The GOP assault on America's social safety net hit new lows with the Dec. 21 budget deal, which will gut public health insurance.
The process was tawdry. Negotiators emerged from a weekend conference meeting at 1 a.m. on Dec. 19 with a 774 page tome that the House leadership had moved to a vote by 6 a.m.
Representatives got just five bleary-eyed hours to review a bill that radically reshapes public health insurance, weakens child support and foster care, threatens disability insurance and further erodes public assistance.
On the Senate side, Republicans got their partisan wish only with Vice President Dick Cheney's tie-breaking vote.
Republicans boasted that they were reducing the deficit. But these same Republicans are planning to increase the deficit by an even bigger margin early next year in the next round of tax breaks planned for the nation's wealthiest.
"This is the one vote you'll have this year to reduce the rate of growth of the federal government," said Sen. Judd Gregg, R-N.H., chairman of the Senate Budget Committee.
All year, the Bush administration and many House Republicans have shunted aside moderate governors' and senators' efforts to reform Medicaid.
In the original Senate bill, moderates carefully crafted a bipartisan consensus through months of work, only to have it summarily stripped from the budget deal in the wee hours of that shameful morning. Instead, GOP leaders found savings by taking them from the poor Americans that the health care safety net was designed to help in the first place.
The final bill boosts cost-sharing from the current $3 limit to what could be hundreds of dollars, in some cases. It allows states to charge co-pays of up to 10 percent on each service for families living on $16,000 to $24,000 a year. (That's between 100 percent and 150 percent of the poverty level for a family of three.) Families above that mark could be charged premiums for the first time ever, and charged co-pays up to 20 percent.
The only limitation is that medical bills may not exceed 5 percent of a family's annual income. But that's little comfort for those living so close to the poverty line. Nothing stops a catastrophic event from eating all of a month's income, driving families into homelessness -- and worse.
All of these bad ideas originated in the House's first bill, and the Congressional Budget Office concluded then that savings would not come from the actual cost-sharing but from discouraging use of public insurance at all. That is a callous way to try to save money.
It is also shortsighted. By cynically discouraging people from using Medicaid coverage, this bill will encourage more people to wait until they are seriously ill to seek care. They will then turn up in emergency rooms, where the cost to the health-care system is higher and the likelihood of successful treatment is lower.
The budget cuts represent a big lump of coal in the stockings of the poor.
Kai Wright is editor of BlackAIDS.org, and lives in New York City. He can be reached at firstname.lastname@example.org.