A few days ago, I wrote a piece here that explained what would be the likely result of the Supreme Court decision making the ObamaCare Medicaid expansion optional rather than mandatory. Gulf States would reject the optional funds unless they were provided with a carrot, so that states from other regions of the country would subsidize them. Politico has decided to look at this same situation today, and comes up with the same conclusion.
Politico says that the main hole card that these governors have to play is that Obama wants them to stay in the optional system, so they will be able to wheedle extra benefits from the federal government. For example, Bobby Jindal will pressure Obama so that the Medicaid funds will be sent to Louisiana as a block grant. Generally, a block grant can be spent in any way that a state would like; a categorical grant must be spent on a specific type of service. When speaking with reporters Friday, Jindal said, “I believe [the feds] can go to the states and negotiate” to convert their Medicaid dollars into unrestricted lump payments. “
Meanwhile, in Mississippi, Governor Phil Bryant said, “I would resist any expansion of Medicaid that could result in significant tax increases or dramatic cuts to education, public safety and job creation.” In Texas, a spokesman for Governor Rick Perry issued the following statement: “Gov. Perry will stand up and do what is right for Texas, based on the priorities of fiscal responsibility and the best interests of Texas taxpayers.”
Invariably, when the federal government expands its purview, this is what happens. Consider this example: With Brown v. Board of Education, it became the federal government’s responsibility that public schools in this region became racially integrated. Well 60 years later, what actually happened?
In Louisiana, for example, a number of private schools popped up in the 1960s and 1970s, as the feds tried to implement the decision. In Baton Rouge, for example, although about 2/3 of the population is white, about ¾ of public school students are not white. Many of these private schools that were set up teach a few handfuls of kids in a couple of rooms. Then, in the last decade, when No Child Left Behind was put into place, kids who failed the achievement tests for their respective grades were moved into private schools that don’t have to give the tests. Since many of these schools aren’t handicapped accessible, and since public schools must be (by federal law), many families send their handicapped kids to public schools, while their other children go to private schools. This increases the cost per pupil for the public schools, with the federal government picking up this extra funding.
What should we learn from this? Well first, maybe we should concede that Madison was smarter than all of these modern politicians put together. He understood that people in different regions would have different priorities, instead of believing in a one size fits all perspective. If people in the West, or Midwest, or the Northeast believe that something like universal health care is important, do it. Down here, it isn’t important to the voters who elect our politicians. So, if the rest of you want to pay for our services, we’ll take your money. But don’t be surprised if reality falls well short of your aspirations.