<div class="header">
<div class="left">
<a href="http://www.nytimes.com/"><img src="http://graphics8.nytimes.com/images/misc/nytlogo153x23.gif" alt="The New York Times" align="left" border="0" hspace="0" vspace="0"></a>
</div>
<div class="right">
<a href="http://www.nytimes.com/adx/bin/adx_click.html?type=goto&opzn&page=www.nytimes.com/printer-friendly&pos=Position1&sn2=336c557e/4f3dd5d2&sn1=84e9b341/ba42e34f&camp=FSL2012_ArticleTools_120x60_1787509c_nyt5&ad=BOSW_120x60_June13_NoText&goto=http%3A%2F%2Fwww%2Efoxsearchlight%2Ecom%2Fbeastsofthesouthernwild" target="_blank">
<br></a>
</div>
</div>
<br clear="all"><hr align="left" size="1">
<div class="timestamp">July 17, 2012</div>
<h1>The Rush to Abandon the Poor</h1>
<div id="articleBody">
<p>
The state with the country’s worst health care record just happens to
have a governor who has been the loudest voice against national efforts
to improve it. </p>
<p>
A quarter of the residents of Texas, 6.3 million people, are uninsured, by far <a href="http://www.statehealthfacts.org/comparemaptable.jsp?ind=125&cat=3&sub=39&yr=252&typ=2&o=a&sortc=6">the highest percentage</a> in the country. (That number includes more than a million children.) Texas ranks last <a href="http://www.statehealthfacts.org/comparemaptable.jsp?ind=44&cat=2">in prenatal care</a> <a href="http://www.statesman.com/news/texas-politics/texas-last-in-nation-on-health-care-report-2411062.html">and finished last</a>
on a new federal assessment of overall health quality that examined
factors like disease prevention, deaths from illnesses, and cancer
treatment. </p>
<p>
Yet Gov. Rick Perry — strangely puffed up as he was so often in his presidential bid — recently <a href="http://governor.state.tx.us/files/press-office/O-SebeliusKathleen201207090024.pdf">told the Obama administration</a>
that he would proudly refuse a huge infusion of Medicaid money that
would significantly reduce those shameful statistics and cover 1.7
million more people. The same indifference to suffering that pushed
Texas to the bottom is now threatening to keep it there. </p>
<p>
At least <a title="A Times article" href="http://www.nytimes.com/2012/07/15/us/governors-face-hard-choices-over-medicaid-expansion.html">five other Republican governors have made a similar choice</a>,
announcing that they will not expand their Medicaid program for the
poor even though the federal government would pay for almost all of it
for several years under President Obama’s health care reform law.
</p>
<p>
Their refusal illuminates a growing divide over the nature of a state government’s role. Around the country, <a title="NYT report" href="http://www.nytimes.com/2012/07/18/us/in-report-on-states-finances-a-grim-long-term-forecast.html?hp">a new study shows,</a> states continue to face a fiscal crisis because of rising costs and Republican-driven cuts in federal aid. </p>
<p>
While some governors and lawmakers are searching for new revenue
sources, others are using the downturn as an excuse to end a long
tradition of states being the final backstop for society’s neediest.
</p>
<p>
Over the last year, for example, <a href="http://www.bloomberg.com/news/2012-07-03/pennsylvania-joins-states-removing-safety-net-for-the-disabled.html">eight states</a>
have cut or eliminated cash welfare payments to their poorest
residents. It happened last week in Pennsylvania, where 61,000 residents
— almost all of whom are disabled and poor — were told that they would
abruptly lose their $200 monthly general assistance payments, all to
save $150 million a year. Our hands are tied by a tightening budget,
welfare officials told astonished recipients, though Gov. Tom Corbett’s
hands didn’t seem restrained when he handed out <a href="http://articles.philly.com/2012-07-03/news/32509089_1_corbett-signs-school-vouchers-state-budget">$300 million in business tax cuts</a> earlier this month. </p>
<p>
Gov. John Kasich of Ohio has cut hundreds of millions from education,
but when the state found itself with a $235 million surplus a few weeks
ago, he announced that <a href="http://www.dispatch.com/content/stories/local/2012/07/04/surplus-goes-from-89-cents-to-482-million.html">it would all go</a> into a rainy-day fund, doing nothing to deal with <a href="http://www.policymattersohio.org/state-budget-ohio-schools-jan2012">rising classroom sizes</a>. In Maine, Gov. Paul LePage — who compared the health care reform law to <a href="http://2012.talkingpointsmemo.com/2012/07/lepage-maine-irs-gestapo.php">the Holocaust</a> — signed a budget bill in May that will reduce or eliminate existing Medicaid coverage <a href="http://bangordailynews.com/2012/07/11/politics/health-ruling-interpretation-puts-feds-at-odds-with-lepages-planned-mainecare-cuts/">for 21,000 people</a>. </p>
<p>
Mr. Perry, too, opposes the existing Medicaid program, and, in a recent
letter to Washington, said that expanding it represented “brazen
intrusions into the sovereignty of our state” and would “threaten even
Texas with financial ruin.” The truth is that Washington will pay all
the cost of the expansion for three years (then scale back to 90
percent). Mr. Perry’s bold resistance may play well politically in his
state, but it’s nothing more than a stomach punch to the millions of
uninsured in Texas who will have to stay that way. </p>
<p>
Many mainstream Republican governors are taking a different approach. In a <a href="http://rgppc.com/medicaid-and-exchange-letter-2/">letter to the president</a>
last week, Gov. Bob McDonnell of Virginia, the chairman of the
Republican Governors Association, said states should think carefully
before they reject Washington’s money. Though he remained quite critical
of health reform and Medicaid, he also noted that refusing the
expansion would create “a significant gap in coverage” for low-income
people. </p>
<p>
For now, at least, Virginia recognizes an obligation to its weakest
citizens. It’s time for Texas, Florida, South Carolina, Wisconsin, Iowa
and Louisiana to do the same. </p>
<div class="articleCorrection">
</div>
</div>
<br clear="all"><br>-- <br>Art Deco (Wayne A. Fox)<br><a href="mailto:art.deco.studios@gmail.com" target="_blank">art.deco.studios@gmail.com</a><br><br><img src="http://users.moscow.com/waf/WP%20Fox%2001.jpg"><br><br>