Map of life expectancy at birth from Global Education Project.

Tuesday, December 28, 2004

And another thing -- Medicaid

The Bush Administration's tax cuts for the wealthy and the huge federal budget deficits that resulted have often been described as irresponsible, but they aren't actually evidence of insanity. The deficits are completely intentional, and the hidden purpose is, in the words of neocon economic Svengali Grover Norquist, to "starve the beast." The beast is, of course, government social programs. The administration has been loudly screaming that Social Security is unaffordable and attempting to destroy it. Our friends elsewhere such as Atrios and Josh Marshall have covered that well.

Still largely under the radar is the Bush assault on Medicaid. Starting with Ronald Reagan, Republicans have wanted us to think of Medicaid as free health insurance for welfare queens in Cadillacs, who buy vodka with their food stamps, but in fact, Medicaid now finances health care for poor children whose parents are working, and most notably, for elderly and disabled people receiving long-term care in nursing homes. 42% of Medicaid expenditures are for people who are also Medicare eligible, and Medicaid pays for the care of 70% of the people in nursing homes, according to the National Governors Association.

Medicare is 100% paid for by the federal government, but the cost of Medicaid is shared with the states. The Republicans in Congress have been talking about cutting tens of billions of dollars from federal spending on Medicare and Medicaid -- we can't afford it, after all, just look at those horrific budget deficits. (Bonus question: what projects and programs, according to the Bush Administration, can we afford?) The governors, however, know what this really means: more of the cost of Medicaid will be shifted to the states. And, if Medicare benefits are cut, those costs will be shifted to Medicaid as well. Why is that? It's simple: the alternative is to throw Grandma out of the nursing home and onto the street. They have written to Congress, unanimously, with no Republican dissenters, asking the extremists who now chair the budget committees not to do this. We'll see if the Liberal Media cares to pay any attention.

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