Republican threats to starve health reform financially are the real deal, as opposed to their teabagger-crowd pleasing repeal kabuki. Digby hones in on what is probably the most important expansion on the chopping block: Medicaid.
But I think this one is the most vulnerable, and it's the main provision that made it so difficult for liberals to vote against the reforms:
Republican governors are trying to tap the brakes on the law's addition of 16 million Americans to the Medicaid insurance program for the poor, starting in 2014. They also want to axe a piece of the law that makes it more difficult for states to cut Medicaid enrollees to patch budget shortfalls.
"The health care legislation is really bearing down on the states," said Republican Texas Gov. Rick Perry. "The mandates that are in that legislation will most likely cripple health care delivery, with a price tag that will absolutely bust the budgets."
That's over half the uninsured who were supposed to be covered under the new reforms.
Sadly, I won't be surprised to see the Democrats help them do it, and I have no idea if the White House would be willing to deal this piece away. After all, it's not the part of the reforms that everyone is so proud of --- it's the old clunky government paid health care that we've decided isn't sexy enough for our modern "market based progressivism."
Sadly, future Medicaid expansion is in the eye of a perfect storm leading from the still crappy economy coupled with austerity fervor, as states struggle now to meet the need of high unemployment and high demand for the program. In an environment where seemingly all social spending has to be on the table in sacrifice to the deficit, preserving this expansion--the one that does the most to make coverage affordable and available--is going to be the challenge.
Democrats say they're ready for the fight, and welcome it.
...To push the GOP back from the brink, Democrats will cast the skirmish with Republicans not as an abstract fight over spending, but as a disagreement between the parties over providing benefits to people.
At a health care event in the basement of the Capitol on Wednesday, top Democrats laid this strategy out. "I think we have to discreetly respond, 'This is what withholding funding for this aspect of [the law] -- this is what it means to you,'" said House Minority Leader Nancy Pelosi.
"I think the things that they would attack now are things that are direct services to American people," said Rep. John Yarmuth (D-KY). "They would have to start saying, well we're going to wack the spending for the donut hole, and for preventive care, and for things that are direct services to American citizens."
.....
"What are they going to cut? There's very little administrative costs being expended, I mean you could do it, but they'd find ways to shuffle money around in the department," Yarmuth said.
To illustrate the conundrum, Yarmuth pointed out that the law expands Medicaid to cover people up to 133 percent of the poverty line, and that the federal government pays for that expansion through the end of the decade.
"You're going to go in and now say to states 'you've got to provide the service now -- that's in the law -- but we're not paying you,'" he said.
"We'll just see how irresponsible [Republicans want to be]," Pelosi said.
Republicans won't have any problem being irresponsible. We've seen ample proof of that. On this one, Democrats are going to have to hold tough. That includes the White House making no deals on social spending.