For the second day, Republican Senators boycotted the scheduled markup of the Kerry-Boxer (S.1733) cap-and-trade bill. Senator Inhofe (R-OK) appeared briefly to emphasize that the minority is holding firm to their demands that the Environmental Protection Agency complete a comprehensive economic analysis.
Rather than use a procedural gambit to trounce the rights of the minority, Senator Boxer announced the committee would receive a briefing from committee staff on the actual provisions of the latest version of the bill. That is certainly not objectionable, but common sense suggests a thorough understanding of the legislation would be a prerequisite for a markup.
In addition, just as Senators prepare to gain a better understanding about the legislation, Senator Rockefeller (D-WV) hinted, “some people are talking about not doing it [global warming] until after the 2010 election.” Senator Olympia Snow (R-ME) went as far to say, “Obviously, it’s not an issue we will be readily addressing this year.”
While some Members will inevitably allocate time to the 2010 elections, the focus will still be the economy. Senator Evan Bayh (D-IN) stressed that “jobs should be our top priority and we shouldn’t do anything that detracts from that.” Representative Bob Etheridge (D-NC) echoed Senator Bayh’s remarks, saying, “Three things ought to be the top priority: jobs, jobs and jobs.”
There’s one thing cap and trade will not do and that’s “save or create jobs.” It will destroy them. Our preliminary analysis of the Boxer-Kerry cap and trade legislation kicks 1.8 million people into the unemployment line as soon as 2012 and ultimately raises unemployment by over 2.7 million.
Even the EPA’s analysis under the most generous assumptions did not project a green economic stimulus. Out of the groups that came to The Heritage Foundation to explain the economic results of their respective cap and trade models (including the Environmental Protection Agency, the Energy Information Administration and the Congressional Budget Office), there was no disagreement on how cap and trade would affect employment. Higher energy prices will put a chokehold on the economy - causing fewer jobs and lower income.
Dan Holler co-authored this post.
Each of the health care bills moving through Congress expands Medicaid by making the government-run program available to all adults with incomes at or below 133 percent of the federal poverty line (PVL). The change would dramatically multiply eligible recipients: 33 states would see increases of at least 30%, including 10 posting jumps of 50% or more.
Fastest-growing Medicaid monsters? Nev. (82.1%), Mont. (80.7%) and Texas (76.9%):
Go here to see a larger PDF version of this chart.
Heritage fellow Dennis Smith explained:
Just hours after the Senate Finance Committee completed its mark-up of its version of health care reform, Committee staff released a statement that announced, “[i]n a letter sent to Congressional leaders yesterday, Democratic governors affirmed their shared commitment to expanding health care coverage to millions of low-income Americans through the Medicaid program.”
Worried Governors
The press release, however, overstates the case. The Democratic governors’ letter does not even mention Medicaid. The very general sentiments expressed in the letter such as “… the status quo is no longer an option …” and “[s]kyrocketing health care costs hurt families …” are broadly if not universally shared. Democratic governors from 21 states signed the letter; eight of them will be out of office before the Medicaid expansion even begins.One governor who did not sign the letter, Tennessee ’s Phil Bredesen, warns: “I can’t think of a worse time for this bill to be coming. I’d love to see it happen. But nobody’s going to put their state into bankruptcy or their education system in the tank for it.”
Tying State Hands
The letter was also produced before the Committee completed its amendment process and before a final score by the Congressional Budget Office (CBO). Amendments will reduce state flexibility in the management of Medicaid. States lost flexibility in designing their benchmark plans.States will be required to extend “spousal impoverishment” rules, which apply when one spouse is in a nursing home, to community settings as well — which will substantially shift costs from private pay to Medicaid. States will be faced with a new, broader definition of medical assistance, the implications of which will be determined through regulation and litigation. The Finance Committee is turning the SCHIP children’s health program into Medicaid. CBO has not yet calculated how much it will cost the states in administrative changes that will be required to comply with the new federal mandates.
Higher State Costs
Medicaid programs will be forced to absorb open-ended costs in the foster care system. In adopting the Stabenow Amendment on therapeutic foster care, the Committee is now on record to overturn litigation won by the state of California to limit Medicaid’s role in funding the child welfare system. California prevailed in part because there is no agreed upon definition of therapeutic foster care. While it is required to provide services, it is not required to “bundle” those services as a package.The Federal Court of Appeals for the 9th Circuit determined that states still have administrative discretion in how to run their Medicaid programs. The Stabenow Amendment takes one more step towardstaking that authority away.
The wide-open language of Stabenow will likely cost states billions as providers will seek to tap into the Medicaid entitlement to fund the child welfare system, which is really what the California litigation was about. Of course the child welfare system must be adequately funded, just as education, child care programs and the criminal justice system must be — to name a few other government programs that are trying to tap into Medicaid.
But should these responsibilities fall to Medicaid? Finance has jurisdiction over the foster care system. But instead of facing its responsibilities in the program, it was apparently easier for senators to push the issue back onto the states’ Medicaid program. Why have schools turned to Medicaid for funding for special needs children? Because Congress has never fulfilled the promises made under the Individuals with Disabilities Education Act (IDEA). Medicaid has become an enabler. Washington promises more then passes the bill to the states.
Medicaid Expansion
States cannot afford a Medicaid expansion and neither can the federal government. The Finance Committee plan includes extra federal funds to pay for most of the new costs and when the bill gets to the Senate floor, Senators will try to get 100 percent federal funding just as Majority Leader Reid has done for Nevada. But simply adding more federal funds into an unreformed Medicaid program is not the answer either.One day perhaps, Congress will realize that expanding Medicaid comes at the expense of other state and federal priorities including education and the child welfare system. As Medicaid grows, funding for other programs shrink, which in turn, increases demand for Medicaid to become the source of funding for those other programs. Only the governors have the clout to push back and break the vicious cycle that, as Gov. Bredesen warns, threatens to bankrupt the states.