What was only a sad set of House proposals regarding Medicaid “reform” set forth, in part, here, has now been accepted in an accord between the 2 versions.  And I can’t figure out, and not for the first time, why nobody is screaming.  
The accord reached by both houses largely affirms the ugly version of the proposals to change Medicaid put forth in the House bill.  And yet nobody is screaming.  And I’m starting to feel physically ill.

Medicaid is the health insurance provider for more than 50 million people nationwide.  The changes will allow states to charge premiums, to increase co-payments and to deny coverage for services that are
currently covered under the program.

And then there’s this.  For those who fail to pay their premiums, States will now be permitted to deny coverage and providers can deny services.  

And yet nobody is screaming.

NYT Link

In addition, states can end Medicaid coverage for people who fail to pay premiums for 60 days or more. Pharmacists can refuse to fill prescriptions, and doctors and hospitals can deny services, for recipients who do not make the required co-payments.

So for those in financial difficulty and least able to provide for their own needs, legislators would prefer to make things even more difficult.  Kick them when they’re down, so to speak.

Republicans hailed the final budget bill as evidence of their determination to rein in the automatic growth of benefit programs.

Representative Joe L. Barton, Republican of Texas, the architect of the Medicaid provisions, said the higher co-payments were needed to “encourage personal responsibility” among low-income people.

At a time when billions more is being authorized for the sorry spectacle that is the illegal Iraqi invasion, Republicans would cut vital social programs, programs that assist many children.  Encouraging personal responsibility amongst the poor, but not amongst power-drunk legislators bent on securing every drop of oil extant for the benefit of big business?  But that’s apparently not a concern because none of those damned rugrats can vote.  And let’s be truthful here, their parents are, well, poor.  So fuck ’em.  (I’m beginning to understand why nobody is screaming.)

And how about this further screwing of the poor:

The agreement also gives states new authority to charge co-payments as a way to discourage the use of high-cost drugs…

Because we wouldn’t want goddamned poor people to have the benefit of high cost drugs.  Those are only for rich people, right?

But let’s not overlook the concerns of all-important big business.  (All bow down!)

Drug makers and health insurance companies escaped largely unscathed. Negotiators rejected several provisions of the Senate bill that would have cut their payments.

And yet, nobody is screaming.

Update: From CNN (Darth Cheney intervenes):

CNN link

WASHINGTON (AP) — The Republican-controlled Senate passed legislation to cut federal deficits by $39.7 billion on Wednesday by the narrowest of margins, 51-50, with Vice President Dick Cheney casting the deciding vote.

The measure, the product of a year’s labors by the White House and the GOP in Congress, imposes the first restraints in nearly a decade in federal benefit programs such as Medicaid, Medicare and student loans.

So the richest amongst them casts the vote to decide the fate of the poorest. How fitting.