Morals, Medicaid, and Middle Ground

April 7, 2014 12:39 pm

by Scarlet Hawk · 39 comments

Moral Mondays has organized a petition to be delivered to the Governor today at 5pm regarding the expansion of Medicaid.  My church, Northside Drive Baptist Church, made the decision to be a part of this organized petition delivery/ protest via a vote per church council, on which I have the privilege of sitting.

The video of Dr. Warnock’s call to action may be found here.

He is the Senior Pastor of Ebenezer Baptist Church.

I’m not big on moral arguments, and it would appear that Dr. Warnock is not either.    But, sometimes the issue has both moral and measureable arguments.  I will speak to the economic arguments.

The General Assembly passed gun legislation that stymies the mythical boogeyman of big gov’ment coming to take their guns.  Admittedly I do not carry, but I also know not of people who are checked at the doors of churches that were clamoring for this legislation.  In contrast, I do know of children who could benefit from the cannabis bill and the autism bill.  I also know that leaving a very real and large amount of federal money on the table that could otherwise be used to further the quality of life and care of the working poor is nothing more than petty political pandering in an election year.  **Please see also:  Senator Carter’s vote on the gun bill.**

Why have the leaders in Georgia allowed themselves to become painted into such tight corners that they cannot make compromises? 

Now let’s be clear: I despise taxes like any Republican worth their salt.

However, I despise even more missing out on a piece of the pie from the federal government to which I have already contributed!  Good heavens, it isn’t as if they’re going to give that money back to me!  I consistently see leaders having to take stances on policy issues that are in the extreme.  And for what: the ability to tell certain factions or personalities that you’re more conservative or more progressive than someone else?

Policymaking is not a pissing contest.  Leadership is not passing the buck from the executive to the legislative branch.  Decision making based on campaign strategy may be effective in the checkers game of election cycles, but not in the chess game of a state’s well-being.

Jack Bernard of Georgia Health News wrote a comprehensive editorial on this subject. Following an interview with Governor Deal, Bernard highlighted some of the fuzzy numbers the Governor touts.

 

Georgia is being sold a bunch of buzz words in lieu of addressing actual healthcare policy.  Citizens shouldn’t buy it and legislators should have the courage to attempt to tackle this challenge rather than pointing fingers between the legislative and executive branch.

 

Don’t pass up your time to shine, Governor, even if it means making a compromise.  You have the courage and the team to create sound Medicaid policy that doesn’t leave Georgians’ hard earned money on the table.  I encourage you and legislators around this great state to create sound policy rather than passing the buck.  The majority of Georgians still believe compromise is not a dirty word.

I hate the fact that people think ‘compromise’ is a dirty word.~Barbara Bush

eburke April 7, 2014 at 2:07 pm

Principle is one thing, bullheadedness to prove a political point is another. The Governor needs to work with the Federal Govt on this issue in order to keep from losing more rural hospitals. Lack of effort in the name of not increasing State taxes has forced tax payers in our county to come up with 10 million over the next 6 years to keep our hospital open.

And don’t think that thumbing your nose at the White House over this issue has nothing to do with the lack of funding for the Port.

This is the time for statesmen to rise and shine. Our people need jobs and our rural communities need health care.

Ghost of William F. Buckley April 7, 2014 at 5:38 pm

Rural hospitals face extremely tough future outlooks as so many docs do not wish to locate away from major metros, Sir. A tough go, no matter how you look at it.

I understand your dilemma and appreciate your call for statesmanship, more than you may ever realize, thank you,

Harry April 7, 2014 at 2:18 pm

The governor doesn’t need to do a blessed thing to advance such bad law. The Supreme Court themselves said so. If you don’t like it, then vote for young Carter. I’m sure young Carter will comply with Obamacare.

Scarlet Hawk April 7, 2014 at 3:01 pm

We can agree to disagree, Harry. While you are correct that the Supreme Court gave states the option of declining these funds (and I support that ruling in recognition of states’ rights), I would assert that other Governors in other conservative states at least have attempted to tailor their Medicaid policies to make them fit. Please see the link from GPPF that I provided in the post. Georgia’s legislature nor our Governor did that. IMHO, they took their little ball and went home when they didn’t like the game….Makes our state look like a petulant child rather than the resourceful, creative, problem-solvers I know us to be.

Harry April 7, 2014 at 3:18 pm

No, it makes us look like we are supporting principles of federalism and self-determination. Why does everything have to be about grabbing maximum funds from the DC extortion mill?

Scarlet Hawk April 7, 2014 at 3:25 pm

Everything isn’t like that, but in this case it is because that’s the way the system is set up. I’m not a fan of the feds bleeding me to death, but if I have a chance to get some of the lifeblood back, why wouldn’t I?

Harry April 7, 2014 at 3:34 pm

You wouldn’t because you have principles. You would want to register opposition to a law which will fail because it’s fundamentally flawed.

ryanhawk April 7, 2014 at 4:16 pm

As I understand it, 1) the Feds would pick up the entire cost of Medicaid expansion for only the first three years, and 2) the Feds would place additional restrictions and reduce state flexibility for managing Medicaid. This is a sucker’s bet and it is no surprise that the “moralists” are in favor of it. At the end of the day this is a fight over whether Georgia spends more/less on healthcare versus more/less on education. And the healthcare lobbyists have been winning that fight.

GOPundit April 8, 2014 at 7:52 am

You’re correct, the ACA requires the Feds to cover 100% of the Medicaid expansion for the first three years after which the match for the expanded populations would drop to 90%. It is important to note that the 90% is not binding on future appropriations and Congress could at anytime change that rate.

Scarlet Hawk April 8, 2014 at 6:42 pm

ryanhawk and GOPundit, You’re both correct in that it is an eventual unfunded mandate. I get the hesitancy around that and I too fear what costs loom in the years to come. I appreciate you pointing this out as I didn’t speak to that point in my initial post, but it is one that bears consideration.

My thought is that Medicaid spending is going to increase in years to come regardless of whether we take the federal money or not. My assertion would be that the federal money is here for us to make the cost more tolerable in the first few years while we figure out how to fully fund it ourselves as a state in the following three years. I conceptualize it as sort of the sugar that makes the medicine easier to go down.

I can understand how those that are farther to the right than myself would assert that this isn’t a medicine we should be taking, but I think what Deal and the General Assembly did this year was effectively kicking the can down the line, namely so that someone else has to deal with it. Essentially they turned this into an all or nothing Ender’s game, which didn’t have to happen.

Generally, I’m more tired of this political aversion to real problem solving and general apathy for long-term planning than I am for my elected officials to make a mistake. I’m not expecting Deal or any members of the General Assembly to create a policy that pleases me in every regard. I’m expecting them to try to tackle the challenges of their time to the best of their abilities.

Essentially, my post is less about Medicaid expansion, and more a plea for some reasonable policy making overall. Inaction is really the only wrong choice I would suggest the legislative and the executive branch are making.

objective April 7, 2014 at 8:07 pm

which is the more important principle?
to fight a flawed law or to fight a flawed healthcare system?
federalism or mercy for the sick?
imperfection in change – in anything in life- is to be expected.
and in the case of healthcare, any short-term change that spurs long-term positive advancement is welcome. even if it means some temporary challenges.
fighting the ACA is not nearly as valuable as advancing functional alternatives or adjustments.

Harry April 7, 2014 at 10:10 pm

Compounding one flaw with another is not an advance.

objective April 8, 2014 at 10:09 am

if at first you don’t succeed….
the saying exists because we are always striving, but rarely getting things done perfectly well.
life is about continuous improvement.
and any attempts at improvement, in no small part due to the unpredictability of our universe, has merely probabilistic odds of success or failure, but at least the effort should be there. life happens in spite of anyone thinking they have all the answers.

Harry April 8, 2014 at 10:46 am

It’s a slow moving train wreck due to being delayed and implemented in stages. The insurance carriers will have to be subsidized out of the general fund, since the low risk element is opting out. Large employee plans will be dragged into it kicking and screaming. The percentage of health care cost to GDP will go to 22-23%. The effects will be cumulative and very apparent.

objective April 8, 2014 at 1:31 pm

i also think short-run cost increases are inevitable, in large part due to so many new people going to the doctor for the first time in god knows how many years. in the medium-term, i’m hopeful some adjustments can be made, particularly in terms of the carriers expanding the number of options in the marletplace. in the long-term, i believe there are some important aspects of the law that will bend the cost curve downward. it’s hard to predict. but if everyone were just to try to get on the same page in terms of the morals just to start with, at least there could be more productive policy discussions- and maybe even good results. ah, to dream…

saltycracker April 8, 2014 at 8:14 am

It may be moral to not let those in need fall in the cracks but it is immoral to declare it is”not my job””none of my business” to be proactive when it comes to addressing mismanagement, fraud, abuse, eligibility and infinite funding.

Lea Thrace April 8, 2014 at 8:55 am

“declare it is”not my job””none of my business” to be proactive when it comes to addressing mismanagement, fraud, abuse, eligibility and infinite funding.”

Who has ever said that?

Harry April 8, 2014 at 9:18 am

Don’t Rely On Government, Help Yourselves – Hong Kong Anti-Poverty Campaign Chief Tells Poor
http://www.zerohedge.com/news/2014-04-07/hong-kong-anti-poverty-campaign-chief-tells-poor-people-not-rely-government-must-hel

Lea Thrace April 8, 2014 at 11:12 am

The heck does that have to do with my question…

Harry April 8, 2014 at 11:43 am

It’s complicated.

Lea Thrace April 8, 2014 at 11:44 am

So nothing then. It has absolutely nothing to do with anything even remotely related to this topic.

Harry April 8, 2014 at 11:49 am

How does your comment ‘who has ever said that?’ properly respond to saltycracker? I think you’re a bit testy, today.

Lea Thrace April 8, 2014 at 5:23 pm

My comment was directly related to the topic and comment. Yours had nothing to do with nothing. The end.

Harry April 8, 2014 at 5:39 pm

Think of the government as your kitchen. If you leave out bread and cheese, the cockroaches multiply.

saltycracker April 8, 2014 at 3:32 pm

Lea,

When has left or right given the effort any more than token effort or gone after only what falls in their hands ? Fed administrators have been clear than strong enforcement in programs are not in the cards as it might hurt one innocent person or corporation….

The evidence is in the high ratios of “issues” (mismanagement, fraud, unexplainable, no accountable party…..) with most programs.

Both parties should join hands and address this mess….lip service, token effort and blame the other does not get it…….then fight over what to do with the billions…..

Lea Thrace April 8, 2014 at 5:22 pm

Agree. I thought you meant that some idiot actually said that in the past.

cj April 8, 2014 at 1:12 pm

Finally, a reasonable view on Medicaid expansion. Medicaid may be a mess but there aren’t many other viable alternatives for providing some measure of health insurance for the poor (the majority of whom I would add are working poor). I would suggest that the GBPI numbers are in fact too low and that the state may well break even over the next 10 years on the expansion. Consider the AJC article on Corrections health care spending that ran recently and suggested that the state may save $20 million. There are also millions in the state public health and mental health budgets that are used to provide stopgap coverage for the uninsured. I don’t think these numbers are in the GBPI amounts. Consider also the state AND local funding for Grady and other public hospitals. The taxpayers of Fulton County stand to benefit a lot from Medicaid expansion and the reduced need for County taxpayer subsidies.

Scarlet Hawk April 8, 2014 at 6:58 pm

cj, You’re totally correct. There is a wave effect bigger than what I’ve represented here. Both good and bad, I would wager. I chose GPBI’s numbers and GPPF’s list of states that tried Medicaid waivers. I try to be as even as I can, as I do not personally party affiliate and would not wish for my writing to identify me as otherwise. Thanks also for the more comprehensive view of the economic impacts in various parts of the state budget.

seenbetrdayz April 8, 2014 at 1:18 pm

Problem is, we don’t get our money back without strings attached.

I know I bring up South Carolina a lot when it comes to the topic of Medicaid expansion, but they took the money last time it was ‘given’ back and now they’re screwed. They can no longer shrink the medicaid pool based on budgetary reality, thanks to the provisions that came in the packaged deal from the Feds. About 1 million South Carolinians are on Medicaid, and the state population is only around 4.5 million.

If my tax money goes to Washington, I get mad because it usually gets wasted. But if they use my tax money to buy a noose for me to place my head in, I’m not gonna eagerly accept the noose just to be getting something back out of the deal, lol.

gcp April 8, 2014 at 2:11 pm

Does Warnock ever talk about god or morality in his church or does he just talk political issues?

northside101 April 8, 2014 at 3:15 pm

GCP, answer is “political issues.” You can watch him on AIB (Atlanta Interfaith Broadcasting) Sunday nights at 8 (he must preach every Sunday; you never see an associate pastor in the pulpit when their service is televised). The other night he was condemning the war in Iraq and the American Christian Church’s unwillingness to fight (that is, fight for liberal causes). He also mentioned Sunday we don’t adequately fund public education (which might be news to Atlanta taxpayers), and at other times he has lambasted voter ID laws. Abortion (which disproportionately impacts blacks in this state)? Can’t remember a peep from him on that. Children out of wedlock (like our current mayor apparently has no qualms about)? Still waiting for a sermon on that. Wonder when he and his group will lead a march to an abortion clinic?

gcp April 8, 2014 at 5:02 pm

Perhaps the IRS should check the “nonprofit” status of his church?

Scarlet Hawk April 8, 2014 at 6:52 pm

northside101 and gcp, I would assert there are a number of churches in Georgia into which one could suggest the IRS look. As a matter of fact, my hometown area is famous for one of them: Angel Ministries.

If the separation of church and state is an issue close to your heart (it is mine), check out bjcpa.org. The Baptist Joint Committee is a Baptist organization that devotes itself to maintaining the separation of church and state from a religious freedom perspective.

Harry April 8, 2014 at 6:58 pm
northside101 April 9, 2014 at 8:37 am

No, I’m not concerned about nonprofit status of Ebenezer—the good Reverend is entitled to preach whatever he would like. I’m just saying in addition to his preaching on more government, maybe every now and then he might preach some sermons on traditional morality, like opposition to abortion (a practice condemned in the Early Church, from writings of the Church fathers), kids out of wedlock, marriage, etc. As for separation of Church and State, well those words aren’t found in the Constitution. We do not have a state-established Church (like in Britain), nor should we, but churches should be free to speak out on issues. Catholic bishops for instance should be free to scold the numerous wayward “pro-choice” Catholic politicians, like one bishop in Illinois has done with ultraliberal Democratic Senator Dick Durbin.

Lea Thrace April 9, 2014 at 9:42 am

He does preach about those topics. It’s just not put forth in the press…

northside101 April 9, 2014 at 10:46 am

Guess I’ve missed those sermons—I would be curious to know what his stances are on those type issues, especially given that very liberal John Lewis is a member there. Unlike most Baptist churches, I don’t see on their website a section on beliefs, like what we believe as a Baptist congregation (a typical Baptist one would have things like inerrancy of scriptures, divinity of Christ, valid baptism, salvation, morlas, etc.)

Back to the protests—with the Legislature out of session til next January, I’m not sure what good they do. So long as there is a GOP majority at the Gold Dome—which likely will remain in effect the rest of this decade—isn’t likely Medicaid expansion is going to happen, “Governor” Jason Carter or not.

Scarlet Hawk April 9, 2014 at 12:47 pm

So I’ve never had the pleasure of attending a service at Ebenezer Baptist, but I believe most are familiar with its dedication to social justice issues. Also, I’d challenge you to embrace a wider view of Baptists. Roger Williams and Will Campbell are two other such Baptists who focused on social justice issues and don’t seem to fit your definition of Baptist. I’m pretty sure I don’t either. being Baptist is a big tent, where I hope and aspire to demonstrate all are welcome. I would kindly ask you not shrink us to those few tenants of faith.

As for the protests- they draw attention to the issue. You’re right in that there may be less now. One of the points I made in the original post was that it seems that very vocal minority groups seem to be able to push legislators into corners- I think Moral Mondays is one vocal minority, and perhaps their level of noise is simply trying to counteract the noise from other vocal fringe groups.

I would assert that Medicaid expansion is going to happen one way or another; no matter who occupies the Governor’s Mansion. It’s coming. This is Georgia’s chance to deal with it head-on and we are letting it slip away. A waiver was a possibility, but instead we kicked the can.

CapitalBride April 9, 2014 at 5:07 pm

So if you want to talk about economics, lets talk about what will happen in 2017 when all of a sudden the feds aren’t picking up the “whole” tab for expanded Medicaid Rolls…

The Georgia Public Policy Foundation’s article discusses the implications of Medicaid expansion.

http://www.georgiapolicy.org/nine-reasons-to-question-medicaid-expansion/#ff_s=tOJB

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