By Bill Boyarsky
There’s nothing good about the House Republican-Mitt Romney budget plan. But perhaps its worst feature is the way it targets the many millions of working and unemployed poor who rely on the federal-state Medicaid program for medical care.
It does this by proposing huge reductions in Medicaid spending, and, most significantly, putting the program in the hands of the states, whose governments, strapped for money, are increasingly run by conservatives.
The plan was conceived by House Budget Committee Chairman Paul Ryan, R-Wis., and is backed by Romney, who is favored to win the Republican presidential nomination after his victory Tuesday in the Illinois primary. If he defeats President Obama and the Republicans win the Senate along with holding the House, consider it a blueprint for 2013.
The Ryan-Romney plan would cut taxes to the affluent and corporations, increase arms spending and cut expenditures for almost everything else, including environmental programs, child care, the Children’s Health Insurance Program, aid to college students and funding for transportation, which includes air traffic control. Medicare would be cut, the health care reform law repealed. If you think the health reform law is too kind to insurance companies, you’ll be amazed at the way Ryan-Romney lets big insurance really run things.
“In essence, this budget is Robin Hood in reverse—on steroids,” said Robert Greenstein, president of the Center on Budget and Policy Priorities. “It would likely produce the largest redistribution of income from the bottom to the top in modern U.S. history and likely increase poverty and inequality more than any other budget in recent times and possibly in the nation’s history.
“Chairman Ryan says these changes in domestic programs are necessary due to the nation’s severe fiscal straits. The nation’s fiscal straits, however, surely do not justify massive new tax cuts for its wealthiest people alongside budget cuts that would cast tens of millions of less fortunate Americans into the ranks of the uninsured, take food from poor children, make it harder for low-income students to get a college degree and squeeze funding for research, education and infrastructure. Under Chairman Ryan’s budget, our nation would be a very different one—less fair and less generous, with an even wider gap between the very well-off and everyone else … and our society would be a coarser one.”
The center’s website has more details. I’ll concentrate on the Medicaid portion of the plan.
The budget plan is one result of the growing influence of conservative statehouses, a quiet revolution taking place in politics and government. Because it is occurring in statehouses, too often poorly covered because of the decline of the media business, the nation has no way of knowing what’s happening.
When enacted in 1965, Medicaid, a centerpiece of the Great Society, was a safety net financed by federal and state funds. Although administered by the states, each state must meet federal standards for eligibility and benefits. Almost 49 million people receive benefits.
The Republican plan would turn Medicaid over to the states by giving them money in the form of “block grants,” large amounts of money that can be used with little restriction. Federal Medicaid expenditures would be reduced by $810 billion—45 percent, The New York Times estimates—over 10 years. So the states would be getting much less to care for their poor.
Republican doctrine says the states are so creative they can figure out how to do more with less. But look what’s happened in recent years.
I noted in Truthdig a while back how the Republicans in 2010 won a majority of the nation’s state legislative seats. It was the largest majority for the Republican Party since 1928. The Republicans now control a majority of legislatures in the South, plus more governorships, including Florida, Wisconsin, Pennsylvania, Ohio and Iowa. These victories came with the help of super PAC donations. Matt Sledge in The Huffington Post cited a study by the National Institute on Money in State Politics showing super PACs gave $36.8 million to state candidates between 2008 and 2010. Most of the donors were conservative.
Elections have results, as the cliché goes. The shift in the composition of the legislatures has resulted in a wave of right-wing restrictive legislation proposed or passed on abortion, contraception, voting and immigration.
As Amanda Marcotte reported on AlterNet, abortion restrictions have been approved or proposed in Idaho, Iowa, Oklahoma, Mississippi, Kansas, Virginia and Texas. There are others floating around statehouses.
Republicans have pushed through Voter ID laws in Wisconsin, Minnesota, Alabama, Kansas, Rhode Island, South Carolina, Tennessee and Texas. Anti-immigrant laws are popping up around the country in places such as Alabama, Georgia, Arizona, Utah, Colorado and New Mexico.
Putting Medicaid in the hands of such state governments will mean that care for the poor will be subject to the whims, prejudices, ideological leanings and budget cutting tendencies of state legislators.
These legislators are pushovers for campaign contributors. What’s a pittance for a super PAC can buy a state senator, beginning with financing a campaign and continuing support into the statehouse. These campaigns to take over state governments will grow as business sees the possibilities.
Think about what’s happening with abortion, contraception, voters’ rights and immigration. Do you want these people in charge of medical care for the poor?
AP / Jacquelyn Martin
House Budget Committee Chairman Paul Ryan holds up a copy of his budget plan, titled “The Path to Prosperity,” during a Capitol Hill news conference Tuesday.