Illustrating the Difference Between Agendas and Legislation Essay

Pages: 5 (1700 words)  ·  Bibliography Sources: 5  ·  File: .docx  ·  Level: Master's  ·  Topic: Healthcare

Budgetary Analysis

The processes of writing policy and funding policy, which are essentially distinguished by the authorization of activities to implement policy and the budgetary appropriations that will fund the activities, are imperfectly aligned. Policymaking is arduous and complex, and it is not unusual for the intentions of lawmakers to conflate with earlier legislative intent. Authorizations that have lapsed may continue to receive funding appropriations. Mandatory or direct spending may continue without being associated by an annual or regular appropriations bill. Examples of mandatory spending include benefits such as Social Security, Medicare, and Medicaid. The Congressional Budget Office conducts cost estimates of mandatory spending programs, and the spending of these entitlement programs may change in response to structural or eligibility modifications.

A constellation of approaches is available for budgeting by the states, including incremental budgeting, performance budgeting, zero-based budgeting, and modified zero-based budgeting. A program budgeting approach is dominant across the states, followed by incremental budgeting.

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Generally, four basic phases to budget processes occur at the state level: Preparation, adoption, implementation, and audit. In the fall of each year, budget preparation begins in earnest. Agencies in the states generally submit funding requests to the governor, and the state budget office staff reviews the requests. State level budget reviews are comprehensive and may include national economic analysis, revenue estimates, program specific demographic and caseload estimates, and also evaluations of program management and performance. Collaboration between the legislature and the budget office is variable from state to state, but the intention is to establish projections for caseload and revenue. The budget committee holds public hearing with various state agencies to review the requests and establish a Revenue Forecast, which is the basis for a comprehensive recommendation to the governor of the state. Typically, the Budget Committee and the State Budget Agency formulate a draft of the budget bill, which the governor delivers to the General Assembly.

Essay on Illustrating the Difference Between Agendas and Legislation Assignment

The second phase of the budget process entail legislative adoption of the budget. The legislative review of the budget begins when the Speaker of the House assigns the budget bill to the House Ways and Means Committee. Hearings and deliberations take place, along with second and third readings of the bill. The Appropriations Committee in the Senate receives the House version of the budget bill. More hearings, deliberations, and readings ensue. The conference committee negotiates the final budget and submits the revised recommendations to each chamber for adoption or rejection. An approved budget is then sent the governor for signature or a veto.

The third phase of the budgetary process is implementation, during which accounts are established and allotments are scheduled. The Budget Committee continues to provide legislative insight of the budgetary implementation. The Auditor of the State provides the accounting oversight and reporting, while the Budget Agency publishes the revenue forecast an annual reports on the use of funds. The Budget Director is authorized to carry out transfers of appropriations as authorized by law. The State Budget Agency may make inter-agency transfers in conjunction with the Governor, the State Board of Finance, the Auditor of the State, and the State Treasurer. In the final phase of the budgetary process, the State Board of Accounts provides audit reports and issues opinions that have been prepared by the State Auditor.

Budgetary Changes and the Community

Changes in the state budget are difficult for people in the community to absorb, whether they are agency staff or beneficiaries. There is an adage that it is harder to take something away from people than it is for them never to have received it. A good example of this is the eligibility changes made with regard to the age at which people can receive Social Security without penalizing their earnings from other sources. Social Security eligibility has undergone several iterations and no longer provides benefits for everyone at age 64. Indeed, the eligibility age is now categorically determined by year of birth. Psychologists assert that people are very quick to accommodate to benefits, even when they are preferred and not necessarily needed. But when people truly depend on benefits, reducing them or taking them away completely is devastating. One can imagine the reaction if the federal government had tried to take back benefits from people already receiving them, in accordance with the new retirement age eligibility tiers.

Given the extraordinary corporate tax advantages in this country -- and the solid evidence that the trickle down theory does not work -- recommendations are for building a budget surplus through increased and new taxation. Additional tax revenue would permit additional funding of entitlement programs. It is important to recognize that not all states offer Medicaid expansion funded programs to citizens; indeed, a number of Republican-led states have not participated in Medicaid expansion as a way of protesting against the Affordable Care Act. While states are eager to attract enterprises through low business taxes, this does not justify passing the burden of business development to those who can least afford to bear it. Indeed, in many states -- Texas included -- unmarried people who do not have children are not eligible for Medicaid regardless of how low their incomes are; the expansion of Medicaid would have been a substantial effort to harmonize health policies for people living in poverty.

The political climate in the state of Texas is particularly interesting since, historically, the state has produced several politicians who have successful run for President. Indeed, the political climate today evidences several aspiring candidates for the office of the President of the United States. In addition, Texas is a hotbed of conservative, independent-minded, card-carrying NRA members, the biggest share of whom simultaneously -- whether tacitly or overtly -- supporting an extraordinary level of economic inequality (Phillips, 2014). The business columnist at the Houston Chronicle wrote about the Texas agenda on climate change and the new EPA regulations, but the comment is also applicable to receptivity to regulation in the state of Texas in general. To wit: "Many Texas business and political leaders condemned the new rule before it was released: Any change is dangerous, any rule is unacceptable. They'll engage in long-running taxpayer-financed legal battles they'll likely lose, wasting time and money better used innovating" (Phillips, 2014).

While a majority of state governors chose Medicaid expansion under the Affordable Care Act, then Governor Rick Perry has repeatedly refused to do so -- along with 24 of his state governor peers (Silverman, 2014). With the expansion, roughly 1.5 million people living in Texas who currently do not have health insurance would be eligible for Medicaid -- a system that nearly anyone with a job has paid into for year, perhaps decades (Silverman, 2014). Note that the federal government pays 100% of the costs of the health care program for the first three years, and during the fourth year, Texas would need to contribute 10% of the program's health care costs (Silverman, 2014). Perry claimed that the 10% contribution would bankrupt the state. Abbott concurs, stating: "What I don't want to do is bankrupt Texas by imposing on Texas the overwhelming Obamacare disaster…If Texas participates, we are making a deal with a federal government that is $18 trillion in debt, that is a bargain I'm not willing to make" (Silverman, 2014). Abbot would like to reform Medicaid and obtain a block grant for a revised program. And so, the poor people in Texas are held hostage and will do without healthcare as the Texas governor and state government have determined that it is more important to make their point about the debt ceiling than it is to ensure the people of Texas are well served by their government. Wendy Davis, on the other hand, said,

"What I will do is work with my legislature, Republicans and Democrats alike, who know this is the right thing to do for their communities, who aren't afraid of being labeled as partisans…I'll work with them to bring their tax dollars, our community tax dollars back to Texas and to keep property taxes from increasing."

Hospitals in Texas and the Chambers of Commerce are lobbying to have the state accept the money; this pressure comes partly from he more than $5 billion absorbed by hospitals each year in uncompensated health care to provide needed services to Texans, and partly from the business sector that rightly asserts workers without healthcare are not as productive or innovative. The Texas agenda continues to be focused on a bipartisan group of state legislator who intend to try again to reform Medicaid.

The Texas agenda is grounded in opposition politics, which a hard game to perpetuate since sooner or later constituents want to see some (any) bills made into laws. According to the Daily Briefing of The Advisory Board Company. Governor Rick Perry (R) and the Republican majority in the state Legislature unanimously rejected the Medicaid expansion, even in the face of the Democrats' action, which was to introduced House Bill 3791, legislation that would establish a strategy to expand Medicaid ("Daily Briefing," 2015). The bill was… [END OF PREVIEW] . . . READ MORE

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