Enforcing Adequate Medicaid Cover for the Poor

Health Care

Nmedicaid+comicew Orleans Reading the report was one of those Sports Center “come on, man!” moments.  This couldn’t be true.  The top Democratic were filing an amicus curia (friend of the court)  brief with the Supreme Court to try to overturn the Obama Administration’s efforts to allow cutting the standards of health protection under Medicaid for the poor by various states.  Furthermore, this was no rouge group but heavy hitters like Nancy Pelosi, Henry Waxman, Harry Reid, and Max Baucus.  They were joined in similar amicus briefs by former health officials, civil rights groups, the AARP, and others.  What the heck?!?
Here’s the problem.  The feds sent a truckload of money to the states and in California where this case arose the number is $20 billion.  The states have to pick up between 25 and 50% of the costs with the feds on the long end of the stick for 75 to 50% depending.  In the crushing domino fall of the USA economic meltdown not surprisingly the poor would be first in line for a beating.  States in dire straits whack down on their Medicaid spending to save money by cutting the standards of care giving themselves a break and finding a friend on the other side of the deal in the federal government which therefore also saves on its share, leading Obama, the health care coverage so-called advocate, to pop the poor hard.  Reimbursement rates get cut when this happens, so doctors feel the system and the poor not only have diluted coverage but no providers either.
Robert Pear of the New York Times is on this beat and cites the other problem which is the requirements of the law:

“Federal law says Medicaid rates must be ‘sufficient to enlist enough providers’ so that Medicaid beneficiaries have access to care to the same extent as the general population in the area.”

In other words the law is clear that you cannot discriminate in health care coverage, the decisions of life and death, against the poor.
The Obama Administration, seeking the cowards’ cave, argues that enforcement of that unambiguous standard should be the “exclusive responsibility” of federal health officials.  The Congressional caucus and anyone else caring two cents about the 55,000,000 who are covered under Medicaid, know that the feds simply do not have the resources or bureaucracy to police all of the standards in 50 states down to the nap, so they want poor people to be able to sue California and others when they are chumped and cheaped out.  In past presidential administrations such lawsuits were not greeted with universal cheer, but they were recognized as having a vital role in securing the standards of health care and protecting the poor.
What is the political equation which makes it acceptable for the Obama Administration to aid and abet discrimination against the poor and encourage by passivity killing them with neglect?