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Justifying Cuts: A Well-Used But Misleading Medicaid Statistic

“Cash-strapped states are also feeling the burden of the Medicaid
entitlement. The program consumes nearly 22 percent of states’ budgets today, and things are about to get a whole lot worse.”

— Sen. Orrin Hatch (R-Utah), June 23, 2011, at a hearing of the Senate Finance Committee

“Medicaid is the lion’s share of that spending burden as it now consumes about 22 percent of state budgets now and will consume $4.6 trillion of Washington’s budget over the next ten years.”

— Former Kentucky governor Ernest Lee Fletcher (R), June 23, 2011, at the same hearing

“Across the country, governors are concerned about the burgeoning cost of Medicaid, which in fiscal 2010 consumed nearly 22 percent of state budgets, according the National Association of State Budget Officers. That’s larger than what states spent on K-12 public schools.”

— Washington Post front page article, June 14, 2011

When a statistic is universally tossed around as a certified fact, it’s time to get suspicious.

Such is the case with this oft-cited statistic that 22 percent of state budgets is being gobbled up by Medicaid, the state-federal program that provides health coverage for the poor and the disabled. Medicaid supposedly is even dwarfing what is spent on educating children and teenagers.

But note the phrase “state-federal.” There’s billions of dollars in federal money involved, and the “22-percent” statistic obscures that fact. Let’s dig a little deeper into the numbers.

The Facts

Medicaid was a central part of President Lyndon Johnson’s “Great Society” initiative in the mid-1960s. Each state administers its own Medicaid program, but with federal oversight, federal requirements—and plenty of federal dollars. On average, the federal government provides 57 percent of Medicaid funds.

Initially, Medicaid was focused low-income Americans, but elderly nursing home care has also become a big part of it. The new health care law would also greatly expand eligibility to people up to 133 percent of the official poverty line.

There’s no question that the recession has put pressure on Medicaid spending, as more people lost jobs or income and so became eligible for coverage. The new requirements of the health care law also will boost Medicaid spending.

The assertion that Medicaid is 22 percent of state spending, and thus now exceeds education spending, comes from an annual survey of the National Association of State Budget Officers (NASBO). But if you dig into the report — if you just go to page
one — you will see that this number includes the federal contribution, in what
is known as “total funds.”

If you want to see what states themselves are spending on Medicaid —“general funds” — you have to use another set of statistics.

As NASBO says on page one, “For estimated fiscal 2010, components of general fund spending are elementary and secondary education, 35.7 percent; Medicaid, 15.4 percent; higher education, 12.1 percent; corrections, 7.2 percent; public assistance, 1.9 percent; transportation, 0.8 percent; and all other expenditures, 27.0 percent.”

In other words, without the federal dollars included, Medicaid falls to second place, far behind education. It turns out that on average, states spend 15.4 percent of their funds on Medicaid — not 22 percent.

Brian Sigritz, NASBO’s director of state fiscal studies, said, “You are correct that there are several different ways of looking at Medicaid spending that you can use. If you consider just general funds, K-12 easily remains the largest component of general fund spending, as it historically has been.”

Indeed, when you look at NASBO’s historical data (table three of this report), it becomes clear that Medicaid spending, as a proportion of general funds, has remained relatively consistent since 1995 — about 15 percent — in contrast to the popular image of being a drain on state budgets.

Sigritz said that the two figures provide a different picture of state spending. “General funds gives you a sense of spending deriving from state revenue, while total funds gives you a sense of total state expenditures,” he said.  “Typically when you discuss overall state budgets you examine the various funding sources that go into them including general funds, other state funds, bonds, and federal funds.”

The Office of the Actuary for Medicare and Medicaid makes this distinction. The 2010 Actuarial Report for Medicaid notes the broad figure, but then takes pains to add: “This amount, however, includes all Federal contributions to State Medicaid spending, as well as spending from State general revenue funds and other State funds (which for Medicaid consists of provider taxes, fees, donations, assessments, and local funds).” The report concludes: “When only State general revenues are considered, however, Medicaid spending constitutes an estimated 16.2 percent of expenditures in 2009, placing it well behind education.”

Antonia Ferrier, a spokeswoman for Hatch, defended the 22-percent figure, noting its wide use. “It is part of their budgets, and there are many different streams of funding that fund those state budgets (including federal funding, taxes, etc.) that fund their many programs,” she said.

But Colleen Chapman, a spokeswoman for the Georgetown University Center for
Children and Families, a policy and research center, said, “In the current budget debate, the data are being misused to argue that the Medicaid program in states is out of control and needs to be cut dramatically, when in fact, Medicaid is still much less of state spending than education and has not grown, as a portion of state budgets, in any way close to the mammoth way that others argue it has.”

The Pinocchio Test

We will label this with one of our rarely used categories: TRUE BUT FALSE.
(We still need to get an appropriate icon for this one — suggestions are welcome.)

Yes, the 22-percent figure is a valid number. But it is being used in an inappropriate way, and therefore is misleading. Hatch and Fletcher are only the latest in a long line of public figures — and news outlets — who have seized onto this number without apparently realizing that it is the wrong statistic to use. If people want to understand the impact the Medicaid is having on state budgets, politicians should begin to use the 15-percent figure — or at the least offer a caveat to the 22-percent number. Otherwise, there might be some Pinocchios in their future.

 

By: Glenn Kessler, The Fact Checker, The Washington Post, July 5, 2011

July 5, 2011 Posted by | Conservatives, Deficits, Economy, Education, GOP, Health Care, Ideologues, Ideology, Lawmakers, Medicaid, Middle Class, Politics, Republicans, State Legislatures, States | , , , , , , , , , , , , | Leave a comment

Memo To Gov Walker: This Is What Solidarity Looks Like

All of us have learned some lessons about the meaning of solidarity from the recent events in Wisconsin. Gov. Scott Walker’s so-called “budget repair bill” was a draconian assault on workers’ rights and unions. He followed this with what the Wisconsin education superintendent called “the greatest state cut to education since the Great Depression” and a host of other cuts that disproportionately affect poor people and people of color. Teachers and other public sector employees, along with parents, students, and many, many others, responded with an outpouring of creative, imaginative, and hope-inspiring acts of solidarity.

Solidarity is parents texting teachers to say: “I heard you were going to Madison today. Do you have space for one more in your car?” Solidarity is firefighters (who are not losing collective bargaining) showing up to parade among thousands of protesters every day for two weeks and sleeping on the cold, hard Capitol floors to keep the “people’s house” open for the people. Solidarity is people from as far away as Egypt and Antarctica calling in donations to Ian’s Pizza to feed protesters. Solidarity is strangers running up and saying “Thank you” as they sign a petition to recall their state senator in the most conservative, affluent white suburbs. Solidarity is when two educators can put together a protest on Wednesday night and get 200 picketers at a biased local news station Friday—after school and in the rain. The experience of being in the midst of something much larger than oneself—and realizing that we can change the world for the better, can take care of each other, can make decisions together—is life changing.

Acts of solidarity are growing in Wisconsin and beyond. And it’s a good thing, because solidarity is what we need to sustain us during the most difficult time for public employees and public education that our country has seen in our lifetimes. As the wealthy—and the politicians they have purchased—continue their pursuit of privilege and privatization, we need to be even more audacious in nurturing solidarity for survival.

The attacks on the public sphere go well beyond Wisconsin. Ohio recently passed a law that prohibits collective bargaining over health care and pensions for all public employees, including police and firefighters. Michigan’s Public Act 4, passed in March, allows the governor to appoint “emergency managers” for municipalities with “fiscal emergencies.” The governors of Wisconsin, Michigan, Ohio, and a handful of other states hope to replicate and expand the policies of Indiana Gov. Mitch Daniels, who eliminated collective bargaining for state employees six years ago through executive order. New Jersey Gov. Chris Christie is refusing to negotiate with state workers over health and benefits, and has proposed eliminating tenure, seniority, and civil service protections for teachers while imposing a mandatory test-based evaluation system not subject to collective bargaining.

Teacher Leadership

In Wisconsin, the teachers’ union was a major force in getting people out to the Capitol, with the Madison local, Madison Teachers Inc., taking the lead. After the first day of sick-outs by Madison-area teachers, the president of the Wisconsin Education Association Council called on 98,000 Wisconsin educators to come to the Capitol to protest the bill on Thursday and Friday instead of going to work. The push and pull between rank-and-file union members and union leaders was evident. Activist locals pushed the state organization, and rank-and-file members pushed their union locals. On the flip side, many union leaders asked reluctant members to go beyond their comfort zones and get active to defend their rights.

When Wisconsin teachers arrived at the Madison Capitol to join the protests, they stepped into a powerful tradition of progressivism and unionism. The signs, T-shirts, and invited speakers made it clear that this wasn’t just about teachers, it was about all workers’ rights. As the days wore on and the fight drew increasing attention in the national media, protesters became increasingly conscious that losing in Wisconsin could be the beginning of the end for workers’ rights across the country. Walker saw the situation the same way. He told a prank caller impersonating billionaire donor David Koch that “Ronald Reagan . . . had one of the most defining moments of his political career . . . when he fired the air traffic controllers. . . . This is our moment, this is our time to change the course of history.”

Walker claimed that “Wisconsin is broke” but, as Michael Moore told protesters at the Capitol: “America is not broke. Not by a long shot. The country is awash in wealth and cash. It’s just that it’s not in your hands. . . . Today just 400 Americans have the same wealth as half of all Americans combined.” In fact, one of Walker’s first acts as governor was to give the rich another $140 million in tax breaks.

America’s wealth is not only held unequally, it’s also misappropriated in obscene ways. Virtually always ignored in these discussions is the looming U.S. military budget, which was $663.8 billion last year. What would that money and those human resources mean, directed to meeting social needs instead of poured into weapons and conquest, including the endless occupation of Afghanistan? The current crisis is not an “unavoidable” consequence of economic recession; it is a bill come due for bailouts, bombs, and unsustainable inequality. And it’s being delivered to the wrong address by the political servants of the rich.

Cuts Target the Most Vulnerable

Compounding public employees’ anger at the attacks on their jobs and unions has been growing anger about the debilitating budget cuts that destroy public services and make it impossible to serve the needs of students, patients, or clients. Among Wisconsin teachers, this led to a feeling of “What do we have to lose?” Late one night, as dozens of teachers debated whether to organize a sick-out, one teacher remarked: “If one-third of your building calls in sick tomorrow, you’ll have the same staffing levels as you’ll have every day next year after the budget cuts.”

Attacks on the public sector—teachers, nurses, social workers, librarians, public health workers—are in essence attacks on the people they serve: children and those who are sick, elderly, homeless, disabled, jobless, newcomers, or otherwise in need of public services. In state after state, budget cuts have targeted those who are most vulnerable. The racial and class injustice of the cuts is undeniable. In Michigan, proposed cuts would close half the schools in Detroit, where 95 percent of the students are African American, and increase class size to 60. The Texas budget proposal would eliminate pre-K funding for almost 100,000 children. In Washington, cuts would eliminate prenatal and infant medical care for 67,000 poor women and their children. In Wisconsin the governor’s new budget hits Milwaukee Public Schools, the state’s largest and most impoverished district, particularly hard. The proposal denies health care coverage and food stamps to many more people in need, including both documented and undocumented immigrants. It will take away college opportunities from undocumented immigrants by repealing the current state law that allows any resident to pay in-state tuition.

Also in Walker’s proposal is a huge expansion of public support for private schools. Milwaukee would become the first city in the United States in which any child, at any income level, could attend private school (including a religious school) on the public dime. And lest we think that this is a peculiarly Wisconsin development, the spending deal to avert a federal government shutdown in April included a plan to provide federal money to low-income students in Washington, D.C., to attend private schools.

This insistence on spending money on vouchers in the midst of a “fiscal crisis” exposes the right’s real goals. This is the future that many people with great wealth, and those who do their bidding, have in mind: the decimation of workers’ rights to organize, the withering of the public sphere, wealth and power increasingly concentrated at the top. The signs that proclaimed “We are all Wisconsin” and the solidarity protests across the country were a recognition that—as the Industrial Workers of the World said more than 100 years ago—an injury to one is an injury to all.

Sustaining Resistance

No doubt, in the face of these increasingly aggressive right-wing attacks, frustration, depression, and even desperation are widespread. But here, too, communities around the country can draw inspiration from Wisconsin. Months after the first protesters marched into the Capitol, people continue to organize. A few examples: massive recall campaigns aimed at state senators who voted to destroy collective bargaining; street protests dogging the governor’s footsteps; teacher “grade-ins” at local malls to make weekend grading and planning visible to the community; campaigns to get out the vote for progressive candidates; a boycott, led by the Wisconsin Firefighters Union, against M&I Bank, whose executives are major funders of Gov. Walker.

Yes, this is no time to despair. There is too much on the line. But it’s also no time to ignore very real and enduring problems in our schools. Too often, the enemies of public education have taken advantage of schools’ failure to meet the needs of disenfranchised communities to push privatization schemes and market reforms—from vouchers to Teach for America—as the alternative. As educators, we need to listen to students’ and parents’ genuine grievances about public schools and respond with engaged imaginations and a determination to work together as school communities. We need to build labor-community alliances that directly confront racial injustice. Moving in that direction were May Day celebrations this year in Wisconsin, New York, and other states built by conscious collaborations of labor and immigrant rights organizations with demands for human rights that were explicitly pro-immigrant, pro-labor, and anti-racist. We need more cross-union alliances like Jobs with Justice to organize the unorganized and support all workers’ rights—here and around the world. We need more teachers’ unions that defend communities as well as contracts, and political organizations that see electoral campaigns as one aspect of a permanent mobilization toward democracy and justice.

As the articles in our cover section point out (see p. 14), we need to equip our students to recognize what’s at stake—and to look at history and current social movements to see what people, including young people, can do when they act on their beliefs. If Wisconsin’s Scott Walker has taught us anything, it’s that what is at stake is the kind of society we want to live in.

These past few months in Wisconsin have shown that consciousness-raising and organizing can be filled with humor, imagination, and a bold spirit of resistance. We can build on this work, deepening and multiplying our expressions of solidarity, to sustain us through this intensely difficult time and propel us toward a more humane and just future.

By: The Editors, Rethinking Schools, June 24, 2011

June 25, 2011 Posted by | Class Warfare, Collective Bargaining, Conservatives, Democracy, Economy, Education, Equal Rights, GOP, Gov Scott Walker, Government, Governors, Health Care, Ideologues, Jobs, Koch Brothers, Labor, Lawmakers, Middle Class, Politics, Public, Public Employees, Republicans, Right Wing, States, Union Busting, Unions, Wisconsin, Wisconsin Republicans | , , , , , , , , , , , , , , | Leave a comment

John Birch Society Celebrates Koch Family For Their Role In Founding The Hate Group

Billionaire brothers David and Charles Koch have been dominant financiers for conservative front groups and nonprofits for nearly three decades. Their money has flowed to organizations dedicated to lobbying for corporate and upper income tax cuts, as well as to groups responsible for mobilizing Tea Party rallies against President Obama. But the Koch family’s association with fringe right-wing groups began a generation earlier with Fred Koch, the patriarch of the clan.

Fred not only founded the company now known as Koch Industries, he also was a founding member of the John Birch Society. As a founding board member, Fred helped engineer a hysterical wave of attacks on labor, intellectuals, public education, liberal clergy members, and other pillars of society he viewed as a threat. Birchers decried everyone from former President Eisenhower to water utility administrators as pawns in a global communist conspiracy. In the last two years, as the Koch name has become synonymous with right-wing plutocracy in the United States, the Koch family has played down its relation to the Birchers.

However, the New American, the official mouthpiece of the John Birch Society, published a piece this morning celebrating Fred and the Koch family’s pivotal role in developing the group:

Koch warned that American institutions were honeycombed with communist subversives, from labor unions and tax-free foundations to universities and churches. Art and newsprint, radio and television — all these media had been transmuted into vehicles of communist propaganda. […] Fred Koch was no fly-by-night pamphleteer. He spent a generous portion of his later years using his wealth and influence to fight the communism he abhorred. He was an early member of the The John Birch Society’s National Council, an advisory group to JBS founder Robert Welch. Koch supported a variety of freedom-related causes, all the while continuing to build the company today known as Koch Industries.

The Bircher ode to Koch glosses over Fred’s record of bigotry. In a booklet he authored, Fred railed against civil rights leaders, and claimed the movement against racial segregation was a communist plot to use African Americans to destabilize the country. The Koch-funded Birchers held numerous rallies during the ’60s claiming integration would lead to a “mongrelization” of the races.

Although the present-day Koch brothers try to eschew explicit racism, their top Tea Party front group, Americans for Prosperity, is currently pursuing similar racial segregation goals. In North Carolina, the Americans for Prosperity chapter led a campaign to end a highly successful public school integration system.

 

By: Lee Fang, Think Progress, June 10, 2011

June 12, 2011 Posted by | Conservatives, Corporations, Democracy, Education, GOP, Ideologues, Ideology, Koch Brothers, Labor, Neo-Cons, Politics, Racism, Republicans, Right Wing, Teaparty | , , , , , , , , , , | 2 Comments

A Plea To Fellow Republicans — Stop Defending Sarah Palin

As a Republican, it pains my heart to watch the response to Sarah Palin’s latest gaffe. Like so many times before, Palin has put herself on the hot plate and shown that she does not know when to be quiet.

From the beginning, Republicans have squirmed through every public appearance she makes.  From the 2008 debates to this current joke of a bus tour, Palin has shown she lacks the basic skills to handle pressure.

This is not a good sign in a potential candidate for the Republican nomination for president.

Why then, does Palin continue to get support from Republicans?

The latest situation with Palin messing up the history of Paul Revere is a perfect example.  It is clear to anyone that saw the video that Palin had no clue what she was talking about.

It was a moment of verbal vomit that made her seem like she had never attended  grade school.  The entire episode could have been prevented any number of ways.  Palin could have simply ignored the question and kept walking.  Palin could have changed the subject.

More importantly, Palin could have actually took a moment to read about Revere before visiting so that she would be prepared for the gaggle of reporters that were sure to follow her. That would have been novel for her.

What makes the entire situation so bad, however, is the aftermath.  Like so many Palin “situations” in the past, Palin is now coming out and saying she was right.  She is trying to use semantics to say that the British were warned because Revere confessed to them.

Republicans are actually following suit and trying to latch onto that argument for her.  That makes the party look completely ignorant right beside her.

Revere did not warn the British. Revere warned the colonists and confessed to the British. Revere did not ring bells or shoot warning shots, as this would have drawn attention and squashed the revolt before it even began.

It is clear that Palin simply tried to fake her way through this and messed up like she always does when she attempts such folly.

After a couple of years of defending and trying to make sense of Sarah Palin, it is time for Republicans to say enough.  Sarah Palin had a chance to come out and say she messed up.  Sarah was too arrogant to do so.

Perhaps it is time that we Republicans simply admit we messed up in backing Palin and move forward.  Liberals are not afraid of Sarah Palin.  That is wishful thinking to say the least.

They pray for her nomination.

 

By: Rodney Southern, Yahoo Contributor Network, June 6, 2011

June 6, 2011 Posted by | Conservatives, Democracy, Democrats, Education, GOP, Ideologues, Ideology, Neo-Cons, Politics, Republicans, Right Wing | , , , , , , , | Leave a comment

The Return Of Back-Alley Abortions

Underground abortions have returned to the United States, just as pro-choice activists have warned for years. And women have started going to jail for the crime of ending their own pregnancies, or trying to.

This week Jennie L. McCormack, a 32-year-old mother of three from eastern Idaho, was arrested for self-inducing an abortion. According to the Associated Press, McCormack couldn’t afford a legal procedure, and so took pills that her sister had ordered online. For some reason, she kept the fetus, which police found after they were called by a disapproving acquaintance. She now faces up to five years in prison, as well as a $5,000 fine.

Idaho recently banned abortions after 20 weeks, and McCormack’s fetus was reportedly between five and six months old. But according to Alexa Kolbi-Molinas, a staff attorney for the ACLU’s Reproductive Freedom Project, under Idaho law, McCormack could have been arrested even if she’d been in her first trimester because self-induced abortion is illegal in all circumstances. “It doesn’t matter if it’s an 8- or 10- or 12-week abortion,” says Kolbi-Molinas. “If you do what you could get lawfully in a doctor’s office—what you have a constitutional right to access in a doctor’s office—they can throw you in jail and make you a convicted felon.”

While horrific, McCormack’s case is not unique. In recent years, several women have been arrested on suspicion of causing their own abortions, or attempting to. Most have come from conservative rural states with few clinics and numerous restrictions on abortion. In America’s urban centers and liberal enclaves, the idea of women being prosecuted for taking desperate measures to end their pregnancies might seem inconceivable, a never-again remnant of the era before Roe v. Wade. In fact, it’s a slowly encroaching reality.

Even more, these cases demonstrate that criminalizing abortion means turning women who have abortions into criminals.

In 2005, Gabriela Flores, a 22-year-old Mexican migrant worker, was arrested in South Carolina. Like McCormack, she had three children and said she couldn’t afford a fourth, and so she turned to clandestinely acquired pills. (The drug she took, Misoprostol, is an ulcer medicine that also works as an abortifacient and is widely used in Latin American countries where abortion is illegal.) Initially facing two years in prison, she ended up being sentenced to 90 days.

In 2009, a 17-year-old Utah girl known in court filings as J.M.S. found herself pregnant by an older man who is now facing charges of using her in child pornography. J.M.S. lived in house without electricity or running water in a remote part of the state, several hours’ drive from the nearest clinic, which was in Salt Lake City. Getting there would have required not just a car—her area had no public transportation—but money for a hotel in order to comply with Utah’s 24-hour-waiting period, as well as for the cost of the abortion itself.

According to prosecutors, when J.M.S. was in her third trimester, she paid a man $150 to beat her in the hopes of inducing a miscarriage. The fetus survived, but she was charged with criminal solicitation to commit murder. When her case was thrown out on the grounds that her actions weren’t illegal under the state’s definition of abortion, legislators changed the law so they would be able to punish women like her in the future.

Meanwhile, prosecutors have appealed J.M.S.’ case to the Supreme Court, and observers expect it to rule against her. She could still face a trial and prison time.

A woman doesn’t even have to be trying to abort to find herself under arrest. Last year, a pregnant 22-year-old in Iowa named Christine Taylor ended up in the hospital after falling down a flight of stairs. A mother of two, she told a nurse she’d tripped after an upsetting phone conversation with her estranged husband. Though she’d gone to the hospital to make sure her fetus was OK, she confessed that she’d been ambivalent about the pregnancy and unsure whether she was ready to become a single mother of three.

Suspecting Taylor had hurled herself down the stairs on purpose, the nurse called a doctor, and at some point the police were brought in. Taylor was arrested on charges of attempted feticide. She spent two days in jail before the charges were dropped because she was in her second trimester, and Iowa’s feticide laws don’t kick in until the third.

These cases are a harbinger of what’s to come as abortion laws become increasingly strict and abortion clinics harder to access in the more conservative parts of the country. They demonstrate the lengths to which women will go to end unwanted pregnancies. But even more, they demonstrate that criminalizing abortion means turning women who have abortions into criminals.

The antiabortion movement likes to see itself as pro-woman. Most of its spokespeople talk about protecting women from abortion, insisting they’re not interested in seeing them punished. “It’s tragic that this young woman felt that this was her only way out,” National Right to Life President Carol Tobias said in a statement in response to questions about the McCormack case. “The pro-life movement has never supported jail sentences for women who are victims of the abortion culture and abortion industry.”

Tobias said her group calls on Idaho officials “to engage in more publicity about the network of pregnancy resource centers and about the existence of Idaho’s safe haven law—either of which would have helped this young mother and saved her child.” But she didn’t call on them to release McCormack or to change the laws under which she’s being charged. If these sorts of prosecutions aren’t what the antiabortion movement had in mind when it pushed wave after wave of state-level legislation, now might be a good time to speak up.

 

By: Michelle Goldberg, Contributing Writer, The Daily Beast, June 3, 2011

 

 

June 5, 2011 Posted by | Abortion, Anti-Choice, Class Warfare, Conservatives, Constitution, Education, Equal Rights, GOP, Government, Governors, Health Care, Human Rights, Ideologues, Ideology, Lawmakers, Planned Parenthood, Politics, Privacy, Pro-Choice, Public Health, Republicans, Right Wing, Sex Abuse, State Legislatures, States, Uninsured, Women, Women's Health, Womens Rights | , , , , , , , , , , , , , , | 1 Comment

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