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Another Reason to Oppose Graham-Cassidy: Hurricanes

Why the Current Sen. Graham Should Heed the Warnings of a Former Sen. Graham

All states would eventually face deep and growing cuts to federal coverage programs due to the plan’s radical structural changes to these programs, which would make federal funding far less responsive to need. But some states would suffer immediate, disproportionate harm because the block grant would not only cut overall funding for the Medicaid expansion and marketplace subsidies but also redistribute the sharply reduced federal funding across states, based largely on criteria unrelated to states’ actual spending needs and the coverage gains they’ve achieved under the ACA.

I think governors like block grants when everything is going well. . . But that doesn’t provide a budget that says ‘oh, but the fourth-largest city in America is underwater and I need a lot more help.’

In addition to an increase in the number and acuity of people seeking health care after a natural disaster, the health care infrastructure in communities hit by a hurricane, flooding, or tornados are often destroyed. For example, Hurricane Katrina destroyed a large part of the health care infrastructure in New Orleans. According to Rowland, Robin Rudowitz, and Adele Shartzer, “A year after Katrina, many hospitals in the New Orleans area [were] still closed, including the Medical Center of Louisiana at New Orleans run by Louisiana State University (LSU), which consists of Charity and University Hospitals . . . .”

These [Medicaid] waivers have been applied in numerous ways following national and local crises. Waivers in New York City after the Sept. 11, 2001, terrorist attacks loosened the documentation requirements for Medicaid enrollment and allowed New Yorkers who had been affected by the tragedy to gain coverage. And, Medicaid waivers have helped the federal government provide targeted and direct resources to populations affected by lead poisoning in Flint, Michigan. In the aftermath of Hurricane Katrina, the Department of Health and Human Services approved as many as seventeen separate waivers.

Just this past week, in the aftermath of Hurricane Harvey, Texas has requested a variety of waivers from the federal government for both Medicaid and the Children’s Health Insurance Program (CHIP). As Rowland points out, the Medicaid waivers will provide Texas with even additional federal support. In contrast, the CHIP waiver requests will help in much more limited ways because the program’s financing is in the form of a block grant, which means no additional federal financial support. Any additional funding for CHIP would require congressional action.

When you talk about putting a cap on [Medicaid] you’re talking about saying ‘OK, we’ll build in what you’re spending today but if you have a disaster tomorrow it’s not going to change unless Congress goes back and gives you a special appropriation.’

Incredibly, rather than doing that to help the children in Texas, Louisiana, Florida, and Puerto Rico with additional CHIP funding, Congress is, instead, on the verge of failing to extend CHIP’s funding for the entire nation, which expires at the end of this month.

. . .when Hurricane Andrew hit south Florida, Mr. President, our Medicaid caseload shot up by 12,000 people. Not only had their homes been blown away, their jobs had been blown away. Therefore, people who had been employed and self-supporting needed the assistance of Medicaid during that time of crisis.

Under block grants, a State that is knocked down to its knees by a flood, earthquake, hurricane, would not find a helping hand from the Federal Government at the time it needed help to get back on its feet. No, Mr. President, acts of God and block grants do not mix.

I say shame on the governors of the states who are now cheerleading for the destruction of that partnership. I have a warning for them, or more accurately a proverb for them. The proverb goes as follows: Fish see the worm, not the hook.

Those governors who are salivating, who are so anxious to gobble up block grants being proposed, will feel the hook when their economies stumble, when an epidemic strikes, when a natural disaster hits, when inflation creeps up again, or when their population grows. Worst of all, they will be held accountable in history for killing a program that actually had achieved its objectives and nurtured a national pride in providing basic health care for fragile and vulnerable citizens.

In the aftermath of Hurricanes Harvey and Irma, those words are true more than ever. Senators and governors would all be wise to heed his warning and reject this health “reform” proposal by Sens. Lindsey Graham and Cassidy.

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Bruce Lesley

@BruceLesley — President of @First_Focus & @Campaign4Kids. Child advocate, husband & father of 4. Basketball fanatic. Follow on Twitter: @BruceLesley.