Fakery, Posturing to Improve Medicaid?

UPDATED: At the same time the National Health Law Program hatched its fake challenge to “save” Medicaid, it was immersed in a “diversity, equity, and inclusion” effort with D.C. consultants (Management Assistance Group). The health law program Board, which is an elite, snarky lot, at least noticed the law program’s glaring whiteness. A lengthy report was given to the Board by the consultants, which included a paragraph with bullet points noting that the org’s leaders bullied Black women at the organization, and alienated LGBTQ people. The white women leading the org besides Elizabeth Taylor included Mara Youdelman, the D.C. office toughie, and Jane Perkins, the group’s racist legal director. The report is available on pdf, if you have tons of spare time.

For almost 50 years, the National Health Law Program has “advocated” for a society where low-income people have access to some health insurance. The Washington, D.C. based organization trumpets itself as the leading advocates of Medicaid, a federal and state program, which provides health care insurance to more than 70 million people mired in poverty at any given time.

Nearing its half-century mark, the health law program ventured into a challenging era of right wing control of all three branches of the federal government. There should have been no better time for so-called heroes of Medicaid to mount an aggressive effort to save Medicaid from what was sure to be incessant attacks by President Donald Trump and the majority of right wing governors from coast-to-coast.

But that’s not what the health law program did. Instead, it concocted a development plan based on a weak litigation strategy. The effort was intended to raise money and “visibility” of the health law program. The health law program executive director Liz Taylor declared the organization would become the “ACLU” of the health care advocacy world (a lame lot, which has done far more for the profits of health care insurers and hospitals than people in poverty). A bit on Liz Taylor, she’s a sixty-some year-old super wealthy white woman and an evangelical Christian. Taylor had a bad habit … of uttering inane religious platitudes in the office. On a Monday after an Easter she asked me what my partner and I did to celebrate. I should have told her we were out Easter-egg hunting with young boys.

Medicaid was not easy for the government to change, until neoliberal policy found its way into Medicaid. That policy, called Section 1115, allows the Secretary of Health and Human Services (HHS) power to waive requirements of Medicaid. Section 1115 should never have crept its way into the law, but centrist lawmakers aligned with conservatives won action to aid future lawmakers in their efforts to weaken if not gut the law.

Right wing administrations did indeed wield Sec. 1115 to attempt to harm Medicaid. Trump was not a conservative president. He is a right wing zealot who jumped at any opportunity to curtail if not scuttle Medicaid, long hated by the Republican party and organizations who despise and demonize people in poverty. Trump and his right wing enabler governors soon ordered HHS to create exemptions to Medicaid to permit high and mandatory premiums on poor people, and to erect new obstacles to obtaining health coverage like drug-testing or mandates to look for work.

The health law program’s plan to challenge Sec. 1115 exemptions was a sham led by white saviors. I know because I was there. The organization’s Board knew the group’s effort to stop Trump’s drive to weaken Medicaid was about money raising concerns, few of its members showed concern other than would the group make headlines and become known.

For legal director Jane Perkins, her team’s lawsuits lodged against the administration would burnish her image as a “legend” of Medicaid law, and reward her state partner groups with cash. Perkins also was obsessed with touting Medicaid as a health insurance program for poor white people. She told me in our first meeting in her Carborro, N.C. office that she wanted white people featured on the health law program’s website for a certain reason: Americans do not like Medicaid because it’s a government giveaway to Black people. Perkins also worked with teams in states like Arkansas, Kentucky, and Wisconsin to find white people to represent in the group’s wobbly lawsuits.

With no passion or competence behind the lawsuits, they went away when Joe Biden won the presidency. The health law program remains in business, pumping out useless white papers, out-of-date email, dry social media, and peddling itself to granters as the ACLU of health care advocates. The program has stayed afloat because of grants from national neoliberal organizations and the “health care” insurance industry.

This story is endemic in Washington, D.C., where organizations have lost touch with people from all walks of life, and are striving to get by for legacy reasoning.

Change, radical change, is needed in the nonprofit “progressive” sector. Leading thinkers and authors like The Daily Poster, Rebecca Slonit, and Stephen Marche understand this. They are working to educate and rally people around the urgent need for foundational change. In times where another authoritarian president is in the making.