in Texas since 1917.
Regardless of the lopsided impeachment vote, one can be forgiven for thinking a conviction in the Texas Senate will be about as difficult to achieve as a conviction in the US Senate was, twice, for Donald Trump.
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¹ After a 12 hour day of pushing through bills as the House’s term was approaching year-end, 57-year-old Speaker Phelan appeared to slur a few words in one sentence. This was recorded on video. It went unnoticed by most. But apparently not by Paxton.
Medicaid work requirements — raw meat to the Republican base
Late yesterday, President Biden and Speaker Kevin McCarthy, the Republican House leader, announced yesterday that they had reached a deal to increase the amount of money the government can borrow. The deal includes additional work requirements for food stamps and welfare.
Getting tougher with Medicaid work requirements was one of the sticking points in resolving the ridiculous debt ceiling crisis. It is something the more conservative, that would be most, elements of the Republican Party have demanded for at least the last two decades.
But what would that achieve in terms of reducing the national debt and helping people get healthier so they can escape poverty?
I have written before about the resource-rich Econofact.org, a product of the Edward R. Murrow Center for a Digital World at The Fletcher School at Tufts University. Econofact, created by eminent economist Michael Klein, is a network of economists and public policy specialists from all over the country who contribute to the non-partisan publication designed to bring key facts and incisive analysis to the national debate on economic and social policies. Unlike most things on the internet these days, Econofact is free to readers. It is well worth subscribing.
Regarding the work requirements continuing dispute, I would like to show you three charts produced by Econofact thought leaders² to put the issue in perhaps a better perspective. Basically, the data show adding to work requirements already in place won’t reduce US spending and, besides being not worth the administrative and bureaucratic effort, would negatively impact many children currently living in poverty and make it more difficult for them to rise out of it.
First, what is the size of the population we’re actually talking about?
It’s the bottom four bars, totaling 11.57 percent of the population, we’re talking about.
Now, how is that 11.57 percent spending its time?
Less than six percent are unemployed, but looking for work.
Finally, to what extent does expanding access to Medicaid increase the probability of rising out of poverty?
This Letter began with research showing that states more liberal in their constituent services experience greater life expectancy. Medicaid is one of those services. The Econofact charts show most people on Medicaid who can work, already are. They also show, in addition to greater life expectancy, enhancing Medicaid benefits is the best way to achieve what should be the desired goal of Medicaid in the first place: getting people healthy, so they can raise themselves out of poverty into productive lives.
This debt ceiling deal, while possibly ending the crisis (if it can actually pass in the Congress), will not help to achieve that goal.
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² The first chart was produced by Econofact contributors Melissa Kearney and Luke Pardue, of
the University of Maryland, Aspen Economic Strategy Group, and Gusto; the second, by Ann Stevens, of UC Davis and the Center for Poverty Research; and the third by Adriana Kugler, of Georgetown University.
