Vol. 10, No. 9 email@example.com www.thespiritualherald.org September 2011 © 2011 Eastern Tsalagi Publishing Co.
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States Rights May Clog Budget Talks
By Don Flynn
WASHINGTON—The age-old fierce battle, known as “States Rights,” is expected to take center stage during negotiations over several major budgetary issues by the so-called Super Committee of the Congress, which is charged with reducing deficits by more than $3 trillion over the next 10 years.
The issue is the control of Medicaid, a state run government insurance program for the poor and minorities. Many states—arguing that they have a right to control all of Medicaid—have attempted to seize control of the program since it was introduced in 1965. Unlike Medicare, the states run Medicaid, but the federal government has the final say. The states’ argument is that high costs of the program are contributing to their deficit problems.
However, many observers see the states’ aim as a Trojan Horse to resurrect Republican power to states and governors to have their way in all matters back home.
Jacob J. Lew, director of the White House Office of Management and Budget, announced in late September that President Obama’s new deficit reduction plan would cut $320 billion from projected spending in Medicare and Medicaid during the next decade.
The plan calls for cuts of $248 billion from Medicare and $72 billion from Medicaid and other health programs, respectively. Some observers predicted that the cuts could lead to the destruction of Medicaid unless the federal government gets more involved in the administration of the program.
Many pundits noted that arch-conservative members of the Congress and tea partiers are overtly pushing other conservative and moderate members of the 12 member Super Committee to give them an upper hand over Medicaid, which they maintain is the jewel in the crown.
The campaign to establish States Rights in America has not seen this level of momentum since the late Governor Strom Thurmond of South Carolina promoted the race-based issue of States Rights back in the 1940s.
States Rights has a long, grim history of Thurmond and other governors and politicians supporting segregation, denying votes to blacks, and recently rigging Medicaid to avoid serving the poor.
“There is a real push for States Rights to take precedence over large government but I’m not so sure it’s going to be capable of being done,” Health Professor James L. DeBoy, Ph.D., of Lincoln University told The Spiritual Herald. “Certainly that is the whole tea party movement—the idea of minimizing the control and the power of the federal government.
“If you strictly push the whole idea of states superseding you wouldn’t have had civil rights,” he said. “You wouldn’t have had a lot of things that have made this country better.”
* * * The Battle Looms * * *
The States Rights offensive knocked public employees unions out of Wisconsin, emboldened New Jersey Governor Chris Christie to attack teachers, demanded “block grants” to the states for Medicaid, and spawned a G.O.P. line-up of White House candidates like Rep. Michele Bachmann (R-Minn.) who cry for a end of federal government “meddling.”
The Medicaid battle looms as an issue to empower States Rights across the board. The growing, energized drive to end restrictions on campaign contributions, finance, business and environmental regulations are all part of a package that will be tested in the 2012 election.
The specter of “Big Brother” control over the people clashes with federal government law to provide Medicaid health care for the poor, disabled and elderly, even as states protest they cannot afford it.
“They are opposed to the whole idea of ‘Big Brother,’” said DeBoy. “We’re between the political aisles, two extremes. Individual rights trump societal needs. I think we’re at a point now in time where the greater good for the greatest number of people has to take precedence over individual rights.”
“The problem is that states have a particularly serious fiscal problem,” said Professor Rodney D. Green of Howard University. “By their own constitutions they are required to balance their budgets on an annual basis.
“In the current period with massive unemployment and general distress in the economy, the revenues—the tax money—has dropped. And the need for social programs as increased.
“Instead of trying to figure out how to solve the social problems, most states are severely cutting Medicaid as one of their bigger expenditures,” he noted.
“They think the vulnerable populations won’t be able to do anything about it. They take advantage of the low income people and they try to balance their budgets on the backs of the poor,” Green added.
Medicaid, provided by the states with matching federal dollars, expanded with the Affordable Care Act to include 32 more million Americans and require every citizen to buy health insurance at subsidized exchanges set up by states. It was the straw that provoked states to rebel, and 28 filed court challenges demanding repeal of the act, which is now before the courts.
“The power of the states is clearly defined in the Constitution and states are limited by their tax bases in what they can do, and second by the powers defined in their state constitutions,” said Fragano Ledgister, Chair of the Political Science Department at Clark Atlanta University.
“There are clear expectations on the part of citizens that the government, whether state or federal, is going to provide a certain level of service, whether it’s healthcare for the elderly through Medicare or healthcare for people of limited income for Medicaid.
“Most people don’t care very much whether their service comes from the federal government or the state. At the same time, there has been a certain degree of success for the argument that the federal government has become too powerful.
“However, the polls suggest that people want a certain minimum level of healthcare at the tax payer expense. The real debate is what that level should be and exactly how that should be provided.”
“My personal view is that universal healthcare is not something that can be handled easily by the states themselves without the federal government,” said Victor G. Rodwin, Professor of Health Policy and Management at the Wagner School of New York University.
“This is an area where the federal government is required, largely because of financing. The states simply don’t have the fiscal capacity to do much about it.
“In the states that have the weakest programs, their very poor population will be worse off because they don’t have the money to support it,” he said. “If you leave things to the states you get greater inequalities because things are very different in California, New York, Mississippi, Louisiana, and Texas.”
It is, in fact, the lack of any national coherence among the states as to what they provide—or can afford—that has bedeviled the program from the start. States originally were to provide half the money, but poor states soon needed 70 or 80 percent from Washington, and Medicaid care became a patchwork as states cut back, denied eligibility, complained and ran deficits.
States cut services, denied specialty care, slashed reimbursement rates to doctors and hospitals causing some to stop taking Medicaid patients, and obtained “waivers” to water-down care and eligibility.
Those policies continue, and the Affordable Care Act was passed to prevent some of that. “It is a federal act, but no state can say, ‘we’re not going to do Medicaid,’” noted DeBoy.
“Right now, what are poor folks doing?” he asked. “If they don’t have health insurance, where are they going? They aren’t going to doctors. They are going to emergency rooms and that is why the costs are so exorbitant. It is breaking the whole healthcare system.”
“The whole idea of this country was founded on equality and justice and all those big principles of human dignity,” he said.
“This always prides itself as trying to help the little guy. I believe in that. That’s a part of our whole foundation for the American ideal. There are pockets of the country that want to keep things the way they are because they ‘have.’
“The ‘haves’ have and they want to maintain what they have. They don’t want to give or share. There has to be some type of central or strong federal government that takes the ‘moral high’ route, which the federal government has done in my 60 years on this planet.
“Why not raise taxes on the big corporations that are operating in your states?” asked Professor Green. “Or increase state income taxes on those making $1 million a year or more, instead of attacking the poor? They can afford it.
“This kind of society we live in is not attuned to that sort of approach and instead is all about making the maximum profits for the business class. As a result, Medicaid is savaged all over the country and people are certainly dying that don’t need to die.”
For Professor DeBoy: “The issue is they perceive President Obama being a Democrat, the idea of society, meaning larger society, meaning big government making decisions which is affecting individuals.
* * * Deeply Invested * * *
“The tea party, the far right, is saying that the individual retains the right to say no to even things that are good for them. The idea is, ‘let me do my own thing,’ even if it means hurting myself I have that right.
“The tea party folks are saying that you can’t force even good things upon people who don’t want it. My point as a healthcare advocate is that this country can no longer afford to let those things go like that with people not getting health insurance, not getting medical care,” DeBoy concluded.
According to some pundits, both Republicans and Democrats are deeply invested in having the Congressional Super Committee reach a compromise by December 23, 2011. If they cannot find common ground by this time, $1.2 trillion in cuts to defense and entitlements will go into effect in January 2013.