Category Archives: Medicaid

Getting out the vote and giving up the fight

Next week the U.S. Supreme Court takes up a case which has ramifications for Texas.   Since the passage of the 1965 Voting Rights Act (VRA), the federal government has expanded authority to act as a watchdog over elections throughout the country.  The VRA prohibits state and local governments from restricting voting rights and access to minority voters by mandating preclearance procedures which require some state and local governments (including Texas and eight states) to submit all changes affecting voting and elections for approval to the U.S. Department of Justice’s Civil Rights Division or to the U.S. District Court in Washington, D.C.  That’s what happens every 10 years after the states conduct redistricting (the drawing of the geographic boundary lines to determine the representative structure for elections).

The question in Shelby County v. Holder (2013) is whether the preclearance process has outlived its purpose.  In 2008, then President Bush’s Justice Department filed a lawsuit against the city when it re-drew voting lines eliminating the only majority black city council seat.   Alabama argues that blacks were integrated into the population, and that continued supervision by the federal courts causes confusion and delay for elections–the South is a different place from 1965.

Texas agrees.

Or at least Republican leaders do.

Attorney General Greg Abbott has filed an appeal in a federal court case which struck down Texas’ 2011 redistricting plan.  Two different federal courts have found that Texas impermissibly interfered with minority voting rights with the plan, and Abbott’s appeal is likely to be on hold while the Supreme Court resolves the Shelby county case.

What do the rest of Texans think? Not everyone agrees with Abbott.  It might surprise you to learn that a recent public opinion poll found a slim majority of Texans (about 51%) including 1/3rd Republicans think there is some place for federal supervision over voting rights.

And speaking of opinions, wonder what Governor Rick Perry is thinking as he watches other Republican governors giving up the fight with President Obama over Medicaid funding under the Affordable Care Act (Obamacare).  Under the law, Medicaid funding (the joint federal-state program providing health insurance to low-income persons) has been hard for governors to resist because it means more money for state budgets.  Eleven Republican are standing firm that they will not accept federal monies because they do not want to be under a national regulatory scheme (structure which allows the federal government to demand conditions from the states), while 12 Republican governors have not weighed in yet.

Trouble for Governor Perry is that this week Republican Governor Rick Scott, who had been resisting federal money, gave in and agreed that Florida will take Medicaid monies.   That draws attention to the fact that if the Governor changed his mind and let Texas participate by putting up the $15 billion (our share of the program costs), the state would receive $100 billion in federal funds in the next 10 years. Those funds could be used to expand  health care coverage for 2 million people–approximately 25% of Texans  have no insurance.

It promises to be a tough battle for the Governor.

Shutting the door

The Fifth Circuit Court of Appeals slammed Planned Parenthood of Texas this week when it denied an appeal by the nation’s largest abortion provider.  In 2011, the Texas legislature prohibited organizations which provide abortion access from being funded by the state, and the Governor enforced that law by mandating that the Women’s Health Program (Texas’ largest public health program) reject funding for Planned Parenthood because it gives women abortion information.  A federal district court had given an injunction (a cease-and-desist order granted by courts which prevents a party from doing something) to Planned Parenthood to prevent Texas from pulling the money. A Fifth Circuit three-judge panel lifted the injunction in August, but the latest appeal was for an en banc rehearing (an appeal to have the full panel re-hear the case because one party argues that the three-judge panel made “exceptional mistakes”).  The denial of a rehearing means that the case is final pending a U.S. Supreme Court appeal.

The states administer Medicaid (the federal health care insurance program for low-income persons), and Texas is one of several conservative states pushing to end taxpayer support for Planned Parenthood. While federal dollars can’t cover abortions, pro-life supporters argue that if Planned Parenthood isn’t given federal monies for cancer screenings and birth control, then that frees up Planned Parenthood’s funds to provide abortion counseling.   Planned Parenthood has 77 independent local affiliates operating about 800 health centers in the U.S., and in Texas, Planned Parenthood is the Women’s Health Program’s largest provider—servicing 40%-50% of patients annually.  About 3% of all its health services are abortion-related. In Texas, neither the agency nor its affiliates perform the procedure.  What conservative groups are hoping is that cutting off funds will stop abortion counseling.

The state’s decision to close the door on federal funding will cost Texas $36.3 million in the first year and $45.2 million in the second.  Prior to this, the state of Texas paid about $5 million per year into the program.   As of November 1, the Women’s Health Program opens its doors. Under the new rules, doctors may give women information about family planning, but must give information in a non-directive way.  What does that mean?  Doctors may offer women with information about who provides abortions, but the physician cannot make a formal referral.

Guess we’ll have to wait and see what happens when women walk out the door.

And speaking of closed doors, Attorney General Greg Abbott told Secretary of State Hillary Clinton that the Office of Democratic Institutions and Human Rights (OSCE) could not be observers in the November elections here in Texas.  The organization, along with Project Vote—a watchdog group which monitors activities of government—had asked to be election monitors because of the state’s voter ID measure (which is not yet in effect because it is being appealed). Such election monitors (persons who come and observe voting activities to make sure the laws are being followed) are thought to be important, especially in states like Texas, which have a long history of voting rights violations.  Abbott argued, however, that the requests were at odds with the Texas’ Election Code because of concerns that the groups would not be “restrained in their activities.” Out of that concern, Abbott indicated that he will have officials block such groups if they come within 100 feet of a polling place.  Doesn’t sound like they are getting in that door even if they have been since 2002 when President George W. Bush invited the OSCE to watch elections in the U.S.