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GOP Complains of Unfunded Mandates, then Cuts Medicaid

I want to revisit David’s earlier post on the punitive measures the GOP House proposed to replace the automatic defense cuts required by the deficit reduction debacle of last year.

That law, passed by both parties after the GOP threatened to force the government into default and signed by President Obama, is one of the most irresponsible ever adopted by Congress.

The logical thing to do would be to repeal the law, because it’s bad policy and bad economics.  But neither party agrees with me, because they want to continue holding a gun to our heads and insist they would pull the trigger just to force even worse results, which is what the GOP House passed today.

So what did the House GOP vote to cut to save the poor Pentagon?  David quotes from The Hill [my bold]:

Under the House-approved legislation, food stamp eligibility is tightened, the Prevention and Public Health Trust Fund under the 2010 healthcare law is ended, the Federal Medicaid match to states is reduced, new stricter eligibility standards for Medicaid are imposed, and the Social Services Block Grant, which funds Meals on Wheels, is ended.

More savings come from cutting all funding for the Consumer Financial Protection Bureau, cutting federal worker pay and through medical tort reform.

As expected, the Republicans’ preferred cuts to save the Pentagon budget are cruel and stupid, hurting the poor, the hungry and jobless, and those too poor to afford health insurance.  So it’s time to recall what these same goons argued in another setting.

For years governors of both parities have complained about “unfunded federal mandates.”  When Congress passes laws that create additional spending requirements, governors insist that the federal government cover the added costs of complying with the federal mandate.  Often both parties agree with this, at least in principle.

During recessions, this issue becomes even more acute, as state revenues decline while safety-net spending goes up.  So when the Obama Administration and Democrats passed the American Recovery and Reinvestment Act of 2009 (the stimulus bill), they increased federal dollars for unemployment insurance, Medicaid, food stamps, and other federal programs administered by states. Most of that extra stimulus money is gone, and the GOP won’t allow Congress to augment it, so states have been slashing spending by firing teachers and other government employees, and many have tried to cut Medicaid eligibility.

The Affordable Care Act promised very generous federal funding for the Act’s major expansion of Medicaid.  The ACA provided that for the initial years, the Feds would pay 100% of the added costs of extending Medicaid to millions of people currently uninsured, and slowly declining percentages in later years after the economy presumably recovered.

Despite this, some States and other opponents who challenged the ACA in court argued before the Supreme Court that the Medicaid expansion itself was an unconstitutional intrusion on states rights, because it forced them to do things they didn’t want to do, like provide Medicaid coverage to people who can’t afford insurance.  Not wanting to admit that, their counsel argued that it was overly coercive to put the states in a position where the feds could cut the funding if a state failed to provide the insurance coverage.

But that was eons — a whole month — ago.  As David’s post reported, on Thursday the clowns in the GOP House decided that the way to avoid automatic cuts to the military budget is to take federal money that would otherwise be paid to states for Medicaid, even though this action would exacerbate the ACA opponents’ claim that Medicaid was coercive because the federal government could withhold funding.

On the same day NJ Gov. Christie vetoed a bill to set up a health insurance exchange — basically a  website where people can shop for competing private insurance plans — because, he claimed, he didn’t know what the Supreme Court would do with the ACA.  Apart from the fact that it’s his team that has made the ACA’s survival uncertain, we should remind ourselves that an insurance exchange was and remains a Republican idea — remember Mitt Romney? Paul Ryan?– to give the private insurance market the exclusive right to solve the problems of rising health care costs and 50 million uninsured by helping people shop for the policies they wanted.

So all together, the GOP position is this:  expanding Medicaid is coercive because the feds might take away funds if a state doesn’t provide coverage, but let’s cut Medicaid funding anyway, and while crippling public insurance, let’s make it harder for people looking for private insurance to find  and compare competing policies.

Alan Grayson got part of it right.  And see Mann and Ornstein

More: NYT editorial, The Human Cost of Ideology

Related: Suzy Khimm, Americans want to slash defense spending . . .

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John has been writing for Firedoglake since 2006 or so, on whatever interests him. He has a law degree, worked as legal counsel and energy policy adviser for a state energy agency for 20 years and then as a consultant on electricity systems and markets. He's now retired, living in Massachusetts.

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