Egan, Idaho Politics, Journalism, Medicaid

The Moral Test

medicaidHard Cases

“The moral test of government is how that government treats those who are in the dawn of life; the children, those who are in the twilight of life; the elderly, and those who are in the shadows of life, the sick, the needy and the handicapped.”

The quote is most often attributed to the liberal icon Hubert Humphrey and dates to a time when there was a broad consensus in American life that government had a very precise role to play in trying to improve the plight of those fellow citizens “in the shadows of life.” The lingering Great Recession more than ever has called that role of government into question and, at the same time, made Hubert’s eloquent quote more relevant than ever.

A massive human hurt is unfolding in nearly every state as governors and state legislators contemplate unprecedented reductions in spending on various services paid for at the state level by Medicaid. In states like Idaho, all the easy stuff has been cut. Now the real pain begins, as illustrated by the estimated 1,000 Idahoans who showed up on Friday, some in wheelchairs, to show state legislators, more eloquently than words ever could, just what the American social safety net really means to real people.

With the 50 states collectively facing a budget gap estimated at $125 billion, the New York Times reports today that Medicaid is “ripe for the slashing” from New York to California, from Idaho to Texas. The times are tough – very tough – but I doubt that even tough-minded, fiscally conservative legislators can live with the implications of ending services for a guy in a wheelchair or an 8th grader with autism.

In Idaho, 20 lawmakers, the members of the powerful Joint Finance-Appropriations Committee (JFAC), make most every spending decision for the rest of the 85 members of the legislature. It is an awesome power and responsibility. The committee has co-chairs, Sen. Dean Cameron and Rep. Maxine Bell, and no one has ever credibly accused these experienced lawmakers of being big spenders. They run a tidy ship and one has to be impressed with the diligence they and their committee have lavished on the hard choices the state faces with both Medicaid and education. Cameron and Bell deserve a lot of praise for showing the political courage to open up the committee to those thousand people who came calling on Friday. It had to have been a sobering experience for anyone paying attention.

Here’s a fearless prediction. Arguably the most conservative legislature in the nation won’t be able to make the $25 million in Medicaid cuts that Idaho’s governor has proposed. It will take a while yet for the reality to sink in, its still early in the legislative process, but Friday was an important day. Not only did the thousand show up, but the budget numbers that have been in dispute since the first day of the 2011 session just gained some clarity and not in a good way.

All this will eventually lead to a frantic search for some barely acceptable source of new revenue to help plug the budget holes. The legislature will come to embrace, in tried and true fashion, the method of patch and scratch tax policy making. Some how, some way, Idaho’s very conservative legislature will “find” some new revenue to avoid these awful choices.

It won’t be easy, and people elected never to raise taxes will anguish over the choices, but it will happen I think. Idaho’s lawmakers have come face-to-face with their fellow citizens who really do, through no fault of their own, live in the shadows. In the end, it will not really be much of a political test. No one is likely to lose an election by making a vote to preserve home care services for an elderly, wheelchair bound neighbor. It will be quite a moral test, however, for lawmakers who infrequently see so clearly the impact of their votes.