GOP's 'heavy heart' attack on health care

So there was John McCain facing Kathleen Sebelius at a U.S. Senate committee hearing.

Arizona’s senior senator reminded Sebelius, who is secretary of health and human services, that his governor sent her a request to waive Medicaid requirements to save $541 million in annual state expenses. This exchange was broadcast on C-span.

It seems like only yesterday - actually, it was last March - when President Obama signed the watered-down Affordable Care Act into law. McCain did his part in quashing any chance for creation of a publicly-funded health-care system.

It was only Jan. 19 when 242 Republicans and three Democrats in the House of Representatives passed the “Repealing the Job-Killing Health Care Law.” Arizona’s Republican House members who voted for it were Jeff Flake, Trent Franks, Paul R. Gosar, Benjamin “son of Dan” Quayle and David Schweikert, while Arizona Democrats Ed Pastor and Raul M. Grijalva voted against the bill. Of course, Democrat Gabrielle Giffords is being treated after surviving the Jan. 8 assassination attempt.

Arizona is among 26 states challenging the health-care law in court. One federal judge even ruled the entire law to be unconstitutional. However, these challenges are expected to be decided by the Supreme Court.

Now Arizona Gov. Jan Brewer faces a cash-flow nightmare: The cash is not flowing. Collectively, many states are contending with a budget gap estimated at $125 billion. Brewer wants to make up for almost half the state’s deficit by dumping 280,000 of her fellow Arizonans from Medicaid coverage.

She sent a letter to Sebelius asking for a waiver in the new health-care law that requires the states to retain eligibility levels if they want to receive federal Medicaid money, according to The New York Times; other governors in both parties might follow suit. She wrote: “Please know that I understand fully the impacts of this rollback, and it is with a heavy heart that I make this request. However, I am left no other viable alternative.”

Here’s a recommended response from Sebelius, the mild-language version: “Jan, you talk about a heavy heart. You and your pals in Congress have hardened my heart. Democratic governors will get serious consideration for a waiver, but not any of you knotheads from Austin, Atlanta, Tallahassee or your beloved Phoenix. You might not have this problem if your cohorts in Congress had not obstructed a serious initiative to reform our health-care system. As my Democratic friends from the Bronx would say, waiver this! And give my best regards to Sen. McCain.”

Those cities are the capitals of four states where Republican governors hope to cut medical coverage to balance their budgets. Did Brewer, Rick Perry of Texas, Nathan Deal of Georgia or Rick Scott of Florida ever rise in support of a single-payer health-care bill and press congressional delegations to back it up?

All four of them, listed in a Jan. 29 New York Times account, exhibit the usual Republican hypocrisy on policy issues. In 2009, the House voted to approve a partially government-funded system, known as the “public option,” that would cover most or all Americans.

The House version was shelved in the Senate after the Republican minority along with a few Democrats threatened a filibuster. The result was the current law now being contested in the courts.

This term, Republicans who took control of the House voted to repeal the Affordable Care Act when they knew full well that the Senate would reject it anyway. The Senate voted it down - the repeal, not the law - by a 51-47 party-line vote on Feb. 2.

The states are telling the courts that the mandate to buy health insurance is unconstitutional.

The health-care act, beginning in 2014, would expand Medicaid eligibility to allow for the addition of 16 million beneficiaries by 2019 and pay for the full cost until 2016, according to the Times. Afterwards, the states must pay for a share that would peak at 10 percent by 2020. Under Medicaid, the federal government has paid most of the cost and sets minimum standards for eligibility that states are permitted to exceed.

At this time, federal money for Medicaid from the stimulus package will end July 1 and force a sharp hike of between one-fourth and one-third in each state’s share of Medicaid expenses, the Times account reports. States are restricted to what they can cut from Medicaid due to federal eligibility limits.

Brewer wants to unload 250,000 childless adults and 30,000 parents from Medicaid who were allowed eligibility as the result of a 2000 referendum. It was funded from cigarette levies and a tobacco lawsuit until 2004, when the general fund took up the slack, according to the Times.

Elsewhere, Georgia’s Nathan Deal seeks to eliminate Medicaid coverage of dental, vision and podiatry treatments for adults; Florida Gov. Rick Scott is proposing expansion of managed care plans; and Texas Gov. Rick Perry is looking at new cuts of up to 10 percent in payments to providers.

The Democratic governors of the most populous and third most populous states, respectively Jerry Brown of California and Andrew Cuomo of New York, are also proposing Medicaid cuts, according to the Times account.

Brown and Cuomo cannot be blamed for bringing this on themselves or, rather, the collective 56.4 million people whom they serve.