In rejecting Medicaid expansion to serve the uninsured in the poorest, unhealthiest state, Mississippi Governor Phil Bryant piously urged eating better and exercising more (in a stranger-than-fiction twist, he then signed a law, pushed by a barbecue chain owner selling sandwiches called “L’il Piggies,” preventing restaurant calorie disclosure).
Bryant has not objected, though, to the federal government paying 73 percent of Mississippi’s Medicaid costs as part of the state’s $2.47 return on each federal tax dollar.
South Carolina Governor Nikki Haley gave Boeing another $120 million in tax incentives this year while bashing Washington state. She should thank us: Our state’s taxpayers subsidize her wooing Boeing. The federal government pays 70.6 percent of South Carolina’s Medicaid costs — the state gets $1.92 back for every dollar paid in federal taxes.
Our economic competitors are pulling themselves up by our bootstraps. In Washington, the federal government pays only half of Medicaid costs. The federal Medicaid formula is income-based, yet we are among only three states without income-based taxation in the bottom 15 for the federal match.
The other two states in that group are Alaska and Wyoming. We are not like them.
Alaska receives so much oil revenue from the national treasure that it gave every citizen, adult or child, a $900 “dividend” this year. Oil accounts for 90 percent of state revenue, and the state has accumulated a $16.1 billion surplus while actually lowering oil taxes this year.
Wyoming also benefits from the national treasure: Revenue from the mineral severance tax, and income from the Permanent Wyoming Mineral Trust Fund, easily dwarfs sales tax revenue.
Not only do we lack an income tax (or oil revenue) but our state’s tax system falls more heavily than any other state’s upon those with the least. Medicaid recipients whose care is underfunded pay the exact same sales tax that a billionaire does.
In negotiating a federal budget deal with anti-government arsonists, Senator Patty Murray was forced to concede a lot of fires. An estimated 94,100 Washingtonians will be denied extended unemployment benefits by the end of 2014. Arbitrary cuts of 2 percent continue for Medicare providers.
Going forward, however, Murray — as Senate Budget Committee chair —is uniquely positioned to argue the equities of Washington receiving a higher federal contribution toward Medicaid costs. Billionaires who opposed the Initiative 1098 high-earners’ tax should support that effort. Contrary to our high-income ranking, we actually trail South Carolina in the federal Bureau of Labor Statistics’ measure of real unemployment, which includes unemployment as well as marginal attachment to jobs and part-time work for economic reasons. By that measure, we are in the nation’s bottom 12 states at 14.8 percent.
We could use any assistance toward social services costs we can get. Murray and Sen. Maria Cantwell could push to amend the Social Security Act to ensure any state without an income tax (a happy development to Republicans, one imagines) receives a federal Medicaid contribution of no less than 55 percent. I’m sure Gov. Inslee would happily accept this, as opposed to Gov. Haley’s taunts as she smugly rakes in Washington taxpayers’ largesse.
For our state, a greater federal Medicaid match would be enormously helpful to funding long-term care, as well as payments for the hospitals and primary care practitioners essential to helping health care reform succeed.
Brendan Williams is a former legislator and a long-term care advocate.
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