Pop quiz, everyone. Think of this like one of those online questionnaires that’s supposed to tell you more about yourself — in this case, where you ought to live.
Question 1: A car is traveling at 60 mph. Ahead, the driver sees another car pulled onto the shoulder. She brakes until she’s only going 40 mph. Is her car now moving a) forward, or b) backward?
Question 2: A man is under doctor’s orders to go on a diet because he’s overweight and has been adding 10 pounds every year. He comes back the next year only 5 pounds heavier. Did he a) gain weight, or b) lose weight?
Question 3: A family rents a house, renewing their lease each spring. For the past several years, their landlord has increased their rent by 3 percent, but this year he raises it by only 2 percent. Is their rent payment going a) up, or b) down?
If you answered A for all of these questions, congratulations: You live in the real world. But if you answered B for even one of them, I’m afraid you belong in Washington, D.C.
Only in Washington, you see, does a smaller increase equate to a “cut.”
This is relevant after the latest GOP health-care bill, Graham-Cassidy, which won’t get a vote in the Senate before the fiscal year ends on Saturday but is expected to survive and go through the legislative process during the months to come. One of the fiercest, and most dishonest, criticisms of the bill was it would “cut” Medicaid spending.
It did nothing of the sort. Even if this particular bill doesn’t go anywhere, it’s important that we understand what “cut” means to Washington, and especially Democrats in Washington, as it relates to spending.
A real spending cut is the kind we saw in Georgia during the last recession, when state spending fell from $18.7 billion in 2009 to $16.6 billion in 2010.
You would be forgiven for thinking Graham-Cassidy would do the same to Medicaid. Headlines screamed about billions in “cuts” to Medicaid under the bill.
There’s just one problem: Funding for Medicaid would have gone up every year, by no less than 5.8 percent, and by a cumulative 49 percent over six years.
Only in Washington can spending soar by tens of billions of dollars and still be called a “cut.”
That’s because what Graham-Cassidy would do is slow the rate of growth for Medicaid spending. On its current path, Medicaid spending would grow even faster. One might call this a slowdown in spending, and some might find the growth rate disappointing or unexpected. But in no sense of the word does an average annual growth rate of almost 7 percent amount to a “cut.”
If such changes are forever held up by demagogues fluent in Newspeak as examples of unconscionable “cuts,” our national finances are truly doomed.
The same kind of thinking has plagued this entire health-care debate. Coverage “losses” estimated by the Congressional Budget Office for various GOP bills included people who so far haven’t chosen to buy health insurance, despite the individual mandate; CBO simply assumed they eventually would. Similarly, the agency counted potential Medicaid enrollees in states (like Georgia) that haven’t expanded the program as “losses,” on the theory those states probably would have expanded Medicaid one day.
A dose of honesty and reality in Washington would be healthy for this debate.
