Posts tagged Medicaid
The late Congressman and Speaker of the House Tip O’Neill famously said, “All politics is local.” Even as the national Congress seems stalemated, unable to enact even such vital legislation as a jobs bill or firearm reform or a new immigration bill, locked in seemingly endless partisan obstructionism — even as inaction reigns supreme, state legislatures across the country are making progress, though too often the progress is in taking states backward.
There is some good news. Colorado will require more background checks for gun sales, and will outlaw high-capacity ammunition magazines. At least eighteen other states, however, have loosened firearms restrictions. As of July 1, for instance, Kansas will allow schools to arm employees with concealed handguns, and will ensure weapons can be carried into more public buildings.
Are there people who honestly believe that the way to reduce gun violence is to have more guns? Perhaps so; or perhaps much action in state legislatures is more partisan than rational.
The Pennsylvania state Senate negotiated with the state’s Republican Governor, Tom Corbett, to include the Affordable Care Act’s Medicaid expansion in next year’s budget. The measure passed in the Senate on Sunday night on a 40–10 vote. A key committee in the state House, however, stripped that provision on Monday from the version of the bill being considered there. This would make Pennsylvania the 22nd state to turn down these billions of dollars in federal aid money.
It is difficult to see why a state would reject the expansion of Medicaid, since it is being paid for through federal funds, and requires nothing from the states for the first three years. After that point, the portion paid by the federal government gradually reduces to 90 percent in 2020. Even with states picking up one tenth of the cost, they will save money, since giving adequate health care will mean lower costs for emergency rooms. A healthier citizenry means fewer missed workdays, fewer medical bankruptcies, and fewer unnecessary deaths — thus, higher tax collections. It’s a win-win, and should a no-brainer.
All is not lost for the Medicaid expansion. In Ohio, the Republican governor, John Kasich, vetoed language in the budget bill that would prevent him from moving forward with this provision of the ACA, though he did leave intact onerous new anti-abortion provisions. In Nebraska, 22 state Senators pledged to continue working on putting the expansion back into the state budget, after it having been stripped out of the current bill. In all, 23 states and the District of Columbia have approved these Medicaid provisions that will help millions of people earning less than 138 percent of the federal poverty line, or roughly $31,800 for a family of four.
Is there any excuse, other than ideology, for denying this coverage? Does withholding health care for poor people serve any legitimate purpose?
As mentioned, Ohio is about to institute severe — and so far, unique — abortion restrictions:
Clinics must have an agreement with a local hospital to transfer patients there in the case of an emergency, but public hospitals are barred from entering into those agreements… Another way the new law is unusual: the director of the state department of health, a political appointee, has the unilateral power to revoke variances given to clinics without a transfer agreement. The director also determines whether transfer agreements are satisfactory.
The new law also cuts funds for Planned Parenthood, requires transvaginal ultrasounds, and forbids most medical counseling that would discuss abortion.
In Texas, an anti-abortion bill was filibustered to death — by a real filibuster! — last week in an heroic effort by state Senator Wendy Davis. In response, the Republican Governor, Rick Perry, called a special session of the state legislature to reintroduce the measure:
The bill would ban most abortions after 20 weeks of pregnancy and would tighten regulations on abortion clinics and the doctors who work at them. Critics said the measure would have shut most of the abortion clinics in Texas.
Indeed, the bill would leave five clinics in operation for the entire, enormous state. Currently, there are about 40, so that’s closing 88 percent of them. At least thirteen states have passed new limits on abortions. A bill intended to close clinics in Alabama has been temporarily blocked by a federal judge.
It’s clear that most of these anti-choice laws would be ruled unconstitutional in light of Roe v. Wade. Or at least, they almost certainly would be by anything other than the Roberts court. A coin flip might be a relatively accurate predictor of what would happen if these laws are challenged today.
In other, non-health matters, in the wake of last week’s Supreme Court decision striking down an important provision of the Voting Rights Act, several states are considering (or have already enacted) restrictive new voting laws; Virginia, North Carolina, Pennsylvania, Alabama, Wisconsin, and Texas are among them.
On the plus side, new legislation in eight states will prevent businesses from demanding passwords to social media sites as a condition of employment. Though, on the downside, this means in at least eight states, such intrusive demands from employers were apparently common enough that the state legislatures felt compelled to enact such laws.
An excellent summary overview of the action in state legislatures can be found here. Some of the new laws will undoubtedly infuriate, some will delight, some will make one sit up in surprise. My personal favorite is that Kentucky has just repealed a Prohibition-era law banning election-day drinking.
Perhaps we all need that sort of release on election day, for America is that sort of nation — no matter your political point-of-view, every cycle brings plenty to celebrate and plenty to lament. At the least, this mix provides plenty of reason for people on all sides to remain active. Our multi-tiered system of government, with elected officials in cities, counties, states, and other regional and local jurisdictions in addition to federal, gives opportunity for both value and mischief of almost infinite variety.
On this July 4, as you watch the fireworks and celebrate another candle in the nation’s cake, take stock of what the nation is doing, where it’s been, where it’s going. Think about where you want it to go, and where you might be able to make a difference. A nation’s life is not a spectator sport.
In America, the people govern. The government is made up of citizens, not nobility ruling hereditary fiefdoms. More, the people chose representatives; even appointed officials are selected by representatives of the people. That is the whole point of America, the purpose of the nation, the reason it was created. To the extent that we relinquish our power to corporate interests, to monied mouthpieces, or to professional lobbyists, we fail to achieve our national purpose.
If you are dissatisfied with the direction of the nation, your state, your city, or your county, it is up to you to do something about that. If you don’t see changes you want, look in the mirror for the cause.
All politics is local. It starts in your home, and spreads from there.