Bookman: Georgia in play as health care worries meet tax cut squeeze

Our columnist asks why would state lawmakers spend hundreds of millions of dollars on tax cuts, rather than on helping hundreds of thousands of uninsured Georgians through Medicaid expansion, helping rural hospitals stay open and leveraging literally billions in federal aid? The 50-bed North Georgia Medical Center in Ellijay closed in 2016 citing the burden of uncompensated care. John McCosh/Georgia Recorder

The Democratic National Committee has added Georgia to its list of states targeted for millions of dollars in spending in the 2020 campaign, and the Georgia General Assembly continues to flirt with a second consecutive big-dollar tax cut that favors corporations and the rich.

These are not unrelated developments.

For example, one of the biggest issues of the 2020 election will be health care, and that’s particularly true in Georgia, which has the second highest rate of uninsured in the nation. Not coincidentally, the state with the highest uninsured rate is Texas, which the DNC has also added to its list of targets this week.

In both states, the uninsured rates are so high because their Republican-controlled legislatures have refused to accept billions of dollars in federal funding that would allow them to expand Medicaid coverage to their working poor and lower middle-class. Both states also have congressional delegations, attorneys general and governors dedicated to killing the Affordable Care Act, even though they have no idea of how to replace it.

In Georgia, the excuse for not expanding Medicaid is that the state can’t afford it, which isn’t exactly true. Last year, it could afford a tax cut for corporations and individuals that easily topped the price tag for Medicaid expansion, with most of the benefits of that tax cut going to the wealthy. And even though that previous tax cut has put a serious squeeze on the state budget, forcing legislators to consider severe cuts in important programs, they are apparently serious about doing it again.

According to the Georgia Budget and Policy Institute, the proposed new tax cut would reduce state revenues by $615 million, and 76% of that $615 million would go to those making $100,000 or more.

The obvious question is why. Why spend that money on tax cuts, rather than on helping hundreds of thousands of uninsured Georgians, helping rural hospitals stay open and leveraging literally billions in federal aid? Why?

To put it in blunt terms, because in the minds of Georgia Republicans, helping hundreds of thousands of uninsured Georgians is socialism.

Medicaid is socialism, just as Medicare is socialism and Social Security is socialism. Food stamps are socialism. Obamacare is socialism. Pretty much any government program that helps people, from public schools to unemployment insurance to financial aid for college students, has been or is described as socialism.

And if decade after decade, Republicans describe and attack good, helpful programs as socialism, then they shouldn’t look around in shock when “socialism” begins to look pretty darn good to people, particularly to those in generations not taught to instinctively associate socialism with the evils of communism.

Likewise, if adherence to capitalism produces a system that isn’t flexible enough or humane enough to provide basic health care as a right to its people, if it produces a system in which students are forced to mortgage their future for decades to achieve a college education, if developers and huge agribusiness and major film studios can be subsidized with billions in tax dollars as “economic development” but a school lunch for poor kids cannot because it’s “socialism,” if it produces levels of wealth inequality not seen in this country for a century, then no one should be surprised if that brand of “capitalism” begins to look a little more dubious.

The top-end tax cuts championed by Republicans here in Georgia, and the punitive spending cuts in social programs that they make necessary, make such a debate not just inevitable but mandatory. The same is true of massive tax cuts at the national level, which have failed to produce anything near the levels of growth promised. We’ve set up a political battle in which we’re forced to take sides, to choose between this or that, when the pragmatic answer is this AND that, together.