"Please, Sir, I Want Some More"

Oliver Twist finds a new home in the GOP state budget

Please, Sir, I Want Some More
Illustration By Doug Potter

This week the other shoe dropped on the Health and Human Services Commission proposals to meet Gov. Perry's mandate to cut 12.5% from HHS programs for the 2003-04 biennium. Just the headline number -- drawn from HHS Commissioner Albert Hawkins' presentations before the legislative budget committees -- was staggering: a 50% cut to the Children's Health Insurance Program, eliminating coverage for 250,000 children. That was, as it turns out, only the mouth of the abyss. The proposals from related agencies would also hollow out literally life-saving programs in the Departments of Health, Human Services, Mental Health and Mental Retardation, and Protective and Regulatory Services.

Of course, it's possible to see the CHIP announcement as a charitable retreat. A week earlier, the agency-floated word was that CHIP would be zeroed out, and all 500,000 insured kids -- whose parents make too much to qualify for Medicaid, but not enough to buy private insurance -- would henceforth, as they say in the insurance biz, go naked. The revised numbers just shift the cuts elsewhere, apparently so the headlines wouldn't read "half a million." The most cynical shell game is to cut already criminally low Medicaid reimbursements to providers by a third -- thereby driving doctors out of Medicaid altogether, and by that sleight-of-hand effectively eliminating the indispensable program in Texas.

It's literally impossible in this space to itemize just the major cuts anticipated in these proposals from the various agencies, but consider these brief lowlights:

  • Reducing eligibility and coverage period for CHIP (i.e., eliminating coverage for more than 250,000 children);

  • Cutting Medicaid reimbursement by 33%, cutting coverage period, and recomplicating application process (i.e., eliminating the program for over 400,000 children);

  • Eliminating prescription drugs, hearing aids, eyeglasses, and other coverages for 500,000 elderly and disabled adults, and all Medicaid coverage for another 41,000 aged and disabled with incomes higher than the princely sum of $6,650 a year;

  • Eliminating Medicaid coverage for more than 17,000 pregnant women;

  • Eliminating community care for over 75,000 people otherwise bound for nursing homes;

  • Eliminating mental health care for more than 30,000 people;

  • Cutting 240 caseworkers from Child Protective Services (you do the math on that one).

    Scrubbing Bubbleheads

    A couple of dozen Democratic legislators (including the Austin delegation) held a press conference Monday to denounce what they called "the Perry cuts" because Rick "Zero-Based" Perry has shifted his responsibility to set initial state priorities down to his agency heads, allowing them to take the heat from the committee members and the press.

    "A society that values cuts over kids is a society that does not invest in hope for its future," said El Paso Sen. Eliot Shapleigh. "We will not balance this budget on the backs of Texas children." Asking why the governor can find funds to bring Toyota to San Antonio but not to pay doctors for the working poor, the Dems also pointed out what should be obvious even to free-market fundamentalists: Medicaid (and its hefty federal matching funds) is an enormous economic driver to the state economy, and these irrational cuts will devastate an already staggering economy in every region of the state.

    The governor's office immediately dismissed the Dem charges as "partisan," although it doesn't take a knee-jerk liberal to be stunned at the GOP leadership's approach to budgeting. The Houston Chronicle -- hardly a fountainhead of left-wing sentiment -- denounced the ruthless axe-wielding as a "Dickensian horror show" and nightmarish "outrage" for a state "already known far and wide for its miserly ways." (And no, for regular Chronk readers, I'm not making that up.)

    The House HHS Appropriations subcommittee chair, Burleson's Arlene Wohlgemuth, also called the Dems' rhetoric "partisan" and argued (like the governor) that the budget process is still in a "preliminary" stage. Houston Sen. Rodney Ellis countered, "You've just heard our preliminary response. ... Go ahead and 'scrub the budget,'" Ellis concluded. "Just scrub it somewhere else."

    Let Them Eat Cable

    As it happens, the Conservative Coalition Research Institute just released its report on "Reforming Health and Human Services" (a project also chaired by Wohlgemuth), and it helpfully makes clear the major priority of the Lege's hard-right caucus -- and it is not the health and welfare of Texas citizens. Of 28 recommendations, the first 16 are in fact tort reforms intended to further insulate doctors, hospitals, nursing homes, and pharmaceutical companies from civil liability for various forms of malpractice. Most of the remaining recommendations underlie, in one form or another, the intentional dismantling of the social contract now under way at the Capitol.

    The abject level of thought and "research" invested in Wohlgemuth's report is amply represented as follows: "Americans willingly pay for luxuries and conveniences like cable television, cellular phones, and entertainment like movies and music, but complain about paying for health care. ... We complain about the cost of monthly premiums and visits that require greater out-of-pocket expense, but purchase VCRs and DVD players without blinking an eye. By most standards, the luxuries come after [sic] the priorities, not the other way around."

    According to Wohlgemuth, et al., that's why more than a million Texas children (most with working parents) have no health insurance, and nearly one in four Texans has neither insurance nor the money to pay for basic health care: They've blown it all on cellular phones.

    That is an argument so willfully ignorant of the lives of ordinary working people -- and so beneath contempt -- that it should by definition disqualify anyone who makes it from any position of public trust, let alone the budgeting process for public health care and human services.

    If you had any remaining doubt about who purchased the state Republican landslide, look no further. The insurance companies and their corporate brethren are lined up in the lobby to collect their markers. And make no mistake: The proposals being forced through the agencies and rushed through highly centralized budget committees have nothing to do with "fiscal conservatism." Like (and in league with) similar proposals descending from the George W. Bush White House, they are part and parcel of a reactionary attack on the very idea of community and of shared democratic values. They are being made in the name of a virulent ethic of social Darwinism, and imposed upon a population intentionally terrified and distracted by war hysteria.

    Dickens would surely have understood. end story

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    Oliver Twist, Rick Perry, Health and Human Services, state budget, Albert Hawkins, Children's Health Insurance Program, Dept. of Human Services, Mental Health and Mental Retardation, Texas Department of Health, Protective and Regulatory Services, CHIP, Medicaid, Chil

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