Hiltzik: The GOP war on children’s health

Question: Is there anything more absurd than red state governors rejecting federal programs that directly benefit their constituents?

Easy answer: Yes. It’s the explanations they give to make their actions appear to be sober, responsible fiscal decisions.

The Republican governors of Iowa and Nebraska brought us the most recent examples of this phenomenon just before Christmas.

The issue in both states is a summer food program that provides $40 a month per child in June, July and August to families eligible for free or reduced-price school meals.

The program is known as the Summer Electronic Benefit Transfer Program for Children, or Summer EBT. Its purpose is to give the eligible families a financial bridge during the months when their kids aren’t in school.

The governors didn’t see it that way. Here’s how Iowa Gov. Kim Reynolds justified her decision to reject the federal subsidy for low-income Iowans: “Federal COVID-era cash benefit programs are not sustainable and don’t provide long-term solutions for the issues impacting children and families.”

Nebraska Gov. Jim Pillen’s explanation was, “I don’t believe in welfare.”

Both governors said their states already had programs in place to address food needs for low-income families, and that was enough.

It’s worth noting that the explanations by both Reynolds and Pillen are fundamentally incoherent. What does Reynolds even mean by calling the program “not sustainable”? It would be sustained as long as Congress continues to fund it, which is almost certain as long as Republicans don’t take control of both houses and kill it.

As for Pillen’s crack about “welfare,” he didn’t bother to explain what he believes is wrong with “welfare” as such; he just uttered the term knowing that it’s a dog whistle for conservative voters aimed at dehumanizing the program’s beneficiaries.

What makes these governors’ refusals so much more irresponsible is that the federal government is picking up 100% of the tab for the benefits; the states only have to agree to pay half the administrative costs. Their shares come to $2.2 million in Iowa and $300,000 in Nebraska, according to those states’ estimates.

In return, 240,000 children in Iowa would receive a total of $28.8 million in benefits over the three summer months, and 150,000 Nebraskans would receive a total of $18 million. Sounds like a massively profitable investment in child health in those states.

The governors’ defenses smack of the same strained plausibility of those statements made by banks, streaming networks and other commercial entities that explain that their price hikes and service reductions are “efforts to serve you better.”

The politicians are asserting that they’re doing their taxpayers a big favor by watching eagle-eyed over their state expenditures, without mentioning how much they’re giving up to show themselves as budget hawks — or how many citizens will suffer in the process.

Reynolds’ defense of her action was particularly fatuous. “An EBT card does nothing to promote nutrition at a time when childhood obesity has become an epidemic,” she said.

Not only is there no evidence that family food purchases under this or any other federal program promote obesity, the truth is just the opposite. It’s universally accepted among poverty and nutrition professionals that food insecurity, which is rampant among low-income families, increases obesity rates.

Iowa and Nebraska may not be the only red states turning down the summer food program. By the Jan. 1 deadline to accept the program, 30 states had done so, including at least nine red states. But the list published by the Department of Agriculture may not be complete as of this writing. Iowa and Nebraska, however, are the only two states that have announced their opposition publicly.

The governors’ announcements drew immediate fire from anti-poverty advocates.

“Announcing three days before Christmas that we’ve deliberately chosen not to feed hungry kids? The Dickensian parallels write themselves,” said Luke Elzinga, chair of the Iowa Hunger Coalition.

These aren’t the only cases in which Republican state administrations have visited what we might call the GOP death wish upon their residents.

In 10 states, Republican governors or legislatures (or both) have blocked the expansion of Medicaid for low-income residents under the Affordable Care Act for a decade, even though the federal government picks up 90% of the benefit costs. Kansas Gov. Laura Kelly, a Democrat, has tried to implement the program in her state, but the Republican-controlled Legislature has refused to provide money for the expansion in the state budget.

Nebraska did not implement Medicaid expansion until 2020, only after voters demanded the expansion through a ballot-box measure in 2018. (Iowa accepted it upon its introduction in 2013, effective the following Jan. 1, under Republican Gov. Terry Branstad.)

The hostility of red-state political leaderships to public health measures also is evident from their records on COVID treatments, especially vaccines. COVID death rates have consistently tracked the level of the Trump vote in the 2020 election: The COVID death rate in the reddest counties (i.e., those with the largest percentage of Trump votes) is nearly three times that of the bluest counties.

COVID vaccination rates are a mirror image of the same trend: Counties that Trump won have lower vaccination rates than those that went for Biden in 2020, surely a reflection of the efforts by conservative Republican political leaders to deliberately undermine confidence in the vaccine and block vaccine mandates.

Efforts to roll back child labor laws, especially to allow children to work in hazardous conditions, have been on the rise, particularly in red states. In May, Iowa’s Gov. Reynolds signed one of the most extreme rollbacks in the country.

The new law allows employers to hire children as young as 14 to work in industrial laundries or factories; for kids aged 16 and 17 to do demolition, roofing, excavation and power-driven machine operation, all of which were previously prohibited; and to allow teens as young as 14 to work shifts as long as six hours during the school year, among other changes. Most of these changes violate federal law, the Dept. of Labor advised the Iowa Legislature. They passed anyway.

Of the 10 states that passed rollbacks of child labor protections in 2021-2023 as tracked by the union-affiliated Economic Policy Institute, seven were Republican-controlled.

The announcements by Reynolds and Pillen seem almost tailor-made to validate the adage that for Republicans, “life begins at conception and ends at birth.” Iowa and Nebraska are antiabortion states.

Iowa requires a 24-hour wait time to receive an abortion, bans coverage by state Medicaid and requires parental consent for a minor’s abortion. Nebraska is much more restrictive. Abortion is banned at 12 weeks or later, Medicaid coverage and coverage by private health plans are banned, and medication abortion (that is, by pills) must be provided in-person because mailing pills to patients is prohibited.

In other words, despite making it harder for women to terminate unwanted or dangerous pregnancies, both states make it harder for low-income mothers to care for their children. Catch-22 doesn’t begin to explain how these policies are meant to act together to “make a real commitment to family well-being,” in Reynolds’ words.