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Judy’s Notebook: As House Votes on Health Law, Washington’s Disconnect

Tourists use umbrellas for shade as they tour the U.S. Capitol grounds. Photo by Chip Somodevilla/Getty Images

Update, 4:30 p.m. For the second time since the Affordable Care act was passed in 2010, the House has voted to repeal the health care reform law in its entirety. The 244-185 vote Wednesday afternoon split largely along party lines, with five Democrats voting in favor of repeal.

Now that we’re in the middle of what may be the hottest summer ever in Washington, some of us who live in the nation’s capital have persuaded ourselves – if only for a moment – that we’re in sync with the rest of the country. After all, temperature records are being broken from one end of the nation to the other, including right here in the District of Columbia. But that heady feeling threatens to disappear as we look around us.

Watching the action on Capitol Hill this week raises the question of how seriously connected Washington is to the 50 states: Is it on a singular track, cut off from what “real people” are thinking? Lawmakers are buzzing around the Capitol building, casting votes and holding meetings. Members of Congress look especially busy as they scurry to and from the House floor to take turns speaking about whether President Obama’s Affordable Care Act, the health care reform plan upheld by the Supreme Court recently, should be repealed. House members have already voted more than 30 times to repeal or partially roll back the law, so by now, arguably, those opposed – almost all Republicans – have made their views clear.

All this is despite the fact there is virtually no chance the Democratic-controlled Senate would agree, and zero chance the President would sign a repeal, ensuring the entire exercise is more about making a statement than changing laws. This would hardly be the first time Washington engaged in a little symbolism: both political parties, presidents past and present and members of the House and Senate have taken turns posturing for public consumption.

But while this is taking place, several Republican governors are starting to make choices about accepting federal funds for health care that would have very real consequences for the poorest citizens of their states. In Texas, Governor Rick Perry has said he will not accept up to $76 billion dollars in federal funds to expand his state’s Medicaid program, money that would help around 2 million low-income Texans. “We’re just not going to be a part of again socializing healthcare in the state of Texas and going in direct conflict with our founding fathers’ wishes and freedom,” Perry said Monday on Fox News.

Patients wait in line to get checked in at Houston’s Ben Taub General Hospital. Photo by Aaron M. Sprecher/AP Images for Kaiser Health News

Other GOP governors, including Rick Scott of Florida and Bobby Jindal of Louisiana, have also indicated they may not accept federal dollars that would enable more poor people to be covered. Jindal is already facing more than $800 million in cuts to existing Medicaid expenditures due to a separate Congressional vote, cuts the Associated Press described this way: “On the chopping block are charity hospitals, rural hospitals, hospice care, a breast and cervical cancer program and the rates paid to nursing homes, doctors and other health providers who take care of Medicaid patients.” A Jindal administration official says the cuts are “doable.”

In Florida, Gov. Scott has already mandated cuts in health and human services agencies, leading to shrinkage of children’s medical programs and the state’s infectious disease control budget, as well as shutting Florida’s leading hospital for treating tuberculosis at a time when news outlets like the Palm Beach Post report a rise in TB infection.

Some of these cuts may be justified, and there is speculation Gov. Perry and the others won’t go through with their tough talk about Medicaid. But the fact that all this is at stake makes one wonder if Washington is paying attention as it busies itself with yet another symbolic vote.

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