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“State Of Disaster”: How Many Natural Disasters Will It Take For The Lone Star State To Wake Up To The Disaster Of Its Elected Officials?

As extreme weather marked by tornadoes and flooding continues to sweep across Texas, Gov. Greg Abbott has requested – and President Obama has granted – federal help.

I don’t begrudge Texas billions of dollars in disaster relief. After all, we’re all part of America. When some of us are in need, we all have a duty to respond.

But the flow of federal money poses a bit of awkwardness for the Lone Star State.

After all, just over a month ago hundreds of Texans decided that a pending Navy Seal/Green Beret joint training exercise was really an excuse to take over the state and impose martial law. And they claimed the Federal Emergency Management Agency was erecting prison camps, readying Walmart stores as processing centers for political prisoners.

There are nut cases everywhere, but Texas’s governor, Greg Abbott added to that particular outpouring of paranoia by ordering the Texas State Guard to monitor the military exercise. “It is important that Texans know their safety, constitutional rights, private property rights and civil liberties will not be infringed upon,” he said. In other words, he’d protect Texans from this federal plot.

Now, Abbott wants federal money. And the Federal Emergency Management Agency is gearing up for a major role in the cleanup – including places like Bastrop, Texas, where the Bastrop State Park dam failed – and where, just five weeks ago, a U.S. Army colonel trying to explain the pending military exercise was shouted down by hundreds of self-described patriots shouting “liar!”

Texans dislike the federal government even more than most other Americans do. According to a February poll conducted by the University of Texas and the Texas Tribune, only 23 percent of Texans view the federal government favorably, while 57 percent view it unfavorably, including more than a third who hold a “very unfavorable” view.

Texas dislikes the federal government so much that eight of its congressional representatives, along with Senator Ted Cruz, opposed disaster relief for the victims of Hurricane Sandy – adding to the awkwardness of their lobbying for the federal relief now heading Texas’s way.

Yet even before the current floods, Texas had received more disaster relief than any other state, according to a study by the Center for American Progress. That’s not simply because the state is so large. It’s also because Texas is particularly vulnerable to extreme weather – tornadoes on the plains, hurricanes in the Gulf, flooding across its middle and south.

Given this, you might also think Texas would take climate change especially seriously. But here again, there’s cognitive dissonance between what the state needs and how its officials act.

Among Texas’s infamous climate-change deniers is Lamar Smith, chairman of the House Committee on Science, Space, and Technology, who dismissed last year’s report by the United Nations’ Intergovernmental Panel on Climate Change as “more political than scientific,“ and the White House report on the urgency of addressing climate change as designed “to frighten Americans.”
Smith is still at it. His committee just slashed by more than 20 percent NASA’s spending on Earth science, which includes climate change.

It’s of course possible that Texas’s current record rainfalls – the National Weather Service reports that the downpour in May alone was enough to put the entire state under eight inches of water  – has  nothing to do with the kind of extreme weather we’re witnessing elsewhere in the nation, such as the West’s current drought, the North’s record winter snowfall, and flooding elsewhere.

But you’d have to be nuts not to be at least curious about such a connection, and its relationship to the carbon dioxide humans have been spewing into the atmosphere.

Consider also the consequences for the public’s health. Several deaths in Texas have been linked to the extreme weather. Many Texans have been injured by it, directly or indirectly. Poor residents are in particular peril because they live in areas prone to flooding or in flimsy houses and trailers that can be washed or blown away.

What’s Texas’s response?  Texas officials continue to turn down federal funds to expand Medicaid under the Affordable Care Act, thereby denying insurance to more than 1 million people and preventing the state from receiving an estimated $100 billion in federal cash over the next decade.

I don’t want to pick on Texas. Its officials are not alone in hating the federal government, denying climate change, and refusing to insure its poor.

And I certainly don’t want to suggest all Texans are implicated. Obviously, many thoughtful and reasonable people reside there.

Yet Texans have elected people who seem not to have a clue. Indeed, Texas has done more in recent years to institutionalize irrationality than almost anywhere else in America – thereby imposing a huge burden on its citizens.

How many natural disasters will it take for the Lone Star State to wake up to the disaster of its elected officials?

 

By: Robert Reich, The Robert Reich Blog, May 31, 2015

June 1, 2015 Posted by | Greg Abbott, Natural Disasters, Texas | , , , , , , , , | 1 Comment

“Pilfering The Federal Treasury”: Mitt Romney’s Medicaid Shell Game

Mitt Romney is lambasting federal aid in his campaign for the presidency, including derisive comments against those who receive government assistance. But he pulled all the stops to pursue federal aid as governor of Massachusetts, even hiring “revenue maximization” contractors to scour federal programs for every possible penny — and using financial schemes to maximize and then divert the aid from his needy constituents.

In his first budget proposal, Romney promised balancing the budget without tapping reserves, and “without the use of fiscal gimmicks.” However, buried in the details, he suggested tapping reserves such as taking $4 million from the Catastrophic Illness in Children Relief Fund, and he included fiscal gimmicks to maximize and divert federal aid into his general state coffers.

His strategies are akin to tax schemes using offshore bank accounts — but instead of avoiding federal taxes, seeking to pilfer the federal treasury. The Wall Street Journal labeled such financing mechanisms “Medicaid Money Laundering” and a “swindle.”

Medicaid is a matching grant program. If a state with a 50 percent match rate like Massachusetts spends $50 on qualifying services, the federal government will provide an additional $50 so there is $100 total for Medicaid services. The federal match payment is much higher in some states, such as Mississippi where its almost 75 percent.

Unfortunately, some states concocted budget shell games, often with private consultants, providing an illusion of state spending to claim federal matching funds, when no state spending has occurred. As governor of New Hampshire, Judd Gregg developed such a practice labeled “Mediscam.” Gregg taxed hospitals serving the poor, routed the money into an “uncompensated care fund” which he sent right back to the hospitals, and used the round-trip of money to claim federal matching funds. Then, the swindle gets worse, because he routed the federal Medicaid funds into his general coffers rather than for Medicaid services.

Romney’s schemes were similar to Gregg’s. Buried in his 2004 budget, Romney proposed maximizing federal aid by taxing hospitals, shifting the resulting tax payments in and out of an uncompensated care fund, back to hospitals as adjustment payments, and diverting resulting federal Medicaid funds to state general revenue. He also proposed using taxes on nursing homes and pharmacies in his efforts to maximize and divert federal aid.

In such strategies, health care facilities serving the poor are used to claim federal funds to help the poor. But the health care facilities and the poor may get nothing, as the state diverts the federal aid to general coffers — and revenue maximization contractors reap millions in contingency fees. Romney used such private companies to help carryout his strategies.

After a US General Accounting Office report responding to concerns of Republican Senator Charles Grassley, the Romney administration vigorously defended using contingency-fee revenue maximization consultants and revenue practices – that the GAO labeled illusory. The GAO responded that “hospitals should benefit from increased federal reimbursements and Massachusetts’s arrangement appeared to result in lower payments to hospitals, despite increased claims for federal reimbursement.” The Romney administration even defended double (if not quadruple) billing practices “of allowing multiple agencies to bill Medicaid” for “services for the same beneficiary.” The GAO concluded that the Romney administration “did not provide convincing evidence that the [Medicaid] services provided by the four state agencies were unique,” and the Bush administration agreed with the GAO’s conclusions.

The Bush administration implemented regulations trying to reduce such practices, and the Obama administration continues efforts to improve fiscal integrity in the Medicaid program. However, Romney would virtually end federal oversight by block-granting federal Medicaid funds to states.

It’s not hard to imagine how a governor — one that employs complex shell games to find loopholes in federal rules in order to maximize and divert federal aid — would use the federal funds if handed to the state without any federal oversight. The answer to state misuse of federal aid is not to give those states even more discretion to do whatever they wish – but to simplify the claiming process, reduce loopholes allowing the revenue schemes, and improve oversight to ensure Medicaid funds are used as intended.

Romney has undergone dramatic and hard to follow shifts in his apparent views of government aid. Romney2004 proposed cutting healthcare while simultaneously proposing illusory schemes to maximize and divert federal Medicaid funds. Romney2006 changed course with the first nearly universal healthcare plan. Now Romney2012 is turning back to cuts, denouncing federal aid he once schemed to maximize and divert, condemning those who need government aid, and seeking repeal of national health care reform that is nearly identical to the plan he signed into law. And now he proposes giving all the federal money from the Medicaid program to states without federal control.

Romney2004 would have a field day with Romney2012’s plan.

 

By: Daniel L. Hatcher, Law Professor, University of Baltimore, Published in The Boston Globe, October 12, 2012

October 15, 2012 Posted by | Election 2012 | , , , , , , , , | Leave a comment

   

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