MOMocrats Guest Contributor: Melissa Schober shares how federal spending affects the daily lives of women and children

Recently the MOMocrats received a note from a commenter who had this to say:

Something I see missing from lots of political blogs is a good discussion of how federal spending affects the day-to-day lives of women and children. For example, Bush's last budget proposal (for FY2009) would cut the reimbursement rate for federal family planning services quite substantially. Given that state economies are tanking, states are unlikely to be able to make up the difference. The result? Fewer providers and the possible closure of Title X clinics.

I know this all reads as sort of wonky but I think it is possible for the Byzantine federal spending process to be demystified and made relevant to everyday life; indeed, if more Americans were conversant with the process, I'd like to think there might be more accountability in the process.

We responded, "You are right. Would you please guest post on this topic?"

Thankfully, our commenter obliged, and so it is with great pleasure that we introduce Guest Contributor Melissa Schober:

Thinking of the first Monday in February, my gut immediately starts churning. It is the day the president releases his budget proposal for the next fiscal year and, since Bush has been in office, the beginning of a terrible, no-good, very bad week for me.

This year proved no different.

Tucked into the miles-long FY2009 budget proposal for the Department of Health and Human Services was a tiny paragraph (pdf, see p. 66) that said something about aligning Medicaid reimbursement rates for family planning services. But, unlike the tiny paragraph, the impact of this proposed change would have drastic and far-reaching effects on women – mostly low-income women.

The proposed change would require the Centers for Medicaid and Medicare Services to align the federal reimbursement for family planning services with the rate for other medical services. Since 1972, Congress has recognized the importance of family planning services by providing a 90 percent match rate. For most other medical services, states are assigned a match rate based on their per capita income; poorer states like Mississippi have a higher match rate (75.84%), while richer states have a lower match rate (Massachusetts has a 50% match, the minimum rate).

Medicaid provides family planning services to Temporary Aid to Needy Family (the new-fangled version of welfare) recipients, those receiving some forms of Social Security income, and pregnant women with income at or below 133% of the poverty line (a measly $23,408 for a family of three in 2008) – pretty much the poorest women in the country.

Sure, the Republicans are touting that aligning the reimbursement rate will save about $10 billion over five years. But consider this: A 2006 Guttmacher study estimated that between $2.20 and $2.90 would be saved for every dollar spent on Medicaid family planning services. If that doesn't sound like a lot of money, think of it on national terms: If we expanded Medicaid family planning services to every woman with an income at or below 250% of the poverty line - $44,000 for a family of three – the country would save an estimated $2.81 billion annually.

Now, I'm no math whiz, but $2.81 billion annually would mean a cost savings of some $14 billion over five years. Last I checked, $14 billion is more than $10 billion.

Let's put aside the cost benefit analysis and focus on the heart of the matter: This administration isn't about fiscal responsibility. It would rather cut reimbursement rates to a vital program – a program that 37% of women living in poverty depend on – to prove a point about what it considers appropriate sexual behavior.

We desperately need new leadership. And we must hold them accountable, both for visionary policy proposals and tiny paragraphs tucked into budget documents. No one, least of all me, expects moms – universally strapped-for-time moms – to examine the intricacies of the federal budget. That's why people like me are around. We're hardcore nerds only too happy to collect a paycheck for examining the fine print.

I know the federal budget isn't scintillating reading. But imagine what might happen if more Americans, more moms, read any one of the many publications devoted to breaking down the impenetrable wonk-speak. What would happen if they became enraged that $177 million was being spent every single day to fund an ill-advised war? What would happen if they had a Network-inspired moment and started shouting, "I'm mad as hell and I'm not going to take it any more!"

What might happen? Might we learn about other rage-inducing items like how the Bush administration didn't propose any additional funding for the Consumer Product Safety Commission in 2009, despite hundreds of recalled toys?

Might we all start flooding our legislators and the Appropriations Committees will demands that our tax dollars be spent on sensible policies to assist the most vulnerable among us? I'd like to think so.

:: :: ::

Melissa is a policy analyst for a small nonprofit in Washington, DC. It will surprise no one to learn that she hails from Boston, one of the bluest cities in the nation. She and her husband, one of those lefty academics, reside in Baltimore. They'd like you to know that their city isn't only what you see on The Wire.

Her first foray into politics came in high school when she lobbied the governor to pass the Safe Schools Act. Her career began in earnest when she started working for NARAL Pro-Choice America six days after graduating from college. After a couple of years, she heard the siren call of the private sector and went to work for a consulting firm. Two soul-crushing years later, she returned to the non-profit world having learned that money isn't everything.

Melissa and her husband expect their first child, a girl, in mid-to-late April 2008. You can read about her pregnancy at their blog, 21st Century Kid. She is also a contributing writer for Free State Politics.

[photo credit earthmommies]

Comments

[Glennia]

Excellent post. I have said for a long time that the Bush Administration has no real interest in saving tax payer money or sensible spending. Now I know where to look to back it up. Thanks for that.

[cynematic]

Excellent post, Melissa! Thank you for reading the fine print, and getting out your calculator.

I emphatically want new priorities in January 2009, and will vote accordingly. Time to end the "blank check sabre-rattling" we've had for almost a decade.

And congratulations on your bun in the oven.

[Rachel]

Thanks for bringing this up. This is why I will vote for any Dem in November, over a Republican.

[LawyerMama]

Melissa, thank you so much for breaking this down for us. Even my fiscally conservative *cough*republican*cough* husband can see the issue more clearly after reading your post.

[KL]

More on the issue of spending, an excellent op ed piece in the NY times today on the true cost of the war in Iraq:

http://www.nytimes.com/2008/03/04/opinion/04herbert.html?hp