Governor Walker’s Misleading Claims On Medicaid
Wisconsin Governor Scott Walker painted a misleading picture of Medicaid in his New York Times op-ed on Friday. Medicaid is neither obsolete nor inflexible and changing it to a block grant, as the House Republican budget that Walker supports would do, would significantly harm the millions of seniors, people with disabilities and children who rely on it every day.
Governor Walker says Medicaid is obsolete because it is biased toward covering people in nursing homes rather than their own homes. In fact, Medicaid is moving in precisely the opposite direction. In 1990, just 13 percent of Medicaid spending on long-term care went for care in the community rather than in an institution. By 2009, the figure was 43 percent. That’s a great example of how Medicaid is changing with the times.
Moreover, health reform, (i.e., the Affordable Care Act) provides several new options to speed this trend along and continues funding for the “Money Follows the Person” program, in particular, which moves people from nursing homes back to the community. With health reform’s new options and funding, progress will likely continue. That won’t happen under the House Republican budget plan, which would sharply reduce funding for Medicaid and convert the program to a block grant.
My colleagues, Edwin Park and Matt Broaddus, have shown how risky a block grant is for states. If the House Republican block grant proposal had been in place starting in 2000, their analysis shows, in 2009 Wisconsin would have received 40 percent less in federal funds – nearly $1.6 billion in that year alone. With such a sharp drop in federal funds, the state would have been ill-equipped to deal with a recession or even to meet the ongoing needs of an aging population.
Governor Walker claims the success of the Children’s Health Insurance Program (CHIP) and state Medicaid demonstration projects show that states could do well under a Medicaid block grant, but he’s wrong on both counts:
CHIP, which does operate under a structure similar to a block grant, has a narrower purpose than Medicaid, as noted in a recent brief from the Kaiser Commission on Medicaid and the Uninsured. It covers far fewer children than Medicaid and covers children in families with higher incomes. Moreover, in the past, some state CHIP programs did run short of funds and had to freeze enrollment and set up waiting lists.
As to Medicaid demonstration projects, they allow states to cover people who are ordinarily not eligible for Medicaid (such as low-income, childless adults) or services that aren’t usually covered (such as short-term, or “respite,” care for families with children with complex medical conditions) as long as they don’t spend more federal funds than they otherwise would have received. This is nothing like the Ryan block grant, which would slash the federal funds that states would otherwise get to help them run their programs, not hold federal funds steady.
By: Judy Solomon, Center on Budget and Policy Priorities, April 25, 2011
Modern Snake Oil: “We Have No Revenue Problem”
OK, this is the day everyone hates. You have to pay your taxes. Who wants to write that check? Nobody, probably.
The truth, however, is that Rep. Paul Ryan, the Tea Party, and most politicians are not being honest when they tell us there is no revenue problem, only a spending problem.
The Associated Press reports today that an IRS analysis tells us that 45 percent of Americans will pay no federal income taxes for 2010. Plus, the 400 Americans with the highest adjusted gross incomes averaged $345 million for the year. Their average federal income tax rate was 17 percent, down from 26 percent in 1992. Wow, and they need another tax break?!
This confirms the Warren Buffett line that his secretary pays a higher percentage of her income in taxes than he does.
But here is our problem: We cannot come close to dealing with this deficit unless we both cut spending and raise revenue. We certainly won’t accomplish anything unless we deal with the tax problem and reform our tax code.
I firmly believe that every American who works or gets income should pay something in federal taxes. Even if it is a small amount. This by itself won’t do much to dent the deficit, but it would be important as a symbol that everyone is in this together. Second, and most important, the gap between rich and poor and the middle class is widening in this country. Those who earn over a million dollars did not deserve an average tax cut of $120,000 under George Bush; they certainly don’t need that raised to $200,000 under the Ryan plan.
We need to recognize that the richest 2 percent of Americans should pay more, but we also need to make this tax system make sense. How can you have a society where nearly half the income earners pay no income taxes, due to deductions, loopholes, and special deals?
I am not arguing that struggling families should be hit with a whooping tax bill, but, rather, that our politicians should be honest with the American people. If you are fighting two wars, you have to pay for them. If you have to save the car companies and our financial institutions, you have to pay, at least initially. If you are going to provide Medicare, Medicaid, Social Security, education, bridges, roads, and air traffic controllers, for that matter, you have to have the revenue.
It is just plain dishonest to put forth a budget and a plan that says “we have no revenue problem.” That is modern snake oil. It is time that we dealt with our tax problem, otherwise we won’t really be dealing with our deficit at all.
By: Peter Fenn, U.S. News and World Report, April 18, 2011
Our Irresponsible American Ruling Class Is Failing
The American ruling class is failing us — and itself.
At other moments in our history, the informal networks of the wealthy and powerful who often wield at least as much influence as our elected politicians accepted that their good fortune imposed an obligation: to reform and thus preserve the system that allowed them to do so well. They advocated social decency out of self-interest (reasonably fair societies are more stable) but also from an old-fashioned sense of civic duty. “Noblesse oblige” sounds bad until it doesn’t exist anymore.
An enlightened ruling class understands that it can get richer and its riches will be more secure if prosperity is broadly shared, if government is investing in productive projects that lift the whole society and if social mobility allows some circulation of the elites. A ruling class closed to new talent doesn’t remain a ruling class for long.
But a funny thing happened to the American ruling class: It stopped being concerned with the health of society as a whole and became almost entirely obsessed with money.
Oh yes, there are bighearted rich people when it comes to private charity. Heck, David Koch, the now famous libertarian-conservative donor, has been extremely generous to the arts, notably to New York’s Lincoln Center.
Yet when it comes to governing, the ruling class now devotes itself in large part to utterly self-involved lobbying. Its main passion has been to slash taxation on the wealthy, particularly on the financial class that has gained the most over the past 20 years. By winning much lower tax rates on capital gains and dividends, it’s done a heck of a job.
Listen to David Cay Johnston, the author of “Free Lunch” and a columnist for Tax Notes. “The effective rate for the top 400 taxpayers has gone from 30 cents on the dollar in 1993 to 22 cents at the end of the Clinton years to 16.6 cents under Bush,” he said in a telephone interview. “So their effective rate has gone down more than 40 percent.”
He added: “The overarching drive right now is to push the burden of government, of taxes, down the income ladder.”
And you wonder where the deficit came from.
If the ruling class were as worried about the deficit as it claims to be, it would accept that the wealthiest people in society have a duty to pony up more for the very government whose police power and military protect them, their property and their wealth.
The influence of the ruling class comes from its position in the economy and its ability to pay for the politicians’ campaigns. There are not a lot of working-class people at those fundraisers President Obama has been attending lately. And I’d underscore that I am not using the term to argue for a Marxist economy. We need the market. We need incentives. We don’t need our current levels of inequality.
Those at the top of the heap are falling far short of the standards set by American ruling classes of the past. As John Judis, a senior editor at the New Republic, put it in his indispensable 2000 book, “The Paradox of American Democracy,” the American establishment has at crucial moments had “an understanding that individual happiness is inextricably linked to social well-being.” What’s most striking now, by contrast, is “the irresponsibility of the nation’s elites.”
Those elites will have no moral standing to argue for higher taxes on middle-income people or cuts in government programs until they acknowledge how much wealthier they have become than the rest of us and how much pressure they have brought over the years to cut their own taxes. Resolving the deficit problem requires the very rich to recognize their obligation to contribute more to a government that, measured against other wealthy nations, is neither investing enough in the future nor doing a very good job of improving the lives and opportunities of the less affluent.
“A blind and ignorant resistance to every effort for the reform of abuses and for the readjustment of society to modern industrial conditions represents not true conservatism, but an incitement to the wildest radicalism.” With those words in 1908, President Theodore Roosevelt showed he understood what a responsible ruling class needed to do. Where are those who would now take up his banner?
By: E. J. Dionne, Opinion Writer, The Washington Post, April 17, 2011
Lucy, Charlie Brown And Football: The Politics Of Personal Grievance
Congressional Republicans all but dared President Obama to engage in a fiscal debate on their terms, demanding to know whether and how he’d tackle long-term debt reduction. The president agreed and presented a credible, realistic plan to cut $4 trillion from the debt over 12 years.
GOP officials obviously weren’t going to like his vision, but I’m a little surprised they’re still whining that Obama was mean to them.
The three Republican congressmen saw it as a rare ray of sunshine in Washington’s stormy budget battle: an invitation from the White House to hear President Obama lay out his ideas for taming the national debt.
They expected a peace offering, a gesture of goodwill aimed at smoothing a path toward compromise. But soon after taking their seats at George Washington University on Wednesday, they found themselves under fire for plotting “a fundamentally different America” from the one most Americans know and love.
“What came to my mind was: Why did he invite us?” Rep. Dave Camp (R-Mich.) said in an interview Thursday. “It’s just a wasted opportunity.”
Paul Ryan was reportedly “furious” and complained that the speech “was extremely political, very partisan.”
It’s worth fleshing this out, because there are some important angles to keep in mind.
First, the Republicans’ politics of personal grievance is based solely on their hurt feelings. They’re not saying the president lied or that his numbers don’t add up, but rather, they’re outraged that Obama was a big meanie. That’s kind of pathetic, and it reinforces fears that the House GOP majority is dominated by right-wing lawmakers with temperament of children.
Second, exactly what kind of reaction did Republicans seriously expect? Their fraudulent and callous budget plan, approved yesterday despite bipartisan opposition, eliminates Medicare. It punishes the elderly, the disabled, and low-income families, and rewards millionaires and billionaires. It calls for devastating cuts that would do widespread damage to the middle class and the economy. Were Republicans seriously waiting for Obama to politely pat them on the head and say, “It’s OK, you tried your best. I’ll give you an A for effort”?
Third, why is it Republicans expect one-sided graciousness? They expected a “peace offering” after pushing their own plan that was “deliberately constructed to be as offensive to Democrats as it’s possible to be,” and didn’t even bother with insincere “nods in the direction of bipartisanship.” I’ll never understand why Obama is expected to be conciliatory with those who refuse to do the same.
And finally, having a debate pitting two competing visions isn’t a bad development. Greg Sargent’s take on this rings true.
Throughout the first two years of Obama’s presidency, leading Republicans have regularly claimed that Obama is taking America towards socialism. Yet when a Democratic president stands up and aggressively defends his vision and worldview, and contrasts it sharply with that of his foes, something’s wrong. That’s not supposed to happen.
Obama’s characterization of the GOP vision was harsh. But so what? Politics is supposed to be an impassioned argument over what we all think the country should be. Is it possible to cross lines? Sure, but Obama didn’t cross any lines — in fairness, neither has Ryan — and no one was blindsided. No one was the victim of any sneak attack. We should want politicians who think their opponents’ worldviews are deeply wrongheaded to be free to say so in very vivid terms. Otherwise, what’s the point of it all?
I’d add just one last point. For two years, Obama pleaded with Republicans to play a constructive role, work in good faith, and compromise. They refused. Lucy doesn’t get to complain when Charlie Brown doesn’t want to run at a football that’s going to be pulled away anyway.
By: Steve Benen, Washington Monthly, Political Animal, April 16, 2011
“I’m Not A Politician So Let Me Be Perfectly Clear”: Raise America’s Taxes!
President Obama in his speech on Wednesday confronted a topic that is harder to address seriously in public than sex or flatulence: America needs higher taxes.
That ugly truth looms over today’s budget battles, but politicians have mostly preferred to run from reality. Mr. Obama’s speech was excellent not only for its content but also because he didn’t insult our intelligence.
There is no single reason for today’s budget mess, but it’s worth remembering that the last time our budget was in the black was in the Clinton administration. That’s a broad hint that one sensible way to overcome our difficulties would be to revert to tax rates more or less as they were under President Clinton. That single step would solve three-quarters of the deficit for the next five years or so.
Paradoxically, nothing makes the need for a tax increase more clear than the Republican budget proposal crafted by Representative Paul Ryan. The Republicans propose slashing spending far more than the public would probably accept — even dismantling Medicare — and rely on economic assumptions that are not merely rosy, but preposterous.
Yet even so, the Republican plan shows continuing budget deficits until the 2030s. In short, we can’t plausibly slash our way back to solid fiscal ground. We need more revenue.
Kudos to Mr. Obama for boldly stating that truth in his speech — even if he did focus only on taxes for the very wealthiest. I also thought he was right to say that we need spending cuts — including in our defense budget. Mr. Obama didn’t say so, but the United States accounts for almost as much military spending as the entire rest of the world put together.
As I see it, there are three fallacies common in today’s budget discussions:
• Republicans are the party of responsible financial stewardship, struggling to put America on a sound footing.
In truth, both parties have been wildly irresponsible, but in cycles. Democrats were more irresponsible in the 1960s, the two parties both seemed care-free in the ’70s and ’80s, and since then the Republicans have been staggeringly reckless.
After the Clinton administration began paying down America’s debt, Republicans passed the Bush tax cuts, waded into a trillion-dollar war in Iraq, and approved an unfunded prescription medicine benefit — all by borrowing from China. Then-Vice President Dick Cheney scoffed that “deficits don’t matter.”
This borrow-and-spend Republican history makes it galling when Republicans now assert that deficits are the only thing that matter — and call for drastic spending cuts, two-thirds of which would harm low-income and moderate-income Americans, according to the Center on Budget and Policy Priorities. To pay for tax cuts heaped largely on the wealthiest Americans, Republicans in effect would gut Medicare and slash jobs programs, family planning and college scholarships. Instead of spreading opportunity, federal policy would cap it.
• Low tax rates are essential to create incentives for economic growth: a tax increase would stifle the economy.
It’s true that, in general, higher taxes tend to reduce incentives. But this seems a weak effect, often overwhelmed by other factors.
Were Americans really lazier in the 1950s, when marginal tax rates peaked at more than 90 percent? Are people in high-tax states like Massachusetts more lackadaisical than folks in a state like Florida that has no personal income tax at all?
Tax increases can also send a message of prudence that stimulates economic growth. The Clinton tax increase of 1993 was followed by a golden period of high growth, while the Bush tax cuts were followed by an anemic economy.
• We can’t afford Medicare.
It’s true that America faces a basic problem with rapidly rising health care costs. But the Republican plan does nothing serious to address health care spending, other than stop paying bills. Indeed, Medicare is cheaper to administer than private health insurance (2 percent to 6 percent administrative costs, depending on who does the math, compared with about 12 percent for private plans). So the Republican plan might add to health care spending rather than curb it.
The real challenge is to control health care inflation. Nobody is certain how to do that, but the Obama health care law is testing some plausible ideas. These include rigorous research on which procedures work and which don’t. Why pay for surgery on enlarged prostates if certain kinds of patients turn out to be better with no treatment at all?
Ever since Walter Mondale publicly committed hara-kiri in 1984 by telling voters that he would raise their taxes, politicians have run from fiscal reality. As baby boomers age and require Social Security and Medicare, escapism will no longer suffice. We need to have a frank national discussion of painful steps ahead, and since I’m not a politician, let me be perfectly clear: raise my taxes!
By: Nicholas Kristof, The New York Times, April 13, 2011
Share This Blog
Unknown Feed- An error has occurred; the feed is probably down. Try again later.
mykeystrokes.com 