Paying the price for the ACA

Published at Socialist Worker.

The introduction of the "insurance exchanges" set up by the Affordable Care Act (ACA)--the "virtual stores" where the uninsured are supposed to be able to comparison shop for health care coverage--are showing everything that's wrong with Barack Obama's health care law.

The exchange websites have been plagued by problems that won't be fixed for weeks--as a consequence of the byzantine complexity of a 2,000-page law where the priority is preserving the role of the private insurance industry. When the uninsured are able to consider their options, they're finding that the "choice" is no choice at all--sign up for still-expensive health plans that contain all kinds of provisions like co-pays and deductibles that make them even more expensive, or stay uninsured and pay a fine on their taxes.

Part of the rationale for the ACA is that the exchanges would bring younger people, who tend to be healthier, into the system, where their premiums would allow the insurance companies to provide less expensive coverage for older people who need more health care. But there's a flaw in the argument: Instead of healthier people subsidizing health care who have a greater need for it, they're also subsidizing the bottom lines of the health insurance companies.

Gary Lapon asked three young adults about their experiences with the health care system and with the ACA: Spring is a 34-year-old freelance makeup artist living on Staten Island in New York City. She is pregnant; she and her husband are expecting their first child in February 2014.Brian is 27 years old and lives in Washington, D.C., where he works full time at a bicycle shop.Melissa is 32 years old and lives in Oakland, Calif. She currently works in retail in San Francisco.

Brian: Not really. When I have gotten sick, I just try my best to make it go away--ha ha.
I was in a bicycle accident last year and sustained a concussion, even with my helmet on. I didn't go to the hospital; I just talked to my sister, who is a doctor, on the phone for some advice. People tell me that if I'm in another accident and it's bad, I'll wish I had paid for the insurance then. But I seriously can't afford to spend another $100 every month. And even if I could, the cost of the co-pays would keep me from going anyway. Why should I pay for something I can't afford to use?
I was in a bicycle accident last year and sustained a concussion, even with my helmet on. I didn't go to the hospital; I just talked to my sister, who is a doctor, on the phone for some advice. People tell me that if I'm in another accident and it's bad, I'll wish I had paid for the insurance then. But I seriously can't afford to spend another $100 every month. And even if I could, the cost of the co-pays would keep me from going anyway. Why should I pay for something I can't afford to use?

HOW WOULD you describe your current health care situation. Are you insured and do you have access to care? What is that like?

Spring: I'm "self-employed," so I have to pay for individual health care. Because my husband and I were planning to get pregnant, we got the only plan we could afford that has maternity coverage, which is over $300 a month.

About two months after finding out we were pregnant, I got a notice that the health care plan that I have will be discontinued as of January 1, 2014. That's just over a month before I'm due to give birth. Their excuse was that they no longer will cover "sole proprietors"--meaning small business owners with no employees, which I am. We tried to find a new plan to replace this one that included prenatal/maternity coverage, but the cheapest plan started at over $1,000 a month, which is way out of our price range.

Brian: I currently don't have health insurance and haven't for almost two years. My employer is small and doesn't offer health insurance. I'm fairly healthy, although my lifestyle of bicycling everywhere puts me in a vulnerable position.

I was hit by a car in late February of this year and broke my heel. Fortunately for me, it was the driver's fault, and his insurance company paid for my treatment after six months of legal disputes, though I had to incur that debt during those six months. It cost me hundreds of dollars for 10 minutes of care every week. For six months, I was on crutches. Normally I ride my bike everywhere, so a 30 minutes commute via bicycle became a 60 minutes bus ride.

I got calls from the hospital almost every week, with new and confusing bills I had to pay and put on my credit card, which gained interest. Every time I went in for a regular checkup, it was $200 to $300 each time, when I really only had about 5 to 10 minutes with the doctor--from what I hear, that was a good deal. All my bills came to about $10,000 total! I had to really tighten my belt on everything that I did during those six months. It gave me an insight into the industry--even most receptionists had no idea how much out of pocket an appointment would be.

Melissa: I'm uninsured. I got my bachelor's degree two years ago and planned to teach ESL, but ESL programs have taken a huge hit since public schools have faced severe budget cuts, and now I'm left with $36,000 in student loans and meager job prospects, much like others in my graduating class.

The thing is, I was 30 when I graduated, so I'm not eligible to be covered by my parents' insurance like many in my cohort--the Affordable Care Act enables people to remain on their parents' health insurance until they reach age 26--assuming their parents have insurance anyway.

I work in a small retail shop in San Francisco, but since I can't afford to live there, I can't get HealthySF, the city insurance for low- to medium-income people. I've gone back to a community college in Oakland to get training in machining, in the hopes that I can get a job with insurance soon.

HAVE YOU ever gone without care due to a lack of health insurance?

Melissa: Fortunately, I live in an area of the country with some decent clinics. I can go to the Berkeley Free Clinic for some very basic care, but not much beyond that.

I have a genetic condition that, while usually mild, can potentially have serious health complications. The seriousness can be mitigated if the complications are caught early, but that requires me to have an EKG more frequently as I get older. The last time I was due was last year. My grandmother died at 56 from this disorder, and my uncle almost died at 48. That's when everyone in my family got tested, and I found out I had it.

I also wear glasses, which the ACA doesn't cover either. Same for dental. It also has very restricted mental health coverage. It's like they don't care if I'm blind, crazy, and my teeth fall out, as long as the rest of me is fit for work.

Spring: Until this year, I went without health care coverage for as long as I've been a freelancer, which is about eight years. I've never been able to afford coverage for myself, and previously had coverage through employers or Medicaid. Once I became self-employed, I no longer qualified for Medicaid, although my income was low.

WHAT DO you think of our options under the Affordable Care Act?

Melissa: I feel pretty confident compared to most, but I'm no expert. The one thing I do know is that I can't afford insurance through it and I'm going to get fined because of it. And I think that's the case for a lot of people.

Spring: The ACA is very confusing, especially when it comes to what types of coverage an individual qualifies for, and how to go about actually getting coverage. I know that I can't be denied because of a pre-existing condition, and that the income level that qualifies for Medicaid has been raised, and I now qualify for Medicaid. The fact that I have to have coverage or face a penalty is ridiculous, and financially penalizes the poor and those who can't afford it.

Brian: I don't feel totally confident that I know my options. However, I'm sure I will become more well-versed as I go through the process a little more.

I do understand it as a handout to insurance companies. All of the sudden, working people will have to shell out a fair amount of money for private insurance, which have some of the highest profits of all companies. There are good things in the bill, like you can't be denied insurance for pre-existing condition, but that won't matter if you can't afford insurance.

HAVE YOU signed up for insurance via the insurance exchanges? If not, do you plan to?

Brian: I've applied for DCHealthLink.com for assistance. I have yet to hear back, but according to estimates, if I don't get assistance, I'll have to pay $200 per month for the most basic plan. This would be a huge chunk of my monthly income, including my rent and other bills. I've thought about just paying the penalty, because that's $95 a year--for now, I know it will be going up in the coming years.

I definitely will be in a worse financial position than I was before. It will be much harder to nearly impossible to be able to save money for either purchasing a place to live and having a family in the future.

It's hard to say how all this will impact my decision-making. I'm sure I will have to pick and choose the food I get and times that I go out to do things. I really want insurance, and it's really hard to be in a position to have to choose how much I value my health.

Spring: I signed up for insurance via the New York exchange website. It proved to be confusing and very time-consuming, and it used terms that I've never heard before. It also had many technical glitches that made it difficult to complete the application or go back in and update information.

I'm forced to use this option because my current insurance is being canceled as of January 1, 2014, and there are literally no comparable plans available. This is directly connected to ACA, as insurance providers are discontinuing their low-rate plans and waiting until January 1 to roll out new ones. To add me to my husband's employer-provided insurance would be $1,000 a month--way outside our budget.

The best part of ACA is that I now qualify for Medicaid. The worst part is that I won't hear back on my application until as late as mid-December, leaving only a couple weeks before I am cut off from my current provider. With a baby due in February, it is very stressful to have to depend on the government to provide insurance on time, and it leaves me potentially without coverage right before our baby is due.

If anything goes wrong with the application, and it ends up that I am not eligible for Medicaid, I will literally have to find new insurance in two weeks, which is impossible.

Melissa: I've decided I'm going to remain uninsured and pay the penalty. I'm pretty sure I'll have a job with benefits before the end of next year, so it'll probably be a one-time thing for me. But I'd still rather spend the penalty money on something that would actually help me--new running shoes or even a donation to the Berkeley Free Clinic.

I feel like I'm being robbed. My options are to pay for something I can't use or pay a fine for not buying something? That sounds like a scam.

Welcome to new and unimproved health care

Published at Socialist Worker.

THE CENTERPIECE of Barack Obama's health care law--the state and federal Health Insurance Marketplaces, commonly known as insurance exchanges--came online on October 1.

The long-awaited opening of the "virtual stores" for the uninsured to obtain coverage was overshadowed by the government shutdown that began at the same time. The health care law was a factor in the shutdown--House Republicans refused to set aside their attempts to delay or defund the Affordable Care Act (ACA), causing a stalemate over passing legislation to keep the federal government operating.

When the media reported on the new exchanges at all, it was to document continuing problems with the websites where customers are supposed to enroll. Technical experts say the glitches will be worked out in plenty of time for people to start getting coverage on January 1. But the computer troubles were an unpromising start for a system that has been criticized, by the right and the left, as unnecessarily complicated.

As a result, though, no one is looking at the substance of this central element in the new health care law.

When the media get around to that (if they do) and when the uninsured make it through the online enrollment process, they'll find a system for providing insurance that's nothing like what its right-wing critics claim about it--but that's also not at all the great leap forward its supporters say it is.

From before it became law, the Republicans falsely claimed the ACA was a "socialist" (if only!) takeover of the health care system, aimed at putting the government in charge of decisions about your medical care. New enrollees using the exchanges will be relieved--but probably not surprised--to find that they don't have to go before an online "death panel" to determine if they will be euthanized.

But those who sign up online hoping they will find that "the health care system is being fixed, step by step," as Barack Obama promised, will be disappointed.

The exchanges--like other parts of the ACA, including the individual "mandate" requiring people without insurance to purchase a plan through the exchanges or pay a penalty with their annual taxes--are designed to preserve the role of the private insurance industry, not to guarantee access to affordable, quality health care for everyone. The signs of this underlying priority will be visible at every step of the way.

Much more will emerge over time about the ACA and how it will impact the lives of the millions of people now subject to it. Some of those experiences will be positive--because there are positive aspects to the law.

But at its core, the ACA is a market-based reform that maintains the central role for private corporations in the provision of health care. It will deliver millions of new customers and more than $1 trillion in subsidies to private insurers over the next decade. As for those customers, those who do find insurance through the exchanges will be paying hefty prices for coverage with all kinds of holes and limits. And when all is said and done, the ACA is expected to leave some 30 million people without insurance.

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THE EXCHANGES are essentially online shopping centers for health insurance plans. Several states, including New York and California, are running their own exchanges, while many others are relying on the federal exchange.

Users can log on, enter their information, and choose between health insurance options at different prices for different levels of coverage. They can also determine their eligibility for Medicaid, the government-run health care program for the poor--and for subsidies to use toward the purchase of insurance from private companies.

Plans come in four tiers, going from bronze, with lower premiums and higher out-of-pocket costs; to silver; to gold; to platinum, which has the highest premiums and lowest out-of-pocket costs.

However, not all states offer much of a choice. In New Hampshire, for example, Anthem Blue Cross Blue Shield is the only insurer participating in the state exchange, though it will offer 11 different plans.

The ACA originally included an expansion of the Medicaid program to everyone earning less than 138 percent of the official poverty line--state governments would be forced to implement the expansion, or lose all Medicaid funding. However, the U.S. Supreme Court ruled that it was unconstitutional to threaten states with losing all their funding if they refused to implement the expansion. Half of the states have essentially opted out of this important aspect of the ACA.

Nevertheless, the Congressional Budget Office predicts Medicaid enrollment will increase by 7 million next year alone, despite the Republican obstructionism. This is arguably the most positive outcome of the ACA--the expansion of premium-free health care with nominal co-pays to millions of poor people.

But Medicaid expansion is also good for business--private companies that run Medicaid managed care plans expect a big surge in revenue as a result. According to USA Today, "For industry titans such as UnitedHealthcare and WellPoint, as well as smaller, Medicaid-focused plans such as Molina, the Medicaid expansion is expected to bring significant enrollment and revenue growth" in the range of hundreds of billions of dollars in coming years.

There are other components of the ACA that are positive reforms--a requirement that health insurance include a minimum level of coverage with free preventive care, and prohibitions on insurers denying coverage due to pre-existing conditions, for example. Young people may remain on their parents' health insurance until age 26, and insurers cannot charge higher premiums for women--who on average access more health care--than for men.

And for the roughly 10 percent of the currently insured who buy health insurance on the private market, they'll find that the cost is less and coverage is better under the ACA.

But weighing against these positives is the mandate--the requirement that individuals who don't have insurance buy coverage from a private insurer or face a tax penalty.

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THE ARGUMENT for the mandate is that it will offset increased costs to insurance companies while also reducing premiums for those who need a lot of health care, such as older adults and those with chronic diseases--by bringing healthy, young adults into the system. It's a zero-sum game where the big winner is the insurance industry--the ACA reduces costs for older and sicker people by increasing them for younger and healthier people.

The mandate to buy insurance is to be enforced via penalties on those who remain uninsured. In 2014, the penalty will be $95 per adult and half that for a child, capped at $285 per family, or 1 percent of income after the tax-filing threshold, whichever is greater. This penalty will increase each year, reaching $695 per person and a family cap of $2,085, or 2.5 percent of income, by 2016.

So an uninsured individual making $30,000 a year would pay an annual penalty of $300 in 2014, rising to $750 by 2016, while an uninsured couple making $60,000 would pay $400 in 2014 and $1,390 in 2016.

The penalties attached to the ACA are clearly regressive. According to Health Affairs, nearly 60 percent of the approximately 30 million people who will remain uninsured under the ACA--and therefore subject to a penalty--are low-income. More than 16 percent of the uninsured will be Black, though African Americans are less than 13 percent of the population.

Faced with these penalties, the CBO estimates that some 9 million people will purchase health insurance on the exchange next year. This is expected to reach 26 million by 2018--enough to cut the percentage of the population without insurance in half, according to the estimates touted by the Obama administration as proof of the ACA's concrete advances.

What Obama and other supporters of the law don't say is that the newly insured will also be new customers for the private insurance industry, buying plans with premium payments that will flow into the bank accounts of private companies. And that's not all. The insurance industry stands to gain enormous sums directly from the government, in the form of a subsidies system created by the ACA.

In order to help the uninsured pay for plans on the exchanges, the federal government is offering subsidies to those earning between 100 percent and 400 percent of the federal poverty level--this year, that's $11,490 to $45,960 a year for individuals and $23,550 to $94,200 for a family of four.

According to the CBO's estimates, four out of five enrollees will qualify for a subsidy--those who qualify will receive an average of $5,290 in 2014. Obviously, this will make insurance relatively more affordable--although many individuals will still pay hundreds of dollars per month for premiums, and everyone will be stuck with out-of-pocket deductibles that can rise into the thousands of dollars before insurance kicks in.

The subsidies will be paid directly to the private health insurance companies selling their plans on the exchanges. The CBO estimates that subsidies will surpass $1 trillion in the first 10 years after the exchanges kick in.

All this revolves around the mandate for individuals to buy insurance or face a penalty. But corporations get to play by different rules.

Under intense pressure from lobbyists, the Obama administration decided to delay the so-called "employer mandate" for at least a year. This mandate would require companies with 50 or more full-time workers to offer affordable health insurance to their employees, or get hit with a penalty themselves. As SocialistWorker.org reported this summer:

The administration had estimated that the federal government would receive about $10 billion in penalties from companies that didn't abide by the employer mandate. Then there's the money that at least some companies would have spent to conform, but won't have to now--which is money in the bank, at least for another year.

If there were any doubts left about the business-friendly character of the ACA, you only have to look at the big gains in stock prices for health insurance companies after the ACA passed--in anticipation of increased profits from an influx of customers and subsidies.According to Barrons, "The Morgan Stanley Health Care Payor Index has jumped 73 percent during the past two years, with Aetna (AET) up 64 percent and UnitedHealth Group up 45 percent. At $41.59, shares of HCA Holdings (HCA), the nation's largest hospital operator, have more than doubled over that same span."

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THE ACA is incredibly complicated, and the Republican lies, misdirection and hyperbole, willingly echoed in the right-wing media, have made it all even more confusing. To make matters worse, the ACA impacts people in similar situations differently based on where they live.

Let's take, as an example, a family of three earning $12,000 per year. Because their income places them well below the federal poverty level, in states that have accepted the ACA Medicaid expansion, they would qualify for Medicaid and have access to health care at little or no cost.

However, if they live in a Republican state that rejected the expansion, such as Alabama, they will not qualify for Medicaid. In Alabama, a family of three must have income under $4,500 to qualify for Medicaid. But because they earn less than 100 percent of the federal poverty level, a family earning $12,000 a year is too poor to qualify for subsidies on the exchange. They will be exempt from paying a penalty, but will almost certainly remain uninsured.

The Republican opposition to Medicaid expansion is particularly cruel given that the states refusing to implement it, including most of the former Confederacy, are home to disproportionate numbers of the poor and nonwhite uninsured. According to the New York Times:

The 26 states that have rejected the Medicaid expansion are home to about half of the country's population, but about 68 percent of poor, uninsured Blacks and single mothers. About 60 percent of the country's uninsured working poor are in those states. Among those excluded are about 435,000 cashiers, 341,000 cooks and 253,000 nurses' aides.

According to the Times, as a result of state-level Republican obstructionism, the ACA "will leave out two-thirds of the poor Blacks and single mothers, and more than half of the low-wage workers who do not have insurance."

That the Republicans would throw these people under the bus to score political points is yet more evidence of the party's racism, free-market fanaticism and cynical disregard for those at the bottom of society.

But it's important to understand as well that Republican state officials are able to weasel through these loopholes because of fundamental problems with the way the ACA was written.

The ACA does not ensure universal access to health insurance and affordable health care. Some 30 million people will remain uninsured years after its implementation, and health care will remain a commodity, not a right, with private companies having a sickening amount of power over whether people get the medical treatment they need or not.

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THIS IS best illustrated by looking at what insurance plans will be like for those with incomes between 100 and 400 percent of the federal poverty level--people who will therefore qualify for a subsidy when they buy health insurance on the exchanges.

A single adult living in Los Angeles, California making $30,000 per year would qualify for a subsidy of $276. They would still end up spending $210 a month for a Silver plan--one of the middle-tier levels of coverage.

That silver plan comes with an annual deductible of $2,000, which means paying that amount out of pocket for many services--including surgery, ER visits, giving birth and mental health services--before insurance kicks in. If they require a lot of care, total out-of-pocket expenses could reach the capped maximum of $6,400.

Add the subsidized premium payment to out-of-pocket expenses, and a person making $30,000 a year could end up spending as much as $8,920 in one year. That's a worst-case scenario--but the minimum, if they access enough medical care to cover the deductible and full coverage kicks in, would be $4,512.

That's the middle-tier plan. Alternatively, a lower-tier Bronze plan costs less--$151 a month, after the subsidy--but it has a much higher annual deductible of $5,000, which applies to almost all non-preventive care. Out-of-pocket costs are still capped at $6,400, but if the insured happens to get sick and need their insurance, they could end up paying much more with a Bronze plan than with a Silver plan.

So a Silver plan is most likely a better deal for all but the healthiest people. But $210 a month is a lot of money for someone earning just $30,000 in an expensive city like Los Angeles.

Those earning less than 250 percent of the federal poverty level may qualify for additional "cost-sharing assistance" from the government to help pay these burdensome out-of-pocket costs.

For example, a family of four earning $35,325 a year--which is 150 percent of the federal poverty level--would pay a maximum of $118 per month for health insurance, and would have to buy a Silver plan to qualify for cost-sharing assistance. Instead of covering 70 percent of their costs, like a normal Silver plan, government assistance would drop the deductible from $2,000 to $250, and drop the out-of-pocket limit from $5,500 to $2,000.

But even with premium subsidies and cost-sharing assistance, that low-income family of four could pay as much as $3,400 a year on insurance and out-of-pocket costs--nearly 10 percent of their income. That's obviously a hardship for families barely making ends meet.

The obvious effect of high out-of-pocket costs will be to cause many people to avoid seeking care in order to save money--and take the risk of their condition worsening down the line. A recent survey by HealthPocket found that over 40 percent of people would go to the doctor less if they had a co-payment of more than $50 for each visit. Co-payments for non-preventive visits to a doctor under California's Bronze plan are $60 after the first three in a given year.

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WHAT DOES all this mean for real people?

Randi Jones Hensley, who lives in Texas, is still deciding whether to sign up--or bite the bullet and take the tax penalty. As she said:

For my spouse and me, the Affordable Care Act is far from "affordable." We're already operating on a pretty tight budget, with rent, bills, outrageous student loan payments, etc. So adding an expense of a few hundred dollars to our already stretched monthly budget is going to leave us with nothing.

We've been without health insurance for several years, and of course, we would love to have access to health care, but it's hard to imagine paying so much extra money a month when it's really unclear what the coverage will be like and how much co-pays are going to cost us. And with so much of our money going to insurance every month, how are we supposed to put anything aside for the future?

For Hensley and millions like her, the ACA is not a sustainable solution to the health care crisis in the U.S.--which spends far more on health care than any other nation, despite the lack of coverage and access.

While the Republicans rant about the ACA being a government takeover of health care, that's far from the truth. Principally drafted by a former insurance company executive, the law creates a marginally improved regulatory framework for insurance, but maintains the central role of private, for-profit health insurance.

In fact, the framework of the ACA, focused around the exchanges, is based on the health care law championed by 2012 Republican presidential candidate Mitt Romney when he was governor of Massachusetts. Romneycare's mandate to purchase health insurancewas itself based on a plan devised by the right-wing Heritage Foundation--which had been promoted by Newt Gingrich in 1993 in opposition to the Clinton administration's failed attempt at health care reform.

Nevertheless, Republicans have made opposition to the ACA a major focus of their propaganda in recent years, despite the fact that it is a fundamentally business-friendly reform. No doubt one central reason is that Republicans fear the ACA could become perceived as a popular success, like Social Security or Medicare--and earn their Democratic rivals prestige and popularity over the long term.

So the Republican attitude has been total rejection. But the fact that the maniacs of the GOP are determined to deny the poorest of the poor Medicaid coverage and to wreck whatever positive effects might come from the ACA shouldn't blind us to the much bigger problem with the law--that it puts the interests of the health care industry before people who need health care.

Health care is a basic human need, and the only way to ensure this need is met is to make it a basic human right, accessed through a single-payer system in which the government assures that everyone has access to health care.

The ACA will do nothing of the sort. Instead, it will make the health care industry ever richer, while people's needs go unmet.

Poor prospects in a "middle class" society

Published at Socialist Worker, Truthout, and the Indypendent.

ONE OF the biggest myths about the United States is that it's a mostly "middle class" society, with poverty confined to a minority of the population.

The reality is exactly the opposite: The vast majority of people in the United States will experience poverty and economic insecurity for a significant portion of their lives.

A recent Associated Press feature article--relying on data from an exhaustive survey to be published next year by Oxford University Press--has put this in stark terms: Around four out of every five people in the U.S. will endure unemployment, receive food stamps and other forms of government aid, and/or have an income below 150 percent of the official poverty line for at least one year of their lives before age 60.

That startling statistic shows the truth about a society where there are a lot more have-nots or have-littles than have-enoughs. But there are so many other myths and misconceptions about poverty in America. For example, the AP and Oxford statistics show that while people of color suffer economic difficulties at disproportionately high rates, large numbers of whites fall into the same category. Similarly, more whites benefit from social programs such as welfare and food stamps than any other group.

These facts contradict the racist stereotypes about who is poor or at risk of falling into poverty. And they underline the reality that the vast majority of Americans of all races are in the same boat--they scramble to get by, at best--while only a small minority of people live comfortably throughout their lives, and a tiny few are obscenely rich.

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THE OFFICIAL government statistics measuring poverty often obscure more than they reveal.

According to the U.S. Census Bureau, in 2011, there were 46.2 million people living below the federal poverty level--15 percent of the 308 million people living in the United States.

If this statistic were an accurate reflection of the number of people living in poverty, it would still represent a crisis. However, actual levels of economic and social deprivation and insecurity are much higher than the official figures show--because they are based on outdated measures that greatly underestimate the true level of impoverishment in the richest country in the world.

For example, in 2013, an individual living in the continental U.S. must make less than $11,490 a year to be counted as officially poor. For a family of four, the poverty level is $23,550.

Those are paltry sums, as anyone reading this article knows. Even the figure used in the AP and Oxford research of 150 percent of the federal government's poverty level--$17,235 for an individual and $35,325 for a family of four--is painfully low. In many parts of the country, making ends meet on twice the federal poverty threshold is difficult if not impossible.

That's what the Economic Policy Institute (EPI) found when its researchers developed their "Family Budget Calculator," which, unlike the federal measures, takes into account specific regional differences in the prices of necessities. The EPI looks at the costs of a variety of goods and services--housing, food, health care, child care, transportation and other basic needs – to determine what a family in a given area would need to earn "in order to attain a secure yet modest living standard."

Regional variations can be extreme. For example, average rent in New York City is now over $3,000, compared to just under $600 in Oklahoma City. But according to EPI, its calculator shows that families everywhere "need more than twice the amount of the federal poverty line to get by."

Nationally, four in 10 people live at or below 200 percent of the federal poverty level. Thus, the number of people in the U.S. who would be classified as poor based on this more accurate standard is more than two-and-a-half times greater than the official figure.

The survey data reported by AP reveal even more widespread experiences with poverty--79 percent of everyone in the U.S. will spend at least one year of their lives facing "periodic joblessness, reliance on government aid such as food stamps or income below 150 percent of the poverty line."

The researchers who calculated that statistics believe things will only get worse if current trends continue--by 2030, they expect that percentage to reach 85 percent.

So economic insecurity isn't the exception, but the rule. Another recent survey found that:

Fewer than one in four Americans have enough money in their savings account to cover at least six months of expenses, enough to help cushion the blow of a job loss, medical emergency or some other unexpected event, according to the survey of 1,000 adults. Meanwhile, 50 percent of those surveyed have less than a three-month cushion and 27 percent had no savings at all.

The consequences of all this plays out in numerous ways in people's day-to-day lives.

For example, bouts of unemployment can have serious, lasting impacts on those affected, even for those who find another job. Unemployment is associated with mental health issues such as depression and anxiety, as well as chronic diseases such as diabetes and high blood pressure.

For children, "poverty experienced at any stage of the child's development is associated with reduced cognitive outcomes," according to researchers at the University of Queensland in Australia.

Increasingly, a period of unemployment can trigger a longer term, if not permanent, drop in living standards. According to the National Employment Law Project, during the Great Recession, 60 percent of lost jobs were at the middle level of wages, paying between $13.84 and $21.13 an hour, but only 22 percent of new jobs in the recover fell into this category. By contrast, low-wage jobs accounted for 58 percent of all new jobs created in the recovery.

Many of these new jobs are in retail and fast food, where workers are often forced to work multiple jobs and still fail to make ends meet. As Terrance Wise, a worker at Pizza Hut and Burger King in Kansas City, who went on strike this month to demand $15 per hour, told Democracy Now!:

I have three lovely daughters and an equally lovable fiancée. And I'm working two jobs at about 50, 60 hours a week, so I'm leaving in the morning...and my daughters were still sleeping. When I get off tonight, they will probably be asleep again. So it's consecutive days where I don't get to see my daughters... That's one element that's really the hardest...

It's just an everyday hustle. I use public transportation every day, so I have to leave early to get to work. So I'm gone 15, 17 hours a day. It's just really hard--a struggle every day.

The flip side of that struggle--and of the fact that vast majority of people in the country live in poverty now, have lived in poverty in the past, or will in the future--is that a relatively small minority has amassed such fantastic wealth that they will never have to worry about going without, even if they never earn another cent.

The 400 richest Americans, with a total net worth of $1.7 trillion as of last year, were worth an average of $4.2 billion each, enough to support over 89,000 families of four at 200 percent of the poverty level for an entire year.

It is no coincidence that overall corporate profits, measured as a share of the gross domestic product, are at record highs while overall wages are at record lows as a percentage of the GDP. The threat of economic insecurity is an important part of discouraging workers' struggles and increasing profits at the expense of the living standards of the vast majority. The personal experience of going without--and the constant reminder from seeing family, friends and others in the community deal with stretches of poverty and unemployment--sends the message that workers who step out of line can face the same fate.

- - - - - - - - - - - - - - - -

THE RESEARCH covered in the AP feature shows growth in the rates of white poverty, something often overlooked in mainstream media accounts. According to AP:

By race, nonwhites still have a higher risk of being economically insecure, at 90 percent. But compared with the official poverty rate, some of the biggest jumps under the newer measure are among whites, with more than 76 percent enduring periods of joblessness, life on welfare or near-poverty.

According to the Census Bureau, there were more than 19 million non-Latino whites living below the poverty line in 2011, compared to 11 million African Americans and 13 million Latinos.

The U.S. Department of Agriculture reports that 36.9 percent of food stamp recipients are non-Latino whites, while 22.8 percent are Black and 9.6 percent are Latino(the race of recipients was unknown in 18.4 percent of cases, according to the USDA). Blacks, whites and Latinos each accounted for roughly the same percentage--between 30 and 32 percent--of recipients of the main welfare program, Temporary Assistance for Needy Families.

Despite these facts, poverty in the U.S. is often racialized by political leaders--more often and more brazenly by Republicans, but by Democrats, too. The common stereotype about these government programs is that they benefit an "undeserving" (read: Black) minority, not workers of all races.

Ronald Reagan, for example, explicitly made race a part of his caricature of Cadillac-driving (Black) "welfare queens" and "young bucks" who were taking advantage of hard-working (white) "taxpayers." During the 2012 Republican primaries, Newt Gingrich recycled the same racist filth when he called Obama the "food stamp president."

But Democrats have latched on to the same stereotypes when they were the ones wielding the budget act. It was a Democrat, Bill Clinton, who promised to "end welfare as we have come to know it"--and carried through his campaign pledge when he signed the "Personal Responsibility and Work Opportunity Act." Likewise, Hillary Clinton, in her losing bid for the 2008 Democratic presidential nomination, was playing the same racist game when she claimed she was better positioned than Barack Obama to win the support of "hard-working Americans, white Americans."

The facts, however, undermine these commonly used stereotypes. As the AP pointed out, "For the first time since 1975, the number of white single-mother households living in poverty with children surpassed or equaled Black ones in the past decade, spurred by job losses and faster rates of out-of-wedlock births among whites."

The fact that widespread poverty and insecurity crosses racial lines on the one hand, but that racist stereotypes are used to justify attacks on social programs that benefit the majority on the other, means that struggles for economic and racial justice must be intertwined in order for either one to be successful. Those who seek to defend and extend unemployment insurance, welfare, food stamps and other benefits that help working people must challenge the racism used to undermine them--while those who seek racial justice must also struggle for economic justice.

On this 50th anniversary of the 1963 March on Washington, it is important to remember that the civil rights demonstrators were demanding jobs and freedom. The calls for racial and economic justice were linked, as they were again in the Poor Peoples' Campaign that Martin Luther King Jr. would help launch a few years later. Speaking of the campaign, King called it "a new co-operation, understanding, and a determination by poor people of all colors and backgrounds to assert and win their right to a decent life and respect for their culture and dignity."

That struggle for the right to a decent life is still with us today.

Still stuck in the waiting room

Published at Socialist Worker.

IN YET another concession to big business demands to weaken its health care law, the Obama administration announced earlier this month that the so-called "employer mandate"--which requires companies with 50 or more full-time workers to offer affordable health insurance to their employees--would be postponed from a 2014 deadline into 2015.

The Treasury Department made the announcement on July 2, claiming that after months of "a dialogue with businesses," the administration had decided a delay was the best way to help Corporate America comply with the Affordable Care Act (ACA) in a "careful, thoughtful manner."

But the delay is really about being "careful" to protect big business profits. Low-wage employers that tend to offer employees few if any benefits--like fast-food chains making hefty profits off the working poor--have been vocal in their criticism of the health care law, and the mandate in particular.

The delay is a victory for them--and a lucrative one: The administration had estimated that the federal government would receive about $10 billion in penalties from companies that didn't abide by the employer mandate. Then there's the money that at least some companies would have spent to conform--which is now money in the bank, at least for another year.

Republicans immediately tried to exploit the announcement as justification for their crusade to get rid of the health care law altogether. A July 10 letter to Obama written by Republican Sen. John Thune of South Dakota and cosigned by 45 Republican senators cynically pretended that their call for the rest of the law to be "permanently delayed" was out of concern that it would cause "significant economic harm to American families."

But the Republicans' all-out opposition to the Obama health care law obscures the bigger truth--that plans for "reform" of the U.S. health care system have been twisted at every step to be as advantageous as possible to big business. The remaining positive provisions of the ACA are being further hollowed out under pressure from industry lobbyists--and those provisions are outweighed anyway by ones that will penalize working people and help expand the profits of the medical-pharmaceutical-insurance complex.

Thus, even if the employers' mandate had kicked in as planned in 2014, it wouldn't go nearly far enough to ensure that companies offer quality, affordable health coverage to workers.

The burden for paying for health care has increasingly shifted away from those who can afford it most--Corporate America, with its record profits--and onto individual workers and families. The terms of the mandate allow this shift to continue. Now, the delay in implementing the penalties for not providing insurance will make those terms even more generous for big business.

- - - - - - - - - - - - - - - -

THE HEALTH care law's "employer mandate" was designed to encourage large employers to offer what the legislation deems to be affordable health coverage to full-time employees.

This provision isn't to be confused with the "individual mandate"--the law's requirement for everyone in the U.S. to have health insurance, or pay a tax penalty. The individual mandate will go into effect in 2014 as planned--there won't be any postponement for workers.

Despite speculation that they will be delayed, too, the state-level "insurance exchanges" established under the law, which are supposed to provide a place for people to purchase coverage, are still set to be open for enrollment on October 1. As of January 1 of next year, individuals with an annual income of over $10,000 ($20,000 for families) will have to pay an annual penalty with their taxes if they don't have insurance. Next year, the penalty will be $95 for an individual and up to $285 for a family--but this will quickly increase, hitting $696 for individuals and up to $2,085 every year for a family in 2016 and after.

The criticism of the individual mandate, of course, is that the uninsured would have to buy the insurance industry's notoriously inadequate policies, complete with weak coverage and high deductibles--or fork over a big chunk of their income anyway in penalties.

With the employer mandate, any business with more than 50 full-time workers (or the equivalent in part-time workers, based on hours worked) would face a penalty if they don't offer affordable health insurance that meets the requirements under the ACA, and at least one of their employees receives a tax credit to purchase health insurance on the exchanges. The penalty was set to begin in 2014 at $2,000 per employee, and $3,000 for those who receive government subsidies.

The White House and leading Democrats in Congress claim that about 95 percent of companies with 50 or more full-time employees already offer health insurance, so the delay in enforcing the mandate impacts a relatively small percentage of the workforce--about 1 percent of U.S. workers, or 1.5 million people.

But other analysts say that millions more workers will be impacted by the delay since they work for large employers that offer insurance to some employees, but not all. Similarly, some big employers who do offer health coverage may not have insurance plans that meet the ACA's requirements for a minimum level of coverage and affordability.

There's a further question that health care experts are asking about the employer mandate--whether the $2,000 per employee penalty is a sufficient incentive to force companies to offer insurance.

That $2,000 is less than the cost of government subsidies to pick up the slack. The Congressional Budget Office estimates that the average subsidy to help people buy insurance coverage on the exchanges will be $5,290 per person per year.

Even more telling, the penalty is much smaller than the average cost to private employers of providing health insurance--which in 2012 stood at $4,224 for individual coverage and $10,704 for family coverage, according to the Kaiser Family Foundation. (That doesn't include the contributions from workers, which averaged $1,053 for individuals and $4,495 for a family plan in 2012.)

So even if and when the employer mandate takes effect in 2015, companies might still conclude that they're better off paying the penalty than coming up with an insurance plan that covers all their workers.

- - - - - - - - - - - - - - - -

A FURTHER pitfall in the employer mandate is whether the coverage offered by big employers is deemed to be "affordable."

Under the terms of the health care law, employer-sponsored insurance is considered unaffordable if the employees' share of the premium is greater than 9.5 percent of household income. But earlier this year, the Internal Revenue Service (IRS) released a ruling clarifying that this benchmark will apply only to individual coverage.

So employers whose insurances plans for individuals would cost employees more than 9.5 percent of their household's incomes would be liable for the now-delayed fine under the employer mandate, and the employee could qualify for subsidies on the insurance exchange.

But family coverage is much more expensive than individual coverage. According to the Kaiser Family Foundation's statistics, workers at private employers pay nearly 30 percent of the cost of health insurance for family plans, compared to nearly 20 percent for individual plans.

By defining what makes coverage "unaffordable" on the basis of "self-only coverage," the IRS will "deny federal financial assistance to millions of Americans with modest incomes who cannot afford family coverage offered by employers," according to the New York Times.

In fact, this definition opens up a gaping loophole to corporations scheming to conform to the letter of IRS regulations while keeping costs down. They can offer decent coverage to individuals that meets the IRS standards of affordability, but prohibitively expensive coverage for families--which, of course, is a primary concern for many working people.

Or companies will decide, in the words of Bloomberg BusinessWeek, "to get out of the health insurance business" altogether. Studies by financial analysts estimate that anywhere from one in 10 to one in three employers that currently offer coverage will drop health insurance as a benefit for employees. The Congressional Budget Office agrees, projecting that "8 million fewer people will be covered by employer plans five years from now under the ACA than without it."

The cost of health care coverage for these millions of workers will fall on workers themselves--both directly for the individuals workers who lose employer-sponsored insurance and indirectly through the taxes paid by workers that subsidize health care coverage.

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HEALTH CARE is a basic human need. The uninsured and underinsured can--and are often forced to--go without health insurance for a time, but eventually, everyone gets sick and requires health care. That's a fact of life. What is contested is who pays for it.

As it stands now, companies that profit off low-wage labor and that don't offer affordable insurance to their employees have their bottom line effectively subsidized by taxpayers, who pick up the bill for health care of these workers, via the Medicaid and Medicare government programs and many other means.

Thus, the same low-wage employers that complained to the Obama administration about the mandate and claimed they would have to pass the costs onto their customers are already passing these costs onto working-class people--just through another means: taxes.

And those costs are huge: A Congressional report released in May found that because Wal-Mart pays such low wages and offers such meager benefits to employees that they qualify for public assistance, including Medicaid, "a single 300-person Wal-Mart Supercenter store in Wisconsin likely costs taxpayers at least $904,542 per year and could cost taxpayers up to $1,744,590 per year--about $5,815 per employee."

Meanwhile, as the report points out, "In the third quarter of 2012, corporate profits reached $1.75 trillion, their greatest share of GDP in history. During that same quarter, workers' wages fell to their lowest share of GDP on record."

With wages so low--and household income, adjusted for inflation, down more than 7 percent between when the recession began at the end of 2007 and early 2013--many workers will find that paying 9.5 percent of their income for health care, and a higher percentage than that for their families, is far from "affordable."

The ugly truth is that the Obama health care law does not represent the reform of a broken system, but the continuation of the trend of putting the burden of providing health care onto workers themselves. As CNN reported, quoting a study by the Commonwealth Fund:

Some 80 million people, around 43 percent of America's working-age adults, didn't go to the doctor or access other medical services last year because of the cost...That's up from 75 million people two years ago and 63 million in 2003. Not surprisingly, those who were uninsured or had inadequate health insurance were most likely to have trouble affording care. But 28 percent of working-age adults with good insurance also had to forgo treatment because of the price.

That's an indictment of the warped priorities of a health care system driven by profit rather than people's needs--and of an Obama administration that promised to fight for genuine reform of the system, but knuckled under to big business, again and again.

Immigrants need not apply for Obamacare

Published in Socialist Worker.

AS THE negotiations and maneuvering over promised immigration legislation drag on, the Democratic Party has demonstrated once again its willingness to sacrifice the interests of its base supporters for the sake of a lousy "compromise" with Republicans.

Late last month, House Minority Leader Nancy Pelosi reiterated that immigrants who embark on the twisted "path to citizenship" under the bipartisan proposal will not qualify for affordable health insurance under the Obama administration's health care law during the 10 to 15 years it will take to complete the process.

According The Hill, Pelosi said, "It is stated very clearly in the Affordable Care Act, [and] it is our position in the immigration bill: no access to subsidies in the Affordable Care Act. Secondly, no access to Medicaid; no cost to the taxpayer...That has always been the Democratic position."

Pelosi's statement is also a reminder of how the health care law's mandate to purchase private health insurance, which kicks in next January, will fall far short of ensuring universal coverage, let alone providing quality, affordable health care for all. The 11 million undocumented immigrants living and working in the U.S. will be consigned to a health care underclass under this law.

This follows on the heels of the betrayal of another component of the party's base: Democrats on the Senate Judiciary Committee bowed to Republican threats and didn't propose amendments to immigration legislation that would have allowed U.S. citizens to sponsor same-sex partners for citizenship or legal residency, as opposite-sex couples are allowed to do.

Then there is the bipartisan "Gang of Eight" proposal itself. It would fund even more border security measures; includes background checks, fines and tax payments just to embark on the legalization process; and would establish several different statuses for guest workers. As Lance Selfa wrote for SocialistWorker.org, the punitive legislative is geared more to the needs of business to exploit immigrant labor than in providing the rights that immigrants deserve.

- - - - - - - - - - - - - - - -

THIS ISN'T the first time that immigrants have been excluded from under a law that was supposed to represent health care "reform."
In a move that foreshadowed the problems with Obama's Patient Protection and Affordable Care Act, the state of Massachusetts just a few years ago discontinued subsidized Commonwealth Care health insurance for 30,000 documented immigrants who had been living in the U.S. for less than five years.

Though Republicans continue to deny it, Massachusetts' health care law, passed while Obama's 2012 challenger Mitt Romney was governor, was a model for the Obama health care law. It includes a mandate to purchase private health insurance, enforced with tax penalties; an insurance "exchange" that acts as a market for approved plans; and subsidies for residents who are determined to need help to be able to afford insurance.

Eventually, benefits were partially restored to the immigrants who were cut off in Massachusetts, but they were greatly reduced--worth about a third of the original coverage provided under Commonwealth Care--leaving affordable care out of reach for many if not most. The deal made to partially restore benefits brought in Centene Corp. to provide second-class coverage for immigrants.

This attack on immigrants' access to health care wasn't just mean-spiritedness at the state level--it was connected to a discriminatory federal law. Legislators cut immigrants off the Commonwealth Care program because they more expensive to cover--as the result of a federal law that bars matching funds for "means-tested" benefits like food stamps and Medicaid to immigrants who have been permanent residents for less than five years.

As in so many other ways, the Massachusetts experience provides a preview of what's to come under the Obama health care law.

Immigrants who are currently undocumented are almost certain to be excluded entirely from the subsidies available to low-income households to help them afford the mandate to purchase private insurance.

Meanwhile, documented immigrants who have had permanent residency status for five years or less won't be eligible for the same benefits that everyone else receives. Under the health care law, they will qualify for subsidies to assist them in purchasing health insurance on the exchanges--but they won't qualify for Medicaid, the government insurance program for low-income individuals and families. Even poor children and pregnant women will be excluded, unless they live in one of the 22 states that opt to extend Medicaid coverage to them.

That's a recipe for second-class health care. According to the U.S. Department of Health and Human Services, "[S]ubsidies for out-of-pocket cost-sharing will provide much less generous coverage than that offered through Medicaid, so even if poor immigrant families enroll, many may delay necessary care because of cost."

The irony in all this is that non-citizen immigrants are more likely than most people to be uninsured--and therefore need the help of subsidies or the Medicaid program to get access to health care. As of 2009, just over 50 percent of non-citizen immigrants were uninsured, compared with 20 percent of naturalized citizen immigrants and 17.4 percent of citizens born in the U.S.

In particular, the undocumented are more likely to live below the federal poverty line--meaning they would qualify for health care coverage under Medicaid if they weren't banned until they have had legal residency status for at least five years. Half of all documented immigrants who have lived in the U.S. for less than five years have incomes below 138 percent of the federal poverty level, which means they would qualify for Medicaid if they weren't excluded.

Immigrants also work in more dangerous jobs, such as meatpacking, construction, agriculture and housekeeping--and so they therefore have higher rates of injuries and death on the job than do workers born in the U.S.

It isn't only a small minority of people that will be affected by these anti-immigrant restrictions. According to a study by the Robert Wood Johnson Foundation, of all low-income, nonelderly adults living in the U.S. today, fully one in six are undocumented or recent documented immigrants.
Even undocumented immigrants who have health insurance face the threat of deportation when they seek care. More than 600 people have been deported from hospitals in the last five years.

- - - - - - - - - - - - - - - -

AT ITS heart, the Obama health care law protects the status of health care as a commodity to be sold for a profit rather than provided as a human right. Thus, even when the health insurance exchanges kick in next year, there will be multiple tiers when it comes to access to health care.

As now, the wealthy will be able to afford world-class care. Meanwhile, workers who receive health insurance from their employer or from the exchanges set up under the health care law will pay up to 9.5 percent of their income in out-of pocket health care costs--more for family coverage--before their coverage is deemed unaffordable, and various provisions such as subsidies kick in. That's $1 in every $10 in wages disappearing at a time of shrinking or stagnant household income and attacks on the government programs workers rely on.

Even after the law is fully implemented, nearly 30 million people will remain uninsured--a "privilege" that many will pay for in tax penalties.

Millions of undocumented immigrants will be excluded from receiving any government assistance, even as they work and pay taxes--and, if the Gang of Eight proposal passes, pay penalties along the obstacle-strewn "path to citizenship." And another 3 million documented immigrants who live in poverty and who have resided in the U.S. for less than five years won't qualify for the Medicaid benefits they would otherwise receive.

Immigrants--whose labor is critical to the U.S. economy and whose low wages boost record corporate profits--have been condemned to second-class status in yet another area.

Generation out of luck

Published in Socialist Worker, Truthout, and Alternet.

What happens to a dream deferred?
Does it dry up
like a raisin in the sun?
Or fester like a sore--
And then run?
Does it stink like rotten meat?
Or crust and sugar over--
like a syrupy sweet?
Maybe it just sags
like a heavy load.
Or does it explode?
--Langston Hughes

COLLEGE GRADUATION is supposed to be a time of celebration--a time for graduates to look back on years of hard work and achievement, and forward to a bright future filled with promise.

Yet the class of 2013--the young women and men who were submitting college applications in the fall of 2008 as the world financial system came to the brink of Armageddon following the collapse of Lehman Brothers--are facing a future of further uncertainty and diminished prospects.

They are the latest entrants into what has been dubbed the "lost generation"--so-called because the high rates of unemployment and underemployment its members endure at the start of their working lives drag them down throughout their working lives, making it more and more difficult to maintain the standard of living of their parents.

Only half of recent graduates have been able to find a full-time job that makes use of their degree. Yet all are still left with the bill from college, with the average student loan burden nearing $30,000. With the number of new graduates expected to outstrip the number of new jobs requiring a degree over the next several years, this trend will only get worse.

If the current priorities of big business and the politicians who serve them continue to set the agenda, millions of young people will be robbed of their hopes for the future.

But this isn't inevitable. For most of the class of 2013, their best possibility for a decent future lies not in the rat race for ever-scarcer decent jobs, but joining together to fight to improve conditions in the jobs they do have and to demand a fundamental transformation of a system that treats them as expendable.

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A REPORT released last month by the Economic Policy Institute (EPI), titled "The Class of 2013: Young graduates still face dim job prospects," paints a picture of a jobs crisis for youth that has multiple layers.

To begin with, nearly 9 percent of college graduates aged 21-24 who aren't in graduate school are unemployed, actively looking for work and unable to find it. This is more than double the rate for college graduates over age 25.

Those who have been able to find jobs are making less money. Average hourly wages, adjusted for inflation, for young college grads were $16.60 in 2012, the lowest they've been since 1997--when most recent grads were in elementary school--and just 25 cents greater than they were in 1989, before many were even born. Had wages kept up with the inflation-adjusted growth in the gross domestic product, which rose by 72 percent over this period, the hourly wage would be over $28 today.

Once student debt is factored in, there has plainly been an outright decline in living standards. The average recent graduate with $25,000 in debt pays between $200 to $300 a month, depending on their repayment plan--a huge burden given the stagnant or dropping income.

Recent grads are also much less likely than previous generations to find jobs with benefits. Just 31.1 percent of employed recent grads have employer-provided health insurance, compared with 60.1 percent in 1989. Just 27.2 percent have a pension.

An increasing number of college grads are working jobs that pay minimum wage. According to the Wall Street Journal, nearly 300,000 people with at least a bachelor's degree are making the minimum wage, double the number in 2007.

The lack of decent jobs with benefits makes it easier for employers to take advantage of young workers, who they know have few other options. Maria, a health care worker in Massachusetts in her early 20s, who earned her bachelor's degree while working full time, explains her situation:

I worked as a switchboard operator when I completed my associate's degree. I took a promotion to case manager, and my new supervisor assured me that I would get a raise after I got my degree. I took the job, and in my last semester, while completing my bachelor's, I was offered a job at another agency. It was better-paying, but I had to turn it down because I was pregnant and needed the paid maternity leave at my current job, which the new job didn't offer, and because I was promised a raise. It's been more than a year after I got my bachelor's, and I still haven't received a raise or found a job in my field.

Beyond joblessness, rising debt and falling wages, there's the issue of underemployment: those unable to find full-time work, and those working in jobs for which they are overqualified.

An increasing percentage of recent graduates qualify as "underemployed," which includes those who are unemployed, those working part-time but seeking full-time work, and those who looked for work in the past year but have given up. According to the EPI report on the Class of 2013, the rate of underemployment for recent college grads jumped from 11.2 percent in 2008, at the beginning of the Great Recession, to a peak of 19.8 percent in 2010, just after the official beginning of the "recovery." Underemployment was still at 18.3 percent in 2012.

As the EPI researchers point out, this "does not include "skills/education-based" underemployment (e.g., the young college graduate working as a barista)." College graduates working in jobs that don't require a college degree is not a new phenomenon, but has gotten worse in recent years, the EPI report found:

[I]n 2000--when jobs were plentiful and the unemployment rate was 4.0 percent--40 percent of employed college graduates under age 25 worked in jobs not requiring a college degree...[T]he share of young college graduates working in jobs not requiring a college degree increased over the 2000–2007 business cycle, increased further in the Great Recession, and has not yet begun to improve...

[I]n 2007, 47 percent of employed college graduates under age 25 were not working in jobs requiring a college degree, and...this share increased to 52 percent by 2012. This increase underscores that today's unemployment crisis among young workers did not arise because these young adults lack the right education or skills.

As the EPI researchers and other economists have shown, these effects will have a lasting, if not permanent, impact on the future prospects of recent graduates. "Research shows that entering the labor market in a severe downturn can lead to reduced earnings, greater earnings instability, and more spells of unemployment over the next 10 to 15 years," the study reports.

Less than half of recent grads are working in a full-time job that requires a degree. Even some of those who have a full-time job have had to take a second just to make ends meet. Gloria, who graduated from Rutgers last year with a journalism degree, finally found a full-time job in her field after nine months of searching, while working in retail and living with a relative:

I started applying for jobs in January of 2012, four months before graduation. By graduation, I was excited, but so stressed out...I had done everything right! Double major, minor, decent GPA, tons of extracurricular activities, study abroad, unpaid internship. I took advantage of everything that my school had offer: I wrote for the paper, volunteered at the radio station, worked for the television channel and even created my own website.

Now I finally have a job in my field, but it's only a temporary position, and I work a second job that I wouldn't have taken in high school, just to afford to live in a dorm-sized studio apartment with roaches. Honestly, it's hard. This past year has been the toughest one yet. All my dreams and all the stuff that I had believed growing up had collapsed...it's all a lie.

This doesn't mean that the alternative--not going to college--is any better. If young college graduates are facing a jobs crisis, young workers with only a high school diploma are facing a catastrophe.

For the 40 percent of high school graduates aged 17-20 not enrolled in higher education, official unemployment averaged 29.9 percent from March 2012 to February 2013, more than three times that of recent college graduates. Underemployment for young high school grads stands at a shocking 51.5 percent--which means more than half are unemployed, working part-time when they'd rather work full-time or have looked in the past year, but have since given up.

- - - - - - - - - - - - - - - -

THE JOBS and career crisis facing the class of 2013 begs several questions: What is causing this crisis? Is this a temporary blip or the "new normal"? What can be done to change it?

The most obvious cause of the crisis for young workers is the one afflicting working people of all ages. According to the Center for Budget and Policy Priorities, nearly four years into the official "recovery" from the Great Recession, there are still more than three people looking for work for each job opening:

[T]he economy has recovered only about 6.2 million of the 8.7 million jobs lost between the start of the recession in December 2007 and early 2010...employment was 1.9 percent (2.6 million jobs) lower in April 2013 than it was at the start of the recession.

According to the EPI's Heidi Shierholz, it would take more than 8 million jobs to replace those and keep up with population growth, which could take more than five years at current rate of monthly employment increases.

Recent graduates are at a disadvantage when competing for jobs since they lack the experience of older workers. And increasingly, older workers have been forced to look for jobs that were once considered entry level. A survey by Rutgers University found that of the 23 percent of respondents who suffered a layoff during the Great Recession, more than half of those who had found another job were making less than they were before.

As Brad Plumer illustrates at the Washington Post's Wonkblog, some 60 percent of the jobs lost during the Great Recession paid between $13.84 and $21.13 per hour, yet only 22 percent of the new jobs created since then fall into that category. The majority of the new jobs, some 58 percent, are low wage, paying less than $13.84 an hour.

So mid- and late-career workers are taking jobs that used to be entry-level positions for recent grads or jobs that don't even require a degree, placing them in greater competition with younger workers to the detriment of workers of all ages. As Sherry Wolf, an author and contributor to SocialistWorker.org, explains:

I graduated college in 1987, have worked since I'm 14 years old and am now a highly skilled writer, editor and copy editor, yet I've spent the last year receiving unemployment insurance for the first time in my life, supplemented by freelancing gigs. What's stunning to me about the current economy is not just the paucity of full-time jobs with benefits, but that neoliberal restructuring has meant that experienced white-collar workers like me are now being paid a piece rate on the level of recent college graduates, while 20-somethings are forced out of my field almost entirely, and compelled to find jobs as baristas.

If trends continue, things are only going to get worse for young college grads. A recent report by the Center for College Affordability shows that from 2010 to 2020, "The number of college graduates is expected to grow by 19 million, while the number of jobs requiring a bachelor's degree is expected to growth by fewer than 7 million. We are expected to create nearly three new college graduates for every new job requiring such an education."

Finally, it's important to keep in mind that not all college degrees are created equal--nor are outcomes anywhere near equal for all college graduates. Higher education, like the society as a whole, has become increasingly unequal in recent decades. Rather than a means of mobility between classes, colleges often function as a means to maintain class stratification and reproduce inequality.
As Thomas B. Edsall pointed out in a New York Times blog last year:

Seventy-four percent of those now attending colleges that are classified as "most competitive," a group that includes schools like Harvard, Emory, Stanford and Notre Dame, come from families with earnings in the top income quartile, while only three percent come from families in the bottom quartile...in the nation's 1,000-plus community colleges, almost 80 percent of the students came from low-income families.

The elite schools are a key place for the wealthy to develop social networks that they will use--in addition to family connections--to land high-paying jobs after college. And elite college alumni networks will aid them in obtaining employment throughout their careers.

Poor and working class graduates will find themselves locked out of these networks. Thus, they will need to take up the task of organizing with co-workers to fight for rights at jobs for which they are overqualified.

Just as it took the union drives of the 1930s to make industrial jobs "good jobs" with decent pay and benefits, and the struggles of the 1960s and '70s to do the same for public-sector jobs that provided a way out of poverty for many African Americans and women, the majority of today's working class college graduates will need to focus on collective struggle, rather than hope that individual striving will allow them to make it against the odds.

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ULTIMATELY, THE mismatch between the number of young graduates and the jobs that require degrees raises questions about the nature of higher education in society, our relationship to work, and whether education should be shaped by the needs of business or the collective social needs of the majority of people in society.

Businesses, although they complain that college students aren't qualified, benefit enormously from a situation where the supply of the commodity they need to purchase--in this case, the labor power of college-educated workers--exceeds the demand. This drives down the price of that commodity--the wages and benefits of workers.

And with students and their families shouldering an increasing burden of the cost of higher education while companies cut back on training programs, businesses are able to pass along the cost of training a new generation to be exploited onto workers themselves.

This state of affairs makes sense--and money--for employers, but is disastrous for the vast majority of people. With so many highly educated people underemployed, not only are they worse off, but society as a whole can't benefit from their wasted talents.

Meanwhile, in a society so wealthy that a fraction of the bloated military budget could make higher education free for all, there's no reason not to expand access to higher education--and to create the public-sector jobs that could provide people with the opportunity to use their education to serve those in need.

For example, average class size in public secondary schools is nearing 25 and is almost double that of private schools. Doubling the number of public school teachers would remove this disparity and create more than 3 million jobs, which would finish replacing the jobs lost during the recession and then some.

There are about 2.4 doctors for every 1,000 people in the U.S., among the lowest ratios in the industrialized world, trailing countries with much less wealth like Kazakhstan (3.8), Cuba (6.7) and Lebanon (3.5). Training an additional 400,000 doctors would put the U.S. in a comparable position with other advanced countries like Germany and France. It could easily be paid for with the savings from switching to single-payer health care.

Clearly, the need exists for more college-educated workers, not fewer. But creating opportunities for them to use their training and talents will require a major shift in social priorities--and achieving that will require mass struggle and organizing.

If the class of 2013 wants a future, they will have to fight for it.