States Slow To Move

By Author: Marcus Stalder
Total Articles: 491
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Politics is a wonderful business. When everything is going well, our elected representatives stand up proudly to take all the credit. They smile for the cameras and issue the soundbites that have made them famous. But when the situation grows more difficult, they are suddenly more difficult to find. Even when a camera happens to catch one of the sneaking out of a government building, there are no smiles and only evasions when asked to comment. This is the usual political dance except that, now, it's beginning to damage the entire decision-making process. The problem is a simple one. No one wants to take the blame for the mess we are in. When they go back to the voters at the next election, they all want to be able to say they resisted and fought the proposals that would have made the bad situation worse. They all need to return to that fight to protect the voters from the next waves of misfortune.

The problems of the deficit are everywhere. Almost without exception, the Republicans have stuck to their campaign promises there would be no tax increases to help balance the budgets. This means the only actions permitted create ...
... smaller government. In this last year, 43 states have cut their contributions to Medicaid. Some have reduced the payments made to doctors and hospitals, payments for prescription drugs have been cut, and some have redefined the local plan to exclude some services. In the current economic circumstances, these are remarkable steps. With the official unemployment rate remaining above 9% and the actual rate significantly higher, ever more people are being driven to claim from Medicaid. This is inevitable as the rate of real poverty rises across the land.

This highlights the real problems that health care poses to both federal and state budgets. So long as states continue along fixed ideological paths, it seems no one will take any real decisions to resolve these problems. What makes this all the more urgent is that, come 2014, Medicaid will be made available to more Americans with higher levels of income. Seeing the problem two years ago, the federal government began giving states extra money for Medicaid. This additional help stops at the end of June this year. If states are cutting their contributions now, this is storing up big problems come 2014.

It's the same when it comes to the health exchanges required under the Affordable Care Act come 2014. So far, only Louisiana has actually rejected the option to build its own exchange. All the other states have either not committed themselves or have made some progress toward implementation. Seven states have laws establishing exchanges. Even the Republican states have accepted federal money to begin planning the exchanges. This is all a tragedy unfolding in slow-motion. At a time when we should be seeing action to make the transition from a broken health care service to a health insurance plan to cover most Americans, we have inaction because politicians are afraid to lose their jobs come the next election. It's ironic. Everyone agrees something should be done, but no one wants to lead down the road to an agreed solution. Individual health insurance should have a higher priority. It should be reformed for the benefit of all.