Abandonment of the most vulnerable of us...

A recent protest by disabled rights activists got zero press attention from the corporate media.

Disability Rights Activists Are Even Invisible Getting Arrested on Capitol Hill

ADAPT organizer Mike Ervin explained that it’s not just the roughly 35 percent funding cuts to Medicaid in the GOP’s budget proposal that concern the disability community, but the plan to convert states' federal shares into block grants. Many people with disabilities rely on Medicaid “for the assistance we get every day to live in our communities," rather than institutions.

As for the claim, from Ryan's Roadmap Plan, that block granting "allows states maximum flexibility to tailor their Medicaid programs to the specific needs of their populations," Ervin says, "That's like saying Jim Crow laws give states more flexibility to decide who gets to drink at their water fountains. Flexibility is basically a code word for abandonment."

Disabled people (one community that anyone can join at any moment) and their advocates are right to worry their concerns won't be heard by lawmakers, to the extent that that involves dealing with a press corps that, evidently, can't even see them.

Ezra Klein posted on this earlier in the week--Don’t worry about Medicare. Worry about Medicaid.

There are two reasons Medicaid is more vulnerable than Medicare. The first is who it serves. Medicaid goes to two groups of people: the poor and the disabled. Most of the program’s enrollees are kids from poor families, though most of the program’s money is spent on the small fraction of beneficiaries who are disabled and/or elderly. These groups have one thing in common, however: They’re politically powerless.

The second is who pays. Medicare is a federal program. Medicaid is a state-federal match, and it kills states during recessions, as unlike the federal government, states can’t run deficits, and so they find themselves with increased costs because they have more people in need but decreased revenues. So there are a lot of governors — particularly GOP governors — straining under overstretched state budgets who’d like a way out of their fiscal crisis that doesn’t include raising taxes, and there are a lot of federal legislators who’d like to save money without having seniors mounting protest marches outside their office, and Medicaid begins to look like an answer to everyone’s problem. “You can shift costs to states so they can be the bad guys while the federal policymakers pretend they didn’t hurt anybody,” says Bob Greenstein, president of the Center on Budget and Policy Priorities.

Indeed, one place where the difference between Medicare and Medicaid comes clear is that Medicare reforms tend to be talked about in terms of health-care policy. It’s all Independent Payment Advisory Boards and choice of private plans just like congressmen have. Medicare rhetoric is about convincing seniors that these reforms will be good for their health care. Medicaid rhetoric, conversely, is almost never about health care itself. It’s usually about state budgets.

In part, that’s because it’s very, very hard to argue that Medicaid could be cheaper, per beneficiary, than it currently is. “Medicaid costs much less than Medicare or private insurance, pays lower rates than Medicare or private insurance, and Medicaid costs per beneficiary have been rising more slowly than private insurance over the last decade,” continues Greenstein. “It all just falls apart under scrutiny.”

Which is why Paul Ryan’s plan doesn’t have anything in particular to say about the way Medicaid should deliver care more efficiently. Rather, he’d convert Medicaid into a “block grant” — notably, most people have no idea what a block grant is — that would give states more “flexibility.”

A block grant simply means that the federal government will give states a lump sum, rather than varying their contributions to cover the actual needs of the program. This saves money in two ways: First, the block grant grows more slowly than health-care costs, meaning the government is paying less and less of the tab. Second, if there’s a recession and many more people suddenly need to use Medicaid, the federal government’s contribution doesn’t change. A block grant, in other words, means less Medicaid funding. It has nothing to do with making the system work better, which means you’ll have more uninsured people flooding into emergency rooms. That’s one reason hospitals and other providers might oppose plans that shifts costs — the costs, after all, will be shifted to them — giving Medicaid some much-needed friends with political clout.

But even without provider opposition, block-granting is a pretty radical move. More likely is an effort that Suzy Khimm has been reporting on to separate federal contributions from state eligibility rules. Right now, states can’t kick people off the rolls or radically reduce benefits without losing federal money. Under the terms of the State Flexibility Act, they could. “That’s the number one likely option,” says Jennings. “It’s relatively invisible. It’ll give states the flexibility they say they want. And it’ll hurt a population that doesn’t vote.”

Which is, in the end, why it might actually happen.

The Republican abandonment of the most vulnerable of us will be cheered on by the base of the Republican party.  And thats just one small reminder of why when choosing which of the two evils I have to side with politically I side with the Democratic wing of it.  The purpose of government is to protect and empower its citizens, especially the most vulnerable of us...  friends don't let friends vote Republican.