Fwd: qotd: Medicaid, red and blue

_______________________________________________
Quote-of-the-day mailing list
Quote-of-the-day@mccanne.org
http://two.pairlist.net/mailman/listinfo/quote-of-the-day

-------- Original Message --------
Subject: qotd: Medicaid, red and blue
Date: Thu, 18 Oct 2012 11:10:25 -0700
From: Don McCanne <don@mccanne.org>
To: Quote-of-the-Day <quote-of-the-day@mccanne.org>



The New Republic
October 25, 2012
E Pluribus Duo
By Jonathan Cohn

In all kinds of real and practical ways, the United States today is not
one nation, but two.

We've come to think of "blue" and "red" states as political and cultural
categories. The rift, though, goes much deeper than partisan differences
of opinion. The borders of the United States contain two different forms
of government, based on two different visions of the social contract.

In blue America, state government costs more — and it spends more to
ensure that everybody can pay for basic necessities such as food,
housing, and health care. It invests more heavily in the long-term
welfare of its population, with better-funded public schools, subsidized
day care, and support for people with disabilities.

In the red states, government is cheaper, which means the people who
live there pay lower taxes. But they also get a lot less in return. The
unemployment checks run out more quickly and the schools generally
aren't as good. Assistance with health care, child care, and housing is
skimpier, if it exists at all.

The result of this divergence is that one half of the country looks more
and more like Scandinavia, while the other increasingly resembles a
social Darwinist's paradise.

The easiest way to grasp what this means for the actual residents of red
and blue America is to look at Medicaid. Although the federal government
sets minimum standards for coverage and benefits, states have discretion
over how many additional people to include. Based on data compiled by
the Kaiser Family Foundation, the five states with the strictest
criteria for working parents are Arkansas, Alabama, Indiana, Louisiana,
and Texas. The five states with the least restrictive requirements are
Minnesota, Connecticut, Maine, Vermont, and Wisconsin. A Minnesota mom
with two kids and a job that doesn't offer health insurance can get
Medicaid as long her annual income doesn't exceed about $40,000. But if
she moves to Arkansas, she'll be ineligible for Medicaid as soon as her
household income reaches $3,150 a year—not nearly enough to pay for
basic living costs, let alone health insurance.

By nearly every measure, people who live in the blue states are
healthier, wealthier, and generally better off than people in the red
states. It's impossible to prove that this is the direct result of
government spending. But the correlation is hard to dismiss. The four
states with the highest poverty rates are all red: Mississippi,
Louisiana, Alabama, and Texas. (The fifth is New Mexico, which has
turned blue.) And the five states with the lowest poverty rates are all
blue: New Hampshire, New Jersey, Vermont, Minnesota, and Hawaii. The
numbers on infant mortality, life expectancy, teen pregnancy, and
obesity break down in similar ways.

Advocates for the red-state approach to government invoke lofty
principles: By resisting federal programs and defying federal laws, they
say, they are standing up for liberty. These were the same arguments
that the original red-staters made in the 1800s, before the Civil War,
and in the 1900s, before the Civil Rights movement. Now, as then, the
liberty the red states seek is the liberty to let a whole class of
citizens suffer. That's not something the rest of us should tolerate.
This country has room for different approaches to policy. It doesn't
have room for different standards of human decency.

http://www.tnr.com/article/politics/magazine/108185/blue-states-are-scandinavia-red-states-are-guatemala?wpisrc=nl_wonk#

And...

Picayune Item
October 17, 2012
Miss. says no thanks to Medicaid expansion dollars

Mississippi has long been one of the sickest and poorest states in
America, with some of the highest rates of obesity, diabetes and heart
disease and more than 1 in 7 residents without insurance. And so you
might think Mississippi would jump at the prospect of billions of
federal dollars to expand Medicaid.

You'd be wrong.

Leaders of the deeply conservative state say that even if Mississippi
receives boatloads of cash under President Barack Obama's health care
law, it can't afford the corresponding share of state money it will have
to put up to add hundreds of thousands of people to the government
health insurance program for the poor.

Under the law, Washington would pay 100 percent of the costs of
expanding Medicaid from 2014 to 2016. Between 2017 and 2020, the federal
share would decrease to 90 percent and the states' contribution would
rise in stages to 10 percent, and that's where it would stay.

"While some people say Obamacare will come as an economic boost with
'free' money, the reality is simple: No money is free," said Republican
Gov. Phil Bryant. "Since when did the federal government ever give free
money without asking for something in return?"

The governor and GOP leaders in the Republican-controlled Legislature
have argued that the expansion will foster a culture of dependency on
government.

GOP Govs. Rick Scott of Florida, Bobby Jindal of Louisiana, Nathan Deal
of Georgia, Nikki Haley of South Carolina and Rick Perry of Texas have
said they, too, will reject a Medicaid expansion, calling it too expensive.

http://picayuneitem.com/statenews/x699448824/Miss-says-no-thanks-to-Medicaid-expansion-dollars


Comment: One strategy in the Affordable Care Act that was introduced to
help cover everyone was to expand the Medicaid program for low-income
individuals. To encourage state participation, the federal government
would pay the full costs of care for three years and then taper down to
90 percent, leaving the states responsible for only 10 percent of the
costs. Yet Governors Bryant, Scott, Jindal, Deal, Haley, and Perry have
rejected the program, decisions which will surely leave many otherwise
qualified individuals with no coverage.

Those of us who supported single payer reform - an improved Medicare for
all - warned repeatedly that the model enacted in the Affordable Care
Act could never cover everyone. Current predictions are that 30 million
people will remain uninsured (CBO).

This is shocking and fills with grief those of us who have been fighting
so long and hard for health care justice in America. It is worth
repeating the last paragraph in Jonathan Cohn's article because he
states it so well:

"Advocates for the red-state approach to government invoke lofty
principles: By resisting federal programs and defying federal laws, they
say, they are standing up for liberty. These were the same arguments
that the original red-staters made in the 1800s, before the Civil War,
and in the 1900s, before the Civil Rights movement. Now, as then, the
liberty the red states seek is the liberty to let a whole class of
citizens suffer. That's not something the rest of us should tolerate.
This country has room for different approaches to policy. It doesn't
have room for different standards of human decency."