Heather Gillers has an interesting article in the Indy Star on the Daniels’ administration’s failure to execute a 2005 law concerning the expansion of birth control available through Medicaid to women at or near the poverty level.
Current law is that pregnant women with income at 200% of the poverty level or less qualify for Medicaid during pregnancy. After the pregnancy, in order to qualify for birth control assistance, they have to be making 23% of the poverty level or less. The 2005 legislation intended to change that system so that, following the birth of their child, women eligible for Medicaid during their pregnancy would continue to be eligible for Medicaid funded birth control (but no other services) for a period of two years following the birth of their child. This is not a novel concept; apparently some 20 odd states structure their Medicaid plans in this fashion. The experience of those states suggests that Indiana would have realized savings in excess of $1 million per year because it would be paying for fewer subsequent births; because second births within two years of the first are more likely to result in medical complications; and the like.
In order to make a change to a state’s Medicaid plan, the state has to apply to the federal government for approval. There were also, apparently, some start up costs involved – such that the state would be about $1 million in the red before the savings started kicking in.
The article says that it’s not entirely clear why the Daniels administration’s application to the federal government was late and inadequate, but that’s apparently what happened and why the changes were never implemented. But, when it’s a snafu at FSSA during the Daniels administration, the first two words that have to jump to mind are “Mitch Roob”, who you might remember from such public sector cautionary tales as “Privatizing Welfare Eligibility Determinations” and “Phantom Economic Development Jobs,” and “Indiana Doesn’t Do Studies, It Does Deals (Just Not Very Well)”. And, indeed, his tenure was from 2005-2008 which seems to be the most relevant time period to this discussion.
The two justifications for this failure seem to be “it’s the Feds’ fault” and “we couldn’t afford it.” The feds dispute that it’s their fault, and, that seems to be a more recent explanation. The start up costs would have been about a million dollars, but would have saved $7 million. (And, the article says that the data is pretty solid on the savings.)
The article also points out that the FSSA knows how to move rapidly on a Medicaid change application when it wants to. The legislation told FSSA to submit the application by Jan 1, 2006. It didn’t submit anything until 2007, and then the submission was inadequate and has been withdrawn and resubmitted and withdrawn again. By contrast, when the General Assembly told the governor to cut off Medicaid funding to Planned Parenthood; FSSA managed that within five days.
Some parts of the Republican coalition are simply not happy with the idea of birth control or family planning in general. But, I don’t really peg Daniels or Roob as holding that view. However, I can definitely see them not being excited about any additional services being provided by Medicaid or the government — even if doing so actually saves the government money. It goes against a dogmatic belief that government can’t (and almost shouldn’t) do anything well; certainly not act in a way that saves taxpayers money. That combined with Roob’s track record in his other government endeavors probably go a long way toward explaining the failure in this case. The administration could have come up with the start up money if it had really wanted to (after all, Mourdock and the Treasurer’s office managed to scrape together $2 million for a doomed legal challenge to the Chrysler bankruptcy restructuring.) So, I doubt lack of money is the real answer.
I agree with everything you say, but I wouldn’t discount Roob’s ideological/religious beliefs as an explanatory factor. A colleague of mine was doing a study for FSSA during Roob’s (unfortunate) tenure there, and was told by Roob that he “strongly suggested” that FSSA employees read two books: Atlas Shrugged, and The Holy Bible.
Well, there you have it.
Geez, how eugenic! That they’ve shown in the 20 states that pay for it that subsequent births go down… well Margaret Sanger is smiling up at us from whatever plane of Hell she currently resides.
;)
Why is it that people who allegedly love the poor (liberals) work so hard to make sure that less of them are born? It’s a strange philosophy y’all subscribe to.
“Poor” is not a genetic condition.
Contrary to the beliefs of the Social Darwinists out there.
If you’re on Medicare, you’re poor. Not only that, but from what you said, this is only open to people who are at 23% of the poverty level. These are the poorest of the poor.
To pretend that we don’t have a class of people that spend a large portion of their lives on public assistance is to put your head in the sand. I would agree with you if being on Medicare was a temporary condition, but I don’t think that that is the case.
I will be you “one million dollars” (said in my best Dr. Evil dialect), that this disproportionately impacts african americans and hispanics. It is eugenic.
Buzz, I think you mean Medicaid, not Medicare. They are different.
I’m pretty sure no one is being forced to take birth control, as Buzz seems to suggest. Any evidence of women being force fed the pill by evil Medicare bureaucrats Buzz?
I don’t know Doug. I am pretty sure that most children do inherit “being poor” from their parents for at least the first quarter-century of their life.
Sorry, you are right, Medicaid, not Medicare. My bad.
The issue is not that people are being forced or not. I am not arguing about intentions, I am arguing results. The results of this program are eugenic.
Margaret Sanger never forced anyone to do anything. She just created an organization (Planned Parenthood) that provided services that she targeted at people she didn’t like (the non-WASP poor), which she correctly saw would result in less of them. She succeeded beyond her wildest dreams.
Buzz, I’m going to say that it’s the opposite: the ability to manage and control their reproduction allows women *significantly* greater ability to control their economic circumstances. Having fewer children gives women greater ability to bring themselves and their offspring out of poverty, giving them and their descendants better opportunities for success.
If you’re only talking about quantity, I’d say this: we’re not rabbits. Humans have different metrics for success than quantity of offspring.
Says Buzz..
“I’m not arguing about intentions.”
Okay, but you said…
“Why is it that people who allegedly love the poor (liberals) work so hard to make sure that less of them are born?”
Isn’t this loaded question really an argument towards the intent of this policy’s proponents?
“Isn’t this loaded question really an argument towards the intent of this policy’s proponents?”
Quite the opposite, in fact. I think that liberals intentions are to help the poor (largely to feel good about themselves), but liberals never look at results. In fact, the results of their programs are always the opposite of what they intend (law of unintended consequences), but instead of that being an argument against their programs, it is an argument that “we just didn’t try hard enough!”.
Buzz, I’m going to say that it’s the opposite: the ability to manage and control their reproduction allows women *significantly* greater ability to control their economic circumstances.
I agree, in theory. However, point of fact, we have a large number of people who are permanently mired in poverty. The number of children they have is not a causal variable in whether or not they are poor.