In an absolute must-read—particularly for anyone who hasn’t thought through the implications of the Romney/Ryan Medicaid block grant proposal—Jonathan Cohn of TNR takes a close look at state-level decisions over the health and subsistence needs of poor people. He discovers, as anyone familiar with the subject would strongly suspect, that the poverty-ridden precincts of the Deep South are precisely where state lawmakers are most likely to make life even more miserable for the needy if they get the chance. Indeed, as I’ve noted here on more than one occasion, today’s southern Republican governors and legislators are not only avid to turn down the incredibly good fiscal deal offered to them via the Affordable Care Act, but routinely attack the status quo as far too generous and “socialistic,” and would greet a block grant for Medicaid (or any other “welfare” program) as an opportunity to cut eligibility and benefits to the bone.
Cohn sums up the political and moral implications very clearly:
Restricting access to public assistance and programs obviously isn’t on the same moral plane as denying people the right to vote or holding them as slaves. But these things should weigh on our consciences all the same. Food stamps keep people from going hungry. Unemployment checks prevent people from losing their homes. Health insurance keeps people from suffering and dying. Food, shelter, medicine—these are basic needs to which all people, and certainly all Americans, should be entitled. Over the course of the last century, from the Progressive era through the New Deal and Great Society, the United States slowly but surely moved toward guaranteeing those things. Giving the red states the power to deviate from this course means giving them the right to undo that progress.
Advocates for the red-state approach to government invoke lofty principles: By resisting federal programs and defying federal laws, they say, they are standing up for liberty. These were the same arguments that the original red-staters made in the 1800s, before the Civil War, and in the 1900s, before the Civil Rights movement. Now, as then, the liberty the red states seek is the liberty to let a whole class of citizens suffer. That’s not something the rest of us should tolerate. This country has room for different approaches to policy. It doesn’t have room for different standards of human decency.
The irony has often been noted that many people who profess themselves to be super-patriots violently reject the very idea of common “standards of human decency” for their fellow-citizens, and fall back on “state sovereignty” arguments for resisting them. But I fear what’s really going on is something worse than what Cohn talks about: a deeper desire to immiserate those people who aren’t true Americans wherever they live, beginning with the places where such discrimination is a fine old tradition. We’re already seeing the tendency of national Republicans to treat states like Texas (with its wonderful job-creating devotion to low public services and high corporate subsidies) and South Carolina (with its open, official hostility to the very existence of unions and collective bargaining, in the private as well as public sector) as paradises and models for the whole country.
The Medicaid block grant is probably a way station to the end of publicly supported health insurance for poor people, since once it’s implemented we’ll begin quickly to hear how Dixie is using its “flexibility” to maximize its business-cost advantage over those decadent “liberal” states. Soon conservatives may celebrate the whole country’s enhanced ability to compete with low-wage developing countries. There’s no end to “race to the bottom” thinking—other than the bottom.
Anyone who’s fished into the whole “Moderate Mitt Meme” or who still believes the differences between the liberal and conservative ideologies are insignificant or exaggerated should read Cohn’s piece and ponder it. Are we really one country, and if so, what should it look like?
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