The GOP is targeting Medicaid in its next attack on health care reform. House Republicans want to take away $20 billion budgeted for the Affordable Care Act's Medicaid expansion and use it to cover defense cuts. This is who they are.
Politico reported yesterday that a small group of House Republicans, led by Rep. Tim Huelskamp (R, Kan.), are doubling down on efforts to defund health care reform through budget negotiations. If there's another continuing resolution in January, Rep. Huelskamp and other House Republicans want to insert a provision that would eliminate $21 billion budgeted for the Affordable Care Act's Medicaid expansion.
The funds would be used to cover $20 billion in defense cuts that will take effect in January, as part of the sequester. Republicans want take out part of health care reform that is working, and give it to one of the most wasteful, fraud-ridden government departments -- the Pentagon.
It's tempting to dismiss this as more tea-party-driven madness, and on some level it is madness. Yet, it's also a calculated attack that reveals the dark, cold heart of conservatism.
The Pentagon: A Bloated, Fraud-Ridden, Accountability-Free Zone
This week, a Reuters special report revealed epic waste at the Pentagon. The report showed that the Pentagon is incapable of keeping track of its immense stores of weapons, ammunition, and supplies. For example, between 2003 and 2011, the Army lost track of $5.8 billion of supplies, causing units to "experience equipment shortages that could hinder their ability to train soldiers and respond to emergencies."
The Pentagon also has "more than half a trillion dollars in unaudited contracts with outside vendors." How much of that money is spent on goods and services actually delivered is anybody's guess. That $500 billion is vulnerable to theft and fraud which might not be discovered for years, because the Pentagon is even worse at keeping track of its money.
Due to an inability to balance its books, the Pentagon is already in violation of a federal law that requires annual audits of all government departments. The Pentagon can't stand up to an audit, because its books are thoroughly "cooked." For years, financial reports have been "doctored" with numbers that have no basis in reality; so that everything appears balanced, provided no one looks too closely.
As a result, $8.5 trillion in taxpayer money doled out to the Pentagon since 1996 has never been accounted for. Yet, Republicans want to take $21 billion intended extend Medicaid coverage to millions of low-income, uninsured Americans, and dump it into the money pit called “the Pentagon.”
The Medicaid Expansion Is Working
Why are Republicans attacking the Medicaid expansion in health care reform? Republicans are attacking the Medicaid expansion because it's working.
In fact, the Medicaid expansion may be the biggest unsung success of health care reform. Alavere Health, a market analysis firm, reported earlier this month that Medicaid signed up 440,000 people in ten states during the first six weeks of open enrollment. Private plans, offered through infamously kludgy websites, have enrolled a fraction of that amount.
It's expanding even existing Medicaid programs. The Kaiser Family Foundation reports that in Washington state 30,000 of the 70,000 who've enrolled in Medicaid since the expansion were eligible even before the health care law took effect. It's working so well that it's expanding existing Medicaid programs in states that have rejected the Medicaid expansion. Even in those "red" states that have rejected the Medicaid expansion, 91,000 people have tried to sign up for health insurance and learned that they were already eligible for Medicaid coverage.
The Medicaid Expansion Is Working for Those Who Need It Most
Republicans are attaching the Medicaid expansion because it working for the "wrong people." Who are the "wrong people"? In the states that have expanded Medicaid, people previously didn't qualify for Medicaid, and didn't make enough money to afford private insurance are now eligible for Medicaid.
Avalere's president summed up the success in a way that underscores why it's so important for Republicans to attack the Medicaid expansion:
“Medicaid is exceeding expectations in most places,” said Dan Mendelson, Avalere’s president. “It is definitely a bright picture in states that have chosen to expand.”
It's a bright picture in those states that have chosen to expand. The ink on the Supreme Court ruling that upheld health care reform while opening the door for states to opt out of the Medicaid expansion hadn't even dried before a "death panel" of Republican governors started rejecting the Medicaid expansion.
Today, 25 states have refused to expand Medicaid. As a result, nearly 5 million people who were supposed to be covered by health care reform are left out of its benefits. They are the poorest resident of some of the poorest states, who would stand to benefit the most from health care reform, if only Republican governors and legislature in those states would let them.
And yet it can work. Not far from Rep. Huelskamp's home state, Kansas -- where safety net officials and 49 state organizations have renew efforts to push for Medicaid expansion, with help from the White House -- Arkansas an example of what successful Medicaid expansion looks like.
Arkansas is one of poorest states in the country, with the third lowest median income in the country, at just $38,413. Last year, a quarter of the state's adult population was uninsured. Using the federal funds available for Medicaid expansion, Arkansas has extended coverage to about 220,000 more Arkansas. That's 220,000 low-income Arkansans who will now have access to health care that did not before.
How Low Can They Go?
The GOP has expanded its "war on the poor" to include the Medicaid expansion. Republicans want to take access to health care away from 220,000 Arkansans, and millions of Americans who now have access to care thanks to the Medicaid expansion. Instead they want to give the $21 billion budgeted for the Medicaid expansion to the Pentagon, which can't keep track of the trillions it’s already gotten.
Never mind that Republicans could take care of those defense cuts by getting rid of the sequester. The GOP would rather rob the poor to pay the Pentagon. This is who they are.
It's going to take a lot more than a Supreme Court Ruling, an election defeat, and a disastrous government shutdown before Republicans give up trying to eighty-six health care reform. How low Republicans will go in their efforts to overturn a law passed by Congress, signed by the president, upheld by the Supreme Court, and reaffirmed by voters last November?
It remains to be seen. Republicans have reached a new low, and show no signs of stopping.