Medicaid (was RE: Walzer on the Left)

[Max B. Sawicky]

I suspect Marta is right that the salad days of Medicaid
are nearing an end.  We were talking about public support
and gross spending, and in this regard Medicaid has done
pretty well.  Jim's point about the broader eligibility
for Medicaid is also well-taken.  In this regard, a key
battleground in the next year or two is the fate of SCHIP--
State Childrens Health Insurance Programs, one of Clinton's
two good deeds (the other was expansion of the EITC).
SCHIP is looking at big funding shortfalls in FY2003
in about ten states.

I disagreee w/Jim about the salience of the state angle;
the financing and control of AFDC were much the same, and
that did little to save it.

The lesson I take from the '90s is that waivers of Federal
standards in the name of 'state flexibility' -- even for
progressive reasons -- that weaken the entitlement
aspect are what can unravel a program.  We see waivers
in Medicaid, just as we saw in AFDC as the '90s got
under way.  The safest course for benefits, if not
always the most efficient in other respects, is for
benefits and eligibility to be stipulated in law and
guaranteed as a matter of right, as if they were
property.

In the same vein, the road to reconstructing AFDC/TANF,
I would say, is to fight for work under TANF auspices
to enjoy the same status as jobs in general, with FLSA
protection.  Minimum wage, EITC, SS benefits, etc.

mbs