GARY ALEXANDER: Hired gun takes a look at Medicaid and other state programs
The Alexander Group
, a self-described "boutique consulting firm" from Rhode Island, this morning presented the results of their report
on Medicaid and other state safety-net programs. The state contracted with the group to examine Arkansas and make recommendations, after a push led by Rep. Bruce Westerman
is an arch-conservative former Pennsylvania Secretary of Public Welfare, where his tenure was marked by dramatic cuts in services (as well as some other controversies — see after the jump). You're never going to believe this, but Alexander concluded that the best bet for Arkansas was to follow a service-slashing wish list of conservative ideas for dramatic changes to safety-net programs. (Alexander would say efficiencies — there are probably some workable ideas in here that don't involve harming beneficiaries at all, but both the logistics and purported savings are too vague to evaluate.) The report combines information about the state's current programs that we already knew along with very familiar conservative talking points about the best way forward. The state paid the Alexander Group $220,000. Nice work if you can get it.
The report is sparsely cited and often baldly conclusory. I may do a closer look later in the week but Max covered the report at length here
. There are long-running and difficult policy disputes buried in here and it will come as no surprise that Republicans greeted the Alexander group with rah-rah questions and Democrats gave them push back. But it was a bit rich to hear Rep. Kim Hammer
take a moment to in today's meeting to say, "Y'all don't have any political affiliations — my phrase is that you are an independent consultant group that takes information, packages it, brings back a set of recommendations on the pure basis and merit of the numbers that can be substantiated." (I'd be curious to see how many of the recommendations would be exactly the same for other states. Just following the numbers, right?) This is hogwash, of course. Westerman and co. picked Alexander, a committed conservative ideologue, to tell them what they wanted to hear. That leads to red meat like bumper-sticker-ready stats on the "economic burden on employed persons," using employment and SNAP/Medicaid stats to state that "each employed person in Arkansas supports an estimated 0.94 persons who are receiving welfare assistance," never mind that most SNAP and Medicaid beneficiaries are children and the elderly, not working-age...or that many receiving public assistance are themselves working...or that not everyone considers low-income human beings receiving public assistance to be a "burden."
Snark aside, $220,000 is a tiny fraction of the total Medicaid budget and constructive ideas for reform, including from the conservative end of the political spectrum, are always worth considering. Anyone that believes that safety-net programs are important should be committed to making them as effective and efficient as possible. Many of Alexander's recommendations are either familiar or vague, so I'm not sure how much practical impact the report will have beyond the talking-point ammo. But a critical look at state programs, with an eye for innovation, is a positive thing. It's just hard to take it seriously from a group that, for example, this morning trumpeted a "correlation" between Great Society programs and a decline in two-parent households (no mention that there is no evidence of causation). It's hard to take the discussion seriously when the very lawmakers excited by the report's findings make sure to demonize beneficiaries, convinced that the single most important issue is that someone, somewhere, might be cheating the system.
Also at today's meeting agency heads testified in response. They were magnanimous, stating they were appreciative of the second opinion and noting many areas in which they are already pursuing efficiencies, sometimes mirroring recommendations in the report.
After the jump, a little more on Alexander.
, compiled by opponents of Alexander's policies in Pennsylvania, for more on what his vision looks like in practice. In addition to his unpopular policies, Alexander also drew controversy in Pennsylvania for spending $20,000 in state money on a flag pole
even as his department was slashing services, setting up a private business on the side while working for state government
, and charging the state for his massive commute from Rhode Island
. Meanwhile, Alexander's controversial $104,470 special assistant, Robert Patterson, resigned because of his role as the editor of an extreme conservative journal, "Family in America":
In announcing Patterson's exit, the Corbett administration distanced itself from views expressed in the journal, which has criticized key welfare programs administered by the Department of Public Welfare and offered opinions that women should be stay-at-home mothers and opposing birth control - as well as musings on how condom use could rob women of reported mood-enhancing benefits of chemicals in semen.
Yikes. Some more on Patterson's work:
Patterson began writing for the publication in 2004 and was named editor in 2009. The journal is published by the Howard Center for Family, Religion and Society in Rockford, Ill., which opposes abortion, divorce, birth control, feminism, and homosexuality, and advocates for a "child-rich, married-parent" family.
In his columns, Patterson presents, summarizes, and opines on research relating to families.
They include entries on how children of single mothers are more likely to be overweight and those of working mothers more likely to be a "couch potato," and how women who take the Pill are less likely to find "Mr. Right."
He also authored a piece advocating scaling back assistance programs such as Medicaid, food stamps, and cash assistance for the poor.
The programs, he argued, are the legacy of President Lyndon B. Johnson's Great Society and War on Poverty - which, Patterson argued, produced "more of a quagmire than Vietnam ever was."