Why do unions care about Medicaid?
Jon Cohn looks at the Medicaid section of Wisconsin Gov. Scott Walker's "budget-repair bill":
Under Walker’s proposal for Medicaid, his Secretary of Health could use “emergency” powers to redefine some of the program’s most basic parameters: Whom it enrolls, what premiums and co-payments [it] charges, etc. Normally, these sorts of decisions would require assent of the full legislature. But, according to Jon Peacock of the Wisconsin Council on Children and Families, under Walker’s proposal the Secretary of Health would need approval only from a joint legislative committee whose membership is heavily tilted towards the majority party. (The Center has more information about the proposal at its website.)
Because Medicaid is a federal-state partnership, federal guidelines do impose some limits on what Wisconsin could do. The state could not, for example, stop offering coverage to children. And in order for Walker’s change to take effect, I gather, the federal government would have to issue a waiver. Typically the feds issue waivers only when states show they can improve or bolster coverage, not when they are looking to weaken it. But Walker’s budget effectively puts a gun to Washington’s head: If the state doesn’t get permission to change the program in the way he wants, under Walker’s proposal, it would simply reduce Medicaid to the bare minimum permissible under federal law.
This is the exact sort of proposal that unions tend to fight. Why? It's hard to say. Relatively few of their members are on Medicaid. The whole point of being in a union, on some level, is that you don't have to be on Medicaid. But unions have this odd notion of "solidarity." So whenever Medicaid cuts end up on the agenda, you'll find the labor movement is the only well-funded, mass-membership lobby throwing its shoulders into the fight to save Medicaid.
This is the role that unions play that some of my conservative friends are missing. Megan McArdle, for instance, asks, "In what way do public sector unions act as a check on the power of corporations?" You can find one of the answers in Walker's agenda. Corporations aren't lobbying against Medicaid, of course. But they're lobbying for massive corporate tax cuts. And they look likely to get them (in fact, they've already gotten some). But the hundreds of millions of dollars or billions of dollars that those tax cuts add to the deficit will have to be made up somewhere. And Medicaid is a likely target. There is no one behind Medicaid with even an ounce of the political power that the business community wields.
No one, that is, except unions. And unions also happen to be the only organized interest group standing in opposition to continual tax cuts for corporations and the wealthy. This is why this fight is so important to both sides. If it were just about the money, it would be easier to resolve. But it's not just about money. And it's not, as McArdle goes on to suggest, about "some extra benefits for the teachers' unions." After all, the unions have already offered to make the concessions on benefits that Walker has asked for. Rather, this is about the balance of political power in Wisconsin and, given the potential for other governors to adopt Walker's proposal, nationally. It's about whether there will be anyone left to speak up next time a state with a yawning deficit proposes to give corporations a massive tax break while slashing Medicaid benefits. And that matters.
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