Iowa’s Republican members of congress have once again leveled a boot into the ass of elderly, poor and disabled Iowans. Thursday the US House held a vote on the 2018 budget resolution. A major feature of that budget is the huge cuts in Medicaid and Medicare. Over the next ten years Republicans plan on cutting Medicaid by as much as $1.3 Trillion dollars and Medicare by nearly $500 billion over the next10 years.
The agenda the resolution outlines is radical. The federal welfare state would be rolled back in just about every dimension, with health care programs particularly affected. All non-Medicare health programs would see a cut of $1.3 trillion, or nearly 30 percent, by 2027, according to the Center on Budget and Policy Priorities.
Medicare would be cut too, to the tune of $473 billion. There is $1 trillion over 10 years in mystery cuts to mandatory programs, cuts that would in practice almost certainly hurt programs for the poor.
Iowa has an abundance of folks, particularly the elderly, who get services from Medicaid and Medicare. We have witnessed what the cutback in Medicaid has done to the poor and the very disabled in Iowa thanks to the Reynolds /Branstad privatization of Medcaid in this state. That program shifted millions of dollars from patient care to management fees that went into private hands. thus money that was once used to treat actual health problems were simply going to management companies.
Due to that shift, disabled Iowans have seen drastic cuts in their care. Rick Smith over at iowastartingline.com did a recent report on the situation. In it he noted:
Disability Rights Iowa filed the lawsuit against Reynolds and the director of DHS. The group is asking a federal judge to force the state to “halt discriminatory cuts in services to 15,000 Iowans with serious disabilities.”
“They are violating very basic human rights, but also very basic Medicaid law, rules and regulations. They’re just totally disregarding them,” said Roxanne Conlin, a civil-rights lawyer who helped in preparing the lawsuit. “It’s kind of amazing to see how callous they are toward Iowa’s most vulnerable people.”
One of the results of that lawsuit is an admission by Jerry Foxhoven, the newly appointed DHS Director, that privatization isn’t working. In September Foxhoven suggested the possibility that some disabled recipients should be exempted from MCO care. That was finally an honest acknowledgment that these disabled Iowans weren’t getting adequate care under the privatization plan. That was revealed following secret negotiations with the for-profit management companies. These companies are demanding more money claiming they can’t fulfill their contract obligations without additional payment.
With that as background, the vote in the House Thursday sends out ominous signals. We already have ample proof on a small scale that cuts in Medicaid kill. The scale the extreme right wing Republicans are proposing are vast and deadly. Much as their proposals to kill the ACA would move many out of any health care system, so too will the cuts to Medicaid.
As will the cuts to Medicare. At the time in life when health care becomes most expensive and more and more frequent, the extremists propose cutting Medicare. They have not officially proposed how a downsized Medicare would work, but it doesn’t take a lot of imagination to figure that cutbacks in Medicare would push the costs down to Medicare patients who can ill afford to pay additional costs, co-pays or deductibles.
In short, cutting the health programs that America’s most vulnerable citizens are dependent on is cruel, short-sighted and frankly stupid. Iowa’s member of congress that fit those descriptors in voting for the resolution are House members Steve King, Rod Blum and David Young. In the senate both of Iowa’s senators Joni Ernst and Chuck Grassley voted for these cuts.
While such cuts may show on the federal balance sheets as a savings, the cost for healthcare will go up dramatically for everyone as more and more people can no longer afford regular maintenance due to the cutbacks. As has happened before they will be using the most expensive part of the healthcare system, the emergency room instead. The costs for this will be paid in higher fees and insurance premiums. There will also be a ripple effect throughout the whole economy as hospitals and clinics cut staff. So the while the federal budget may look better, the overall cost will be most likely higher.
There is one bright spot in the Iowa delegation on this whole debacle. That is second district Representative Dave Loebsack. Thanks once more to Representative Loebsack for being a voice of common sense.
Having a healthcare system that discriminates against various segments of society while privileging other segments on its face feels so anti-democratic that it should be tossed out lock, stock and barrel. We have a system that is divided along socio-economic lines. Politicians, especially Republicans, having been using those divisions to play off one segment against another for decades. They have been using those divisions to favor one segment while punishing another segment.
Maybe this resolution will shock the country into realizing that someday soon they too may be on the outside looking in and may someday be in danger of dying from some simple injury or disease in the wealthiest country ever.