Who Matters in this Country?

Knowing the health care struggles for people without insurance, my heart was aflutter with the news of a debt ceiling deal that protected Medicaid. It didn't take long for my glee to turn into a sinking feeling.
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As Congress wrestles to find budget solutions for our country in the next few months, a central moral question remains. Most of the coverage of debt ceiling discussions has focused more on political histrionics and gamesmanship than on the real lives at stake. I wonder if the needs of Americans will shine through after all of the mudslinging is done. The stakes are high for working class and poor families. While the Obama administration and many members in Congress (at least those who weren't intent on wreaking havoc on the economy to make a point -- about what, I'm not sure) worked on a debt ceiling deal to address the needs of Wall Street, it's important to think about those whose well-being is most affected by the drive to cut spending, even for essential programs.

Our country faces staggering racial and ethnic inequity in health coverage. Although Latinos averaged 15% of the overall population between 2007-2009, they represented nearly one in three (32%) uninsured Americans during the same period. Most of this disparity is due to Latinos' concentration in jobs that don't offer health care coverage and other benefits. Medicaid has often stood as the only other bridge to health insurance. The program is essential for one in six Americans, providing coverage for 58 million individuals in our country, and more than one in four Latinos (26.5%). NCLR recently noted that the impact is even greater among many of the most vulnerable Latinos. For instance, the program covers nearly half of all Latino children (46.2%), the majority of whom (58.5%) live below the federal poverty level.

These numbers drive home how important Medicaid is to our communities across the country, but we can't forget that there are people behind the data. The Alliance for a Just Society illustrates this in their new publication, Medicaid Makes a Difference: Protecting Medicaid, Advancing Racial Equity, which shares the stories of patients, health providers, and community leaders who experience firsthand the benefits of Medicaid to communities of color. The document tells the story of Eduardo Magaña, 17, who understands that his performance at school is tied to his ability to obtain good preventive health care through the program, and Sagrario, whose coverage to treat her ovarian cancer is only possible due to her Medicaid.

Knowing the health care struggles for people without insurance, my heart was aflutter with the news of a debt ceiling deal that protected Medicaid. Latinos across the country answered the call to action when cuts were proposed. Letters and calls poured into congressional offices, and for a brief moment, we won. It didn't take long for my glee to turn into a sinking feeling. For the immediate future, negotiators of the debt deal did the right thing, avoiding helter-skelter cuts to several essential programs. But the devilish details reveal that while Medicaid is safe -- at least for today -- the mechanics of this deal and lack of political will to go to the mat for the most vulnerable could put millions of Americans at risk of harm.

After an initial $1 trillion spending cap on all national programs, it is now up to a "super committee" to carve an additional $1.5 trillion out of our budget. This committee will need to be superhuman to overcome the partisan gridlock and absence of civility that led to this point. Despite symbolic nods toward "shared sacrifice," Republicans shunned many -- actually, all -- options, and the first round of cuts from the debt ceiling deal will disproportionately affect the poor and vulnerable, potentially driving those working class families struggling to join the middle class into poverty. Revenue raisers that could reform and simplify our tax system and help to pay off our debt have not been a serious part of the conversation. And make no mistake: as this deal moves forward, Medicaid is still on the table to be cut in the second round of discussions. Ironically, the first round of cuts could force more people into poverty and swell Medicaid participation rates. The way Washington works these days, that scenario could make Medicaid more vulnerable to cuts.

If budgets are about values, as we are told, a decision to gut Medicaid after allowing continued tax breaks for the wealthiest Americans will give us clear indications for whom Congress is fighting and how Congress really feels about working class families. Should Congress pull the rug out from under Medicaid, federal lawmakers will be sending a brutal message to Latinos -- and the many others who stand to suffer -- about who really matters in this country.

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