Tags: states, states counterplan, camp09,

What follows is a an organized collection of all of the cards that have been put out at various camps to answer the states counterplan for different affirmative cases.

This listing is not comprehensive in that it only includes cards from camp materials that we've had access to to date (8/2) and we have not reproduced every single states counterplan answer card -- only the ones that made different arguments. We did our best to minimize the reproduction of repetitive evidence.

We hope that you will be able to take advantage of this organized collection in a number of ways:

a) If you are running one of these affirmatives, this is a quick way to gain some states counterplan answers

b) If you are interested in running the states counterplan, you should go through each of these arguments and write blocks to answer them, as well as a specific counterplan text for each affirmatives. You can find an organized listing of the various plans here.

c) You should be able to quickly see what affirmatives have strong states counterplan answers and what ones do not.  We suggest running an affirmative with a strong set of states counterplan answers.  We also suggest beating as many affirmatives as you can with the states counterplan and then spending your time preparing more specific strategies against other affirmatives.  Given the weakness of some of these states counterplan answers, you should be able to quickly see what affirmatives you can beat with the states counterplan.

We also strongly suggest Winning the States Counterplan in (Almost) Every Debate

__ABORTION


The Hyde Amendment is an important symbol for the anti-abortion movement.
Fried, director of the Civil Liberties and Public Policy Program, 2007
(Marlene, William Patterson University.edu, “Hyde Amendment: the opening wedge to abolish abortion,” Winter 2007, http://www.wpunj.edu/~newpol/issue42/Fried42.htm, accessed July 9, 2009, GD).
Passing the Hyde Amendment was the first big victory for the anti-abortion movement and evidence of its growing political clout. It was also a clear example of the anti-abortion two-pronged strategy of pushing for restrictions on abortion in the short-term while pursuing a full ban in the long-term. In response to the challenge that the Amendment was a vote against poor people, Rep. Hyde said during the floor debate, "I would certainly like to prevent, if I could legally, anybody having an abortion, a rich woman, a middle class woman, or a poor woman. Unfortunately, the only vehicle available is the HEW Medicaid bill. A life is a life."5

The federal government is the only viable solvency option – states have no long term solutions to their budget crises and need immediate federal government support.
Families USA, non-profit organization supporting healthcare, 08
(FamiliesUSA.org, 7-2008, http://www.familiesusa.org/assets/pdfs/state-budget-cuts-2008.pdf, accessed 7-1-2009, AEL)
State leaders often have a knee-jerk tendency to cut Medicaid and other safety net programs when their state is in a fiscal crisis. As mentioned above, states often have no choice but to balance their budgets, so they must either make cuts or increase taxes, neither of which is popular or even politically feasible. States do have a few other options to avoid making drastic cuts in Medicaid and other important programs, such as tapping tobacco settlement or rainy day funds (see “Sin Taxes and Other Funding Sources” on page 9), but these measures are short-term solutions that do not boost a state’s economy. These measures are not long-term solutions, and they should not be seen as a substitute for federal action. During a national recession, only federal relief can help states protect and sustain Medicaid. As the nation’s economy continues its downward spiral, Medicaid programs in a number of states are in jeopardy. Several states are proposing to balance their budgets by making cuts to Medicaid in the form of raising cost-sharing amounts, shrinking eligibility, or reducing benefits. Many of these cuts can be minimized or averted if Congress acts now to bring fiscal relief to the states.

Federal action is key to solve the “chilling effect” and prevent more restrictive state legislation
Stewart, MD, UCSF Center for Reproductive Health Reseach & Policy; Wayne C. Shields, ARHP President and CEO; Ann C. Hwang, MD, UCSF Center for Reproductive Health Research & Policy, 04
(Felicia H. Stewart, “The federal abortion ban: a clinical and moral dilemma, and international policy setback,” Contraception 69 (2004) 433–435, Elsevier. JM)
The only logical extension, based on the valuation of the fetus as a child, is that other kinds of abortion will also face bans or restrictions on the basis that they too are “inhumane” to the “unborn child.” Anti-abortion legislators are already pursuing this logic: a recently proposed Virginia law requires that fetuses receive pain medication (through the pregnant woman) before abortions after the first trimester [4]. This proposed law builds on the use of a “cruelty to fetuses” argument that legitimates subjecting pregnant women to interventions that have nothing to do with protecting their health. The ultimate result of this logic can be found in South Dakota's recent proposed law that bans all abortions unless a mother's life is in danger. There is no exception for rape victims or women who could suffer permanent serious health problems from delivery. The chief sponsor of the proposed legislation, Republican Rep. Matt McCaulley, explained, “When we're considering an innocent life, the health of the mother is not a substantial enough justification to take the innocent life” [5].  In addition to furthering a fetus-centered framework for abortion (which lays the groundwork to ban all abortion), the Federal Abortion Ban is the first federal law to criminalize abortion since the U.S. Supreme Court decision in Roe v. Wade legalized abortion in the United States in 1973. Physicians convicted of performing the procedure face up to 2 years in jail. Incarceration is a serious threat, and one that undoubtedly intimidates potential providers. In addition, the “chilling effect” of criminalization may deter clinicians from a wider range of patient care, education, and research activities than is explicitly banned. Physicians challenging the ban in court have had their patients' medical records subpoenaed by the U.S. Department of Justice. The Justice Department argues that the records are needed to counter the plaintiffs' claim that procedures outlawed by the Federal Abortion Ban are at times necessary to preserve a woman's health. Opponents of the subpoena worry that the Justice Department is violating patients' privacy and intimidating and harassing abortion patients and providers. In some cases, judges have rejected the subpoena, agreeing that turning over the records would violate patients' privacy protections.  The chilling effect has international implications as well, by discouraging reform of restrictive abortion laws. The Mexico City Policy, or “global gag rule”, currently bans foreign non-governmental organizations from receiving U.S. family planning aid if they provide any abortion-related counseling or advocate liberalizing abortion, with their own funds. Like the global gag rule, the Federal Abortion Ban is likely to create confusion about what is and is not banned, and thus has the potential to “chill” a much broader range of clinical and educational activities.  Finally, Federal Abortion Ban supporters are exploiting and fomenting discomfort over late term abortions, even though the law is written in a way that applies to abortions over a much broader range of gestational ages. Some abortion-rights advocates might understandably believe that restricting or banning later term abortion would be a reasonable compromise to shore up public support for abortion rights, given that the vast majority of abortions in the United States occur in the first trimester [6]. But ceding this issue in the hopes of establishing a truce or compromise is simply misguided. The Federal Abortion Ban specifies no gestational limits, and the ban itself is predicated on principles antithetical to allowing women to make decisions about their pregnancies: namely, that fetal “interests” can overcome the health considerations of the pregnant woman, and can justify the criminalization of medically appropriate care


 the Hyde Amendment is preventing states from being able to pay for abortions through Medicaid
Schewel, Ph.D., 2006
(susan, Womens health network, “The Hyde Amendment's Prohibition of Federal Funding for Abortion -- 30 Years is Enough!”, http://www.nwhn.org/newsletter/article1.cfm?newsletterarticles_id=106,  October 2006, accessed 7-1-09, NG )
For the 12.8 million women of reproductive age who depend upon Medicaid for health care today, the impact of the Hyde Amendment is staggering.4 Between 1973, when abortion was decriminalized nationally, and 1977, when the Hyde Amendment went into effect, Medicaid paid for about one third of all U.S. abortions.5 Today, women who are least able to pay for an abortion must cobble together the fee or continue an unwanted pregnancy to term. In Philadelphia, a first trimester abortion costs about $350, but delays can result in fees as high as $2,000. Women who are able to raise the money for an abortion often do so at great cost to themselves and their families—using meager public assistance checks or paychecks from low-wage jobs, forgoing payments for rent and heat, sometimes risking homelessness or resorting to prostitution. The time it takes to raise the needed money means that lowincome women often have to delay their abortion procedure by two or three weeks; as a result, they are more likely to have later abortions and to need more complicated and expensive second trimester abortions than do women with higher incomes.6 Those who continue the pregnancy to term may be forced to stay in abusive relationships, end their formal education, or experience greater difficulty raising their children with dignity. When the Hyde ban was implemented, the pro-choice movement immediately challenged this inequitable measure in the courts. In 1980, the Supreme Court found the Hyde Amendment to be constitutional. Since its inception, both Congress and the courts have fluctuated about including exceptions to the Medicaid coverage ban. Presently, federal Medicaid funds can be used in cases where the pregnancy resulted from rape or incest, or if the pregnancy endangers the woman’s life. Yet states have set up myriad bureaucratic hurdles that make it difficult for individual women—often already traumatized by the circumstances of their pregnancy—to take advantage of these exceptions.

Only the federal government can pay for women that are under federal health plans
NNAF, 2008
(National Netword of Abortion Funds, “Abortion Funding” , 2005, accessed 7-05-09, NG)
The central problem is the denial of funding for abortion in government health programs for low-income people. When abortion first became legal in 1973, poor women who qualified for healthcare through the Medicaid program were covered for abortion just as they were for other medical care. But only three years later, Congress passed the Hyde Amendment, banning federal Medicaid funding for abortion. No other medical procedure was singled out for exclusion. Today, 33 states have followed suit, prohibiting state Medicaid funding as well. Bans on Medicaid funding for abortion burden some of the most disadvantaged women in our society – those who rely on the government for healthcare. Given racial inequalities, women of color disproportionately depend on such coverage, making abortion funding a matter of racial justice as well as economic justice and women’s rights. Young women and rural women are also hard hit by funding bans. In addition, Congress denies abortion coverage to many other women who rely on federal health plans: women in the U.S. military and Peace Corps, federal employees, disabled women, residents of the District of Columbia, federal prisoners, and women covered by the Indian Health Service.

Only federal government can guarantee abortion rights for female prisoners. 
Martin, managing editor, 2006
(Brent, Missourinet, “Prison Abortion Rights Upheld,” 7/18, http://www.missourinet.com/gestalt/go.cfm?objectid=40EBA924-6FFF-419D-9500747473D76EBF, 7/5/09, GMK)
A court ruling that forced the state to transport a pregnant female prisoner to an abortion clinic last year has been made to apply to all women in Missouri prisons. Federal Judge Dean Whipple has ruled that the US Supreme Court order that Missouri provide the transportation and guards to the inmate, known only as Jane Roe, applies to any pregnant inmate who wants an abortion. Whipple made the original ruling that the state must provide transportation and guards so that Roe could be taken from the Vandalia prison to a St. Louis abortion clinic. The state estimated the cost for transportation and guard salaries at $350. Roe had been sentenced to four years in prison after being arrested for probation violation in California. She had an abortion October 20th, three days after the US Supreme Court upheld Whipple's ruling. The American Civil Liberties Union asked the court to make the ruling a class action on behalf of all pregnant women imprisoned in Missouri. The ACLU states that at least one female inmate was denied transportation to an abortion clinic since the Roe case. Governor Blunt has urged the Attorney General to appeal the decision, stating, "This ruling violates our traditional Missouri values and is an affront to everyone that values the sanctity of human life."

State programs fail. Several laws require deliberate misinformation to turn away abortions.
Human Rights Watch 06
(“U.S.: Abortion Regulations Undermine Women’s Right to Choose” 10-26-06, http://www.hrw.org/en/news/2006/10/29/us-abortion-regulations-undermine-women-s-right-choose , Accessed 6-29-09, KLM)
The mounting obstacles to abortion services include in some states a legal requirement to provide medically inaccurate information as part of obligatory pre-abortion counseling. For example, some state regulations compel doctors and nurses to say that abortion leads to breast cancer and that fetuses feel pain throughout the pregnancy. Both claims are scientifically unfounded.  “These regulations undoubtedly are a back-door attempt to curtail women’s rights. There is a direct assault on women’s right to safe abortion through deliberate misinformation,” said Marianne Mollmann, advocacy director in Human Rights Watch’s Women’s Rights Division.  Several U.S. state laws and regulations on abortion may in fact contravene Supreme Court rulings. Since 1973, the Supreme Court has consistently held that states cannot place an “undue” regulatory burden on a woman or girl seeking to terminate her pregnancy. But some regulations do just that, notably where the law compels the mandatory imposition of false information.  States have also sought to curtail access to abortion by re-imposing criminal sanctions for the provision of services. Most prominent is the blanket ban on abortion in South Dakota, signed into law in March, and subject to a state referendum during the mid-term elections next week. South Dakota’s law makes abortion illegal except when the procedure is carried out to save the pregnant woman’s life. Several other states, including Georgia, Indiana, Ohio, Louisiana and Tennessee, have moved to enact similar legislation.  

States don’t have adequate funding for all abortions
Boonstra, Senior Public Policy Associate at the Guttmacher Institute, 2007
(Heather D, Guttmacher Policy Review, The Heart of the Matter: Public Funding Of Abortion for Poor Women in the United States, Winter 2007, http://www.guttmacher.org/pubs/gpr/10/1/gpr100112.pdf, 6-29-09, AMG)
Perhaps the most tragic result of the funding restrictions, however, is that a significant number of women who would have had an abortion had it been paid for by Medicaid instead end up continuing their pregnancy. A number of studies have examined how many women are forced to forgo their right to abortion and bear children they did not intend. Studies published over the course of two decades looking at a number of states concluded that 18–35% of women who would have had an abortion continued their pregnancies after Medicaid funding was cut off. According to Stanley Henshaw, a Guttmacher Institute senior fellow and one of the nation’s preeminent abortion researchers, the best such study, which was published in the Journal of Health Economics in 1999, examined abortion and birthrates in North Carolina, where the legislature created a special fund to pay for abortions for poor women. In several instances between 1978 and 1993, the fund was exhausted before the end of the fiscal year, so financial support was unavailable to women whose pregnancies occurred after that point. The researchers concluded that about one-third of women who would have had an abortion if support were available carried their pregnancies to term when the abortion fund was unavailable.

Hostile states limit access to abortions. 
Towey, Poggi and Roth, communications director, executive director, PhD in Political Science at Yale University, 2005
(Shawn, Stephanie, and Rachel, National Network of Abortion Funds, “Abortion Funding: a Matter of Justice,” http://www.nnaf.org/pdf/NNAF%20Policy%20Report.pdf, 7/1/09, GMK)
Some six million women of reproductive age (15-44) depend on Medicaid for their health care.3 Because of the Hyde Amendment and state bans on Medicaid funding, the majority of these women are denied coverage for abortion. In 33 states and the District of Columbia, women have virtually no access to Medicaid-funded abortions, unless their pregnancy is a result of rape or their doctors will attest that continuing the pregnancy endangers their life. Even women in these circumstances are frequently denied coverage because of hostile state agencies, bureaucratic barriers, and misinformation. In these 33 states, Medicaid pays for less than 1% of abortions. By contrast, in the 17 states that provide coverage, Medicaid pays for 27% of abortions.

Federal action key to a signal
Guttmacher, 5/8
(“President Obama’s 2010 Budget: A Decidedly Mixed Bag,” Guttmacher Institute, May 8, 2009, http://www.guttmacher.org/media/inthenews/2009/05/08/index.html)

Access to Abortion: Absence of Leadership. The president had the option to assert his prochoice credentials and propose in his budget that the many abortion funding restrictions that exist throughout a range of federal health programs be deleted. The most infamous of these, the Hyde Amendment, prohibits Medicaid from paying for abortions for poor women. The president chose politics over principle on this set of issues. His budget proposal leaves almost all the abortion funding restrictions intact. The one restriction his budget does recommend changing, as a matter of home rule, is the one that bans the District of Columbia from using its own local revenues to pay for abortions for its indigent residents—the way states may do. The administration is sending an ominous signal about the priority that access to abortion services will have in the context of health care reform.


Federal action is key to solve the chilling effect and prevent more restrictive state legislation
Stewart, 4
(Felicia H. Stewart, MD, UCSF Center for Reproductive Health Reseach & Policy; Wayne C. Shields, ARHP President and CEO; Ann C. Hwang, MD, UCSF Center for Reproductive Health Research & Policy, “The federal abortion ban: a clinical and moral dilemma, and international policy setback,” Contraception 69 (2004) 433–435, Elsevier)

The only logical extension, based on the valuation of the fetus as a child, is that other kinds of abortion will also face bans or restrictions on the basis that they too are “inhumane” to the “unborn child.” Anti-abortion legislators are already pursuing this logic: a recently proposed Virginia law requires that fetuses receive pain medication (through the pregnant woman) before abortions after the first trimester [4]. This proposed law builds on the use of a “cruelty to fetuses” argument that legitimates subjecting pregnant women to interventions that have nothing to do with protecting their health. The ultimate result of this logic can be found in South Dakota's recent proposed law that bans all abortions unless a mother's life is in danger. There is no exception for rape victims or women who could suffer permanent serious health problems from delivery. The chief sponsor of the proposed legislation, Republican Rep. Matt McCaulley, explained, “When we're considering an innocent life, the health of the mother is not a substantial enough justification to take the innocent life” [5].  In addition to furthering a fetus-centered framework for abortion (which lays the groundwork to ban all abortion), the Federal Abortion Ban is the first federal law to criminalize abortion since the U.S. Supreme Court decision in Roe v. Wade legalized abortion in the United States in 1973. Physicians convicted of performing the procedure face up to 2 years in jail. Incarceration is a serious threat, and one that undoubtedly intimidates potential providers. In addition, the “chilling effect” of criminalization may deter clinicians from a wider range of patient care, education, and research activities than is explicitly banned. Physicians challenging the ban in court have had their patients' medical records subpoenaed by the U.S. Department of Justice. The Justice Department argues that the records are needed to counter the plaintiffs' claim that procedures outlawed by the Federal Abortion Ban are at times necessary to preserve a woman's health. Opponents of the subpoena worry that the Justice Department is violating patients' privacy and intimidating and harassing abortion patients and providers. In some cases, judges have rejected the subpoena, agreeing that turning over the records would violate patients' privacy protections.  The chilling effect has international implications as well, by discouraging reform of restrictive abortion laws. The Mexico City Policy, or “global gag rule”, currently bans foreign non-governmental organizations from receiving U.S. family planning aid if they provide any abortion-related counseling or advocate liberalizing abortion, with their own funds. Like the global gag rule, the Federal Abortion Ban is likely to create confusion about what is and is not banned, and thus has the potential to “chill” a much broader range of clinical and educational activities.  Finally, Federal Abortion Ban supporters are exploiting and fomenting discomfort over late term abortions, even though the law is written in a way that applies to abortions over a much broader range of gestational ages. Some abortion-rights advocates might understandably believe that restricting or banning later term abortion would be a reasonable compromise to shore up public support for abortion rights, given that the vast majority of abortions in the United States occur in the first trimester [6]. But ceding this issue in the hopes of establishing a truce or compromise is simply misguided. The Federal Abortion Ban specifies no gestational limits, and the ban itself is predicated on principles antithetical to allowing women to make decisions about their pregnancies: namely, that fetal “interests” can overcome the health considerations of the pregnant woman, and can justify the criminalization of medically appropriate care.

Federal action is the only option – state action will produce a patchwork of inconsistent laws
Correia 91
(Edward, The Uneasy Case for a National Law on Abortion, The American Prospect, March 21, http://www.prospect.org/cs/articles?article=the_uneasy_case_for_a_national_law_on_abortion)
As the political conflict over abortion in America has moved from the courts to the elected branches of government, many people have expected that the states, rather than the federal government, would become the key to preserving abortion rights. But while the states undoubtedly will be critical battlegrounds, supporters of reproductive choice do have another option. They can press Congress to enact national legislation guaranteeing the right to abortion. If, as seems likely, the Supreme Court continues to erode and perhaps ultimately reverses Roe v. Wade, federal legislation may be the only way to establish nationwide the reproductive rights that the Court no longer finds protected by the Constitution itself. The logic of national legislation is clear. Leaving abortion policy entirely to the states will produce a patchwork quilt of laws, permissive in states like California and New York, harshly restrictive in others with politically powerful pro-life movements. Recently, for example, Pennsylvania, Utah, and Guam enacted statutes that erect substantial barriers to access to abortion. And as Walter Dellinger has pointed out in these pages ("Should We Compromise on Abortion?" TAP, Summer 1990), even some less draconian regulations on access to abortion pose serious obstacles to many women. Middle- and upper-income women living in the restrictive states may be able to afford travel to take advantage of more permissive laws elsewhere. But poor and otherwise disadvantaged women in restrictive states will be driven to back alleys or forced to accept the lack of alternatives. Only a federal statute can guarantee all women a minimum level of protection. Yet supporters of reproductive rights must face political realities. They are unlikely to persuade Congress to pass an ideal statute. If they cannot bring themselves to support federal abortion legislation that limits choice more than they would prefer, they risk losing the political battle before it begins. Their objective should be to secure a federal statute that provides a floor of minimum protections for choice. If individual states pass more permissive laws, women in those states could still take advantage of them. Pro-choice groups are understandably reluctant to accept limitations on access to abortion that only a few years ago seemed unthinkable. Endorsing a federal law with such limits could appear to lend legitimacy to pro-life efforts to impose those same limits in state laws. As a result, a statute intended to create a "floor" could, at least indirectly, help create a "ceiling" on abortion rights. The task facing advocates of choice, therefore, is complicated and painful. They must decide upon a political strategy that can command a majority in Congress in favor of the broadest freedom of choice possible. They must also be wary, however, of endorsing a minimal federal law that provides little gain to poor women while handicapping efforts to secure wider protections of choice in the states. A pure, uncompromising approach will not succeed politically; whether we like it or not, compromise goes hand in hand with successful legislative strategies. As a practical matter, moreover, it is impossible to set out in advance exactly what compromises pro-choice groups should be willing to settle for. For obvious tactical reasons, proponents of strong legislation never discuss "acceptable" compromises openly, and they even hesitate to discuss them privately. Many a previously unthinkable concession has been made at the eleventh hour when it spelled the difference between a victory in hand and an uncertain outcome in the next Congress. Nonetheless, those concerned about achieving the best protections of choice, particularly in a world without Roe, should be thinking through what they can realistically expect to achieve with national legislation and what issues matter most to women who have to face the prospect of an unwanted pregnancy. In that effort to fashion an approach sensitive to both strategic and moral concerns, it is critical to understand what Congress can, and cannot, be expected to do. The Basis of Congressional Action Any national legislation on abortion will have to meet several tests. The legislation must be framed to make it as likely as possible that the Supreme Court will hold it to be constitutional. It must command enough public support to win a majority in Congress. And it must be capable of generating enough support to override a presidential veto -- or, perhaps, to help elect a new president. To fight for a national law on abortion, only to see it overturned by the Supreme Court as unconstitutional, would obviously be disastrous. It should be possible, however, to meet the test of constitutionality, even with the Court's likely shifts in membership in the 1990s. To be sure, a constitutional amendment guaranteeing abortion rights would minimize uncertainty, but the history of amendment battles, from the Equal Rights Amendment to school prayer to flag-burning, shows that amendments pass only when there is a very broad consensus. On abortion, there isn't one. In framing a national bill to protect abortion rights, therefore, advocates of choice will have to look to the powers given to Congress by the Constitution. Congress has at least three sources of authority to enact such legislation. First of all, it could bar the states from interfering in access to abortion under its authority to enforce the guarantees of individual liberty that stem from the due process clause of the Fourteenth Amendment. This approach is the most intuitively appealing and many legal scholars endorse it. The Supreme Court, however, has never clearly stated how far Congress can go in protecting a personal freedom that the Constitution itself, in the Court's interpretation, does not provide.  Second, the spending power, which enables Congress to put conditions on the receipt of federal funds for health care and other purposes, is probably broad enough to sustain a statute limiting federal funds for states with restrictive abortion practices. This approach, however, is the most politically heavy-handed; it would allow a determined state to thumb its nose at federal funds altogether and potentially end up harming poor people and others in that state who benefit from federal programs.  Finally, the Commerce Clause provides a third basis for a uniform federal law, since inconsistent state laws will drive women to travel across state lines in search of abortion alternatives. This approach is the soundest and safest for ensuring constitutionality. To make the constitutional underpinnings of legislation as solid as possible, Congress should rely on the Fourteenth Amendment and Commerce Clause together.

Medicaid is the critical avenue to protect prisoner’s rights – state policies are deeply discriminatory.
Roth, 04 (Rachel Roth is a reproductive justice scholar and advocate. As a Soros Justice Fellow, she is writing about the impact of imprisonment on women's reproductive rights. “Do Prisoners Have Abortion Rights?” Summer 2004, Feminist Studies, Proquest)

Where litigation is needed, one promising avenue lies in states that provide Medicaid funding. If state courts have already determined that funding bans violate the privacy or equal protection guarantees of poor women in the free world, then poor women in jail and prison can try to marshal those same arguments on their behalf, because all departments of correction pay for pregnancy care. In addition, any class action litigation on behalf of poor women should include prisoners. The Medicaid program also pays for abortions for women who have been raped, as does the federal Bureau of Prisons. State prison policies make no such distinction; in almost all cases, they are silent on the question of sexual assault. A woman who is raped in prison or who winds up in prison after being raped encounters exactly the same official policies and obstacles as any other prisoner. The arbitrary limits imposed on prisoners' access to abortion after the first trimester are another area for possible intervention. Nothing in the Supreme Court's abortion decisions authorizes such limitations before viability; even after viability, abortion bans must include exceptions for women's health. Finally, prisoners may even find recourse in the Planned Parenthood v. casey decision. This 1992 Supreme Court decision was a setback for abortion rights, because it held abortion regulations to a lower constitutional standard than Roe v. Wade and gave a green light to the states to restrict access to abortion.5' Yet the specific language of the casey standard may be useful to women in prison. The Court held that "an undue burden exists, and therefore a provision of law is invalid, if its purpose or effect is to place a substantial obstacle in the path of a woman seeking an abortion." As we have seen, the path to an abortion for imprisoned women is strewn with substantial obstacles, obstacles that prisoners cannot necessarily circumvent on their own. Incarcerated women may be able to prove that restrictive policies "unduly burden" their ability to exercise their rights because of the reality of confinement in prison.52 Incarceration by definition entails the loss of freedom. But does this mean that any and all forms of punishment may be meted out to prisoners? Denying women access to abortion-in essence, forcing them to bear children-constitutes a uniquely gendered form of punishment. Forced childbearing is all the more troubling for prisoners who must endure pregnancy under adverse conditions, only to confront a legal regime that almost guarantees they will lose their parental rights if they have to place their children in foster care for more than one year. This kind of punishment calls into question the legitimacy of state power, especially when it is unwritten, unregulated, and wielded in an arena fraught with race and class bias. Relegated to the far end of a continuum of "reproductive freedom," prisoners' difficulties exercising their constitutional rights serve as stark reminders of the barriers that increasingly characterize access to abortion throughout the United States.

Federal action is key--states will produce a patchwork of inconsistent laws based on local politics.
Correia 91 [Edward, “The Uneasy Case for a National Law on Abortion”, The American Prospect, March 21. Correia is the founder and CEO of Sagacent Technologies. http://www.prospect.org/cs/articles?article=the_uneasy_case_for_a_national_law_on_abortion]
 
As the political conflict over abortion in America has moved from the courts to the elected branches of government, many people have expected that the states, rather than the federal government, would become the key to preserving abortion rights. But while the states undoubtedly will be critical battlegrounds, supporters of reproductive choice do have another option. They can press Congress to enact national legislation guaranteeing the right to abortion. If, as seems likely, the Supreme Court continues to erode and perhaps ultimately reverses Roe v. Wade, federal legislation may be the only way to establish nationwide the reproductive rights that the Court no longer finds protected by the Constitution itself. The logic of national legislation is clear. Leaving abortion policy entirely to the states will produce a patchwork quilt of laws, permissive in states like California and New York, harshly restrictive in others with politically powerful pro-life movements. Recently, for example, Pennsylvania, Utah, and Guam enacted statutes that erect substantial barriers to access to abortion. And as Walter Dellinger has pointed out in these pages ("Should We Compromise on Abortion?" TAP, Summer 1990), even some less draconian regulations on access to abortion pose serious obstacles to many women. Middle- and upper-income women living in the restrictive states may be able to afford travel to take advantage of more permissive laws elsewhere. But poor and otherwise disadvantaged women in restrictive states will be driven to back alleys or forced to accept the lack of alternatives. Only a federal statute can guarantee all women a minimum level of protection.

Congress must act to give substance to Equal Protection.
Kay, 94 (Julie F., Senior Staff Attorney for Legal Momentum, “If men could get pregnant: an equal protection model for federal funding of abortion under a national health care plan”, Spring, 60 Brooklyn L. Rev. 349, Lexis)

Instead of merely relying on the Court's slowly evolving recognition of gender discrimination, the legislature must recognize equal protection guarantees in those areas in which such protection has been weak--for example, with laws governing reproduction. The state's interest in the fetus is not "compelling" if proper emphasis is given to the amendment's negative effects on women and the possibility of less-burdensome alternatives. But until women's interests are valued, the detrimental effects of oppressive legislation will continue to be ignored.  The proposed national health care plan offers not only an  [*397]  opportunity, but an obligation to reconsider abortion funding in the broader context of gender discrimination. Since the Court has been slow to grant women's rights, a legislative solution may be a more effective--and more appropriate--method of facilitating social equality for women.

Government involvement is key – low-income women face dire health risks.
Kay, 94 (Julie F., Senior Staff Attorney for Legal Momentum, “If men could get pregnant: an equal protection model for federal funding of abortion under a national health care plan”, Spring, 60 Brooklyn L. Rev. 349, Lexis)

Moreover, since earlier abortion is safer, any delay in obtaining abortion services increases health risks. Research reaffirms the need for government funding and involvement in providing reproductive health care services. According to one study, when abortion is not publicly funded, 20% of Medicaid  [*364]  eligible women who would choose to have an abortion instead carry their pregnancy to term. n57 Later-term abortions simply are less safe. For example, women are sixteen times more likely to die of an abortion performed in the sixteenth week than in the eighth week of pregnancy. n58 An abortion past the thirteenth week may require a more complicated and dangerous procedure than an abortion earlier in the pregnancy. n59 It is more likely to require a hospital stay or a higher dose of anesthesia. Because pregnancy may involve more of a health risk than abortion, a woman may choose a first trimester abortion for health reasons.  Safety is not a reason for every woman to choose to abort a pregnancy rather than carry it to term. But a woman must be able to choose if she is willing to accept the health risks of continuing her pregnancy, particularly if she has pre-existing medical conditions, such as diabetes or multiple sclerosis, which would be exacerbated. The inequity is clear. By denying access to abortion funding, the government forces a low-income woman to take a health risk which her wealthier counterpart need not take, simply because she cannot afford the price of an abortion.

Only the federal government can solve inequalities in the health care sector, because of their unique expertise, funding, and influence.
Ikemoto, 6 (Lisa C., Professor of Law @ Loyola Law School, “deconstructing the image repertoire of women of color: In the Shadow of Race: Women of Color in Health Disparities Policy”, March 39 U.C. Davis L. Rev. 1023, Lexis)

A. The Federal Government's Influence   The federal government is the most significant actor in the national-level effort to reduce inequalities in health care. n3 State governments and nongovernmental participants, including insurers, can do much to reduce inequalities that impair health care. n4 Yet, a combination of funding and regulatory power enhances the federal government's direct and indirect influence on health care. The federal government is the biggest payer of health care services. n5 These services include programs  [*1029]  that provide care for half of the nation's racial minorities. n6 The Department of Health and Human Services and related agencies provide oversight for much of the access to and quality of health care in the United States. n7 The federal government is a major funding source for biomedical research and has the accompanying regulatory authority over health care access and quality. In addition, history shows that the government has experience in addressing inequality in health care. As a result, the federal government has unparalleled direct and indirect influence over health care policy and practice.

Only the Court scrutiny of equal protection is key to solve discrimination and human right violations.
Kay, 94 (Julie F., Senior Staff Attorney for Legal Momentum, “If men could get pregnant: an equal protection model for federal funding of abortion under a national health care plan”, Spring, 60 Brooklyn L. Rev. 349, Lexis)

A revised equal protection model, which considers gender as a suspect class and de-emphasizes the discriminatory legislative intent requirement, offers greater protection from legislation that oppress women. The Court should concentrate not on whether a legislative goal to classify by gender is substantially related to important governmental ends, but instead should ask: "Has the challenged action harmed women in ways that enforce, perpetuate, or aggravate their subordinate social status?" n139 This revised analysis would focus on the practical effects of the challenged legislation rather than the relatively minor and uncertain question of whether legislators were aware of these effects when they passed the legislation. Such a standard would enable a more substantial challenge to gender discrimination, while maintaining the substance of the traditional equal protection analysis.  Under traditional equal protection analysis, once the Court determines that the legislation enforces harmful gender stereotypes, the burden shifts to the state. The Court should develop an equal protection standard under which a law could discriminate on the basis of gender only if a compelling state interest  [*386]  was shown. Such a standard would allow courts to require a non-discriminatory alternative when a law negatively affected women. Additionally, at the point of determining whether a state interest was in fact compelling, the Court again would consider the "broader substantive concerns of sex equality, including the oppression of women and the constraints of traditional sex roles." n140  Under this revised approach to equal protection, the Court would be required to perform a more comprehensive analysis, balancing the legislative goals against the burdens the law, in practice, places on women as a class. A law would be upheld only if it had "no significant impact in perpetuating either the oppression of women or culturally imposed sex-role constraints on individual freedom," n141 or if the government had a compelling interest in what the law sought to regulate. Such a standard of scrutiny for sex-based classifications places the burden on the state to justify the law and ensures that important governmental reasons exist to justify disparate treatment of men and women. n142 D. Application of a New Model of Equal Protection Guarantees  The proposed revised standard would effectively strike abortion restrictions such as the Hyde Amendment. Under this standard, the Court would be required to reconsider whether the state's interest in the fetus is compelling enough to encourage forced pregnancy through a denial of abortion funding. Unlike the Court's deferential rational relation standard applied to the Hyde Amendment in Harris v. McRae, n143 a revised standard of equal protection genuinely would consider the gender inequality perpetuated by a denial of access to abortion through funding bans. An application of the revised standard to the facts in Harris demonstrates how this standard is useful for genuinely facilitating equal protection for women.  In 1980, when abortion rights, as defined by Roe v.  [*387]  Wade, n144 were at their strongest, the Supreme Court in Harris upheld the Hyde Amendment and declared that the federal government was not required to provide abortion funding. The Court's analysis did not consider gender a suspect class. Instead, Harris applied a traditional equal protection analysis, rejected the notion that the Hyde Amendment burdened a "fundamental right" to abortion access, n145 and declined to consider economic classifications suspect. n146 Accordingly, the  [*388]  Court upheld the Hyde Amendment on the ground that the legislation's means were "rationally related" to its purported  goal. n147


Permutation solves best – states are ineffective and sporadic, federal action needed to uphold equal protection.
Friedelbaum, 3 (Stanley H., Senior Consulting Editor, State Constitutional Commentary, Professor of Political Science @ Rutgers University, “State Equal Protection: Its Diverse Guises and Effects” 66 Alb. L. Rev. 599, Lexis)

From the experiences in a few states, it is difficult to assign high levels of positive reinforcement and reliability to state equal protection as it has developed in recent years. Equal protection, in its conceptual grasp and projected reach, has not reflected an image dramatically different from its federal archetype. In most areas, state courts have been inclined to parallel the Fourteenth Amendment paradigm with minor modifications introduced along the way. The promise evident in state experiments has not always resulted in creative decisionmaking. Unlike the growth of personal liberties, historically separated from the intrusive acts of government, egalitarian advances have been sporadic and not centrally directed. On most occasions, state courts have not ventured beyond a triadic approach to equal protection safeguards marked by recurring conflict and minimal gain. While Justice Holmes' somber prophecy concerning the inadequacy of equal protection as a constitutional tool may have been exaggerated, a latent equal protection still attests, at least in part, to his negative characterization. There is little to suggest that federal equal protection, apart from its state counterparts, has proved to be notably innovative. Nor has a  [*630]  combination of equal protection and due process dependably portended a greater propensity for constitutional advances. The notion of a merger of the two, arising initially from the limitations implicit in the educational desegregation ruling in Brown v. Board of Education, 158 revealed the possibility of a spirited joinder. 159 Whether a reliance upon the two constitutional precepts one day will result in demonstrably enlarged or effective egalitarian gains remains open to question as new cases continue to unfold.

States have tried to provide alternatives to Hyde but their efforts have been rolled back by the courts. 
Pollock & Rainer, 5 (Daniel Lublin, NATALIE E, “SIXTH ANNUAL REVIEW OF GENDER AND SEXUALITY LAW: VI. HEALTHCARE LAW CHAPTER: HEALTHCARE ACCESS: A REVIEW OF MAJOR BARRIERS TO HEALTH CARE SERVICES FOR WOMEN”, 6 Geo. J. Gender & L. 825, Lexis)  

Inability to fund an abortion under the Hyde Amendment or to pay for an abortion out of pocket made some women unable to receive treatments that were incompatible with pregnancy. The court used as an example chemotherapy, which cannot ordinarily be administered during a pregnancy because of potential birth defects. n310 Women on Medicaid whose cancer was life-threatening could get funding to abort, but women without immediately life-threatening cancer could not get funding, risking "serious and permanent adverse effects on their health and lessen[ing] their life span." n311  The Arizona court applied a strict scrutiny standard because women's privacy and equal protection rights were invoked. The court held that, "[h]aving undertaken to provide medically necessary health care for the indigent, the state must do so in a neutral manner" n312 and not discriminate between women whose lives were threatened versus those whose health was threatened. "The state," the court held, "is not simply influencing a woman's choice but actually conferring the privilege of treatment on one class [women with life-threatening pregnancy or pregnancy due to rape or incest] and withholding it from another." n313  [*872]  Moreover, the state's compelling interest in promoting childbirth, while important, did not trump the interest of the mother in her own health. n314  Like Arizona, the courts' orders in other states to fund medically necessary abortion reflect a battle between state courts and legislatures. In Alaska, Illinois, Minnesota, Montana, and New Jersey, the court decisions have invalidated state statutes that funded abortions at or below federal Hyde Amendment standards. n315

State Medicaid spending trades off with other state programs, like education.
Kaiser 04 [Vernon Smith  Health Management Associate, October 2004, “The Continuing Medicaid Budget Challenge: State Medicaid Spending Growth and Cost Containment in Fiscal Years 2004 and 2005: Results from a 50-State Survey,” http://www.kff.org/medicaid/7190.cfm]

Given these growth rates in Medicaid spending compared to other state programs, it is not surprising that when asked whether pressures on the Medicaid program were growing, subsiding or remaining constant, Medicaid officials in more than three-fourths of states (39 states) responded that pressures were “growing.” Twelve states said that pressures were remaining constant and no state reported their pressure was subsiding (Figure 11). Even in these states, officials sometimes commented that pressure on Medicaid remained intense. State officials indicated that the fact that Medicaid continues to command a greater share of state spending, growing at the expense of education or other state programs, has meant increasing pressure to find a way to slow the rate of growth in state Medicaid spending.
Only 17 states pay for limited, medically necessary abortions.
McBride 07 (Dorothy E., Emeritus Professor of Political Science in the Dorothy F. Schmidt College of Arts and Letters @ Florida Atlantic University, Abortion in the United States, pg. 48)

Hyde Amendment Since 1976, Congress has attached the so-called Hyde Amendment, named after Republican Congress member Henry Hyde of Illinois, to the annual appropriations bill that provides funds for the Medicaid program. Medicaid is the publicly funded health care program for the poor, that is, those on welfare-mostly women with children-or those who are destitute. It is funded jointly by the federal government and the states. The Hyde Amendment prohibits the use of the federal funds to pay for abortions of women who receive Medicaid, even though the program is required to pay for "medically necessary" procedures. Thirty-two states follow the federal standard and provide Medicaid abortions only for life endangerment, rape, or incest (South Dakota pays only for life endangerment and a few states also pay for fetal abnormality). That leaves seventeen states that use Medicaid funds to pay for medically necessary abortions. The amendment always provides an exception for those few cases where pregnancy threatens a Woman's life. Sometimes Congress also allows funding for abortions when pregnancy is due to rape or incest, although these exceptions are considered difficult to administer.


States follow the federal regulations for their prison system.
Roth, 04 (Rachel Roth is a reproductive justice scholar and advocate. As a Soros Justice Fellow, she is writing about the impact of imprisonment on women's reproductive rights.. “Do Prisoners Have Abortion Rights?” Summer 2004, Feminist Studies, Proquest)

Given the silence of state statutes and regulations, where might prison officials look for guidance when forming abortion policy? Only two state DOCs, Georgia's (1977) and South Carolina's (1974), have requested an opinion from the attorney general. The federal courts have been clear that women do not automatically lose their constitutional rights once they cross the prison threshold; yet, the language and structure of state policies suggests that they are more likely to take their cue from federal prison regulations and nongovernmental accreditation standards, neither of which fully protects women's rights. I examine all three sources and evaluate state policies in terms of the extent to which they provide women with meaningful access to abortion.

IHS services for Native Americans are a direct violation of women rights – they have even gone beyond hide to refuse abortions when the mother’s life is in danger.
Schindler et al, 2 (Kati, Master’s candidate @ Free University of Berlin, Anna E. Jackson, A.B. @Harvard University, Charon Asetoyer, Executive Director of Native American Women’s Health Education Resource Center,  “Native American Women’s Health Education Resource Center  A PROJECT OF THE NATIVE AMERICAN COMMUNITY BOARD  Indigenous Women’s Reproductive Rights  The Indian Health Service and Its Inconsistent Application of the Hyde Amendment”, October)
IHS Abortion Policies in Practice In June and July 2002, the Native American Women’s Health Education Resource Center (NAWHERC) conducted a survey to assess Native American women’s access to legal abortions through the Indian Health Service.ix The survey findings showed that 85% of the surveyed Service Units were noncompliant with the official IHS abortion policy and thus in violation of the Hyde Amendment. In 62% of the surveyed Service Units, personnel stated that in cases where the woman’s life is endangered by the pregnancy, they do not provide either abortion services or funding. The results additionally demonstrated that IHS personnel at individual Service Units have assumed a significant degree of autonomy in their handling of abortion cases. The standard of abortion counseling, the information provided to a women interested in abortion, and the referrals to alternative abortion providers are often left to the discretion of the IHS personnel in charge. In many IHS Service Units, no standardized protocol is followed, and Service Units often show significant variance from one to another in their provision of abortion services. Another finding of the NAWHERC survey was that IHS personnel frequently demonstrated uncertainty as to which services Native American women are legally entitled. IHS personnel stated several times that Native American women are also covered by Medicaid and therefore have access to abortion services through Medicaid. This assumption is incorrect, as not every Native American woman is financially eligible to receive Medicaid coverage. This has especially been the case in recent years, as several casinos have been built on reservation land, providing many Native American women with minimum wage jobs. Many of these women are ineligible for Medicaid coverage, but are still without the financial means to pay for private insurance coverage. For many women, IHS is the sole provider of health services. The assumption that Native American women are covered by Medicaid undermines the status of IHS as the principal healthcare provider for Native American people. Also included in the survey by the NAWHERC was an assessment of the usage of Mifeprex™ (RU-486) in IHS Service Units. In 2000, Chief Medical Officer of the IHS Kermit C. Smith, D.O., M.P.H. issued a statement to all IHS clinical and administrative staff, stating that “RU486 may be considered as a reasonable therapeutic choice” for abortion in cases of life endangerment, rape, or incestx. However, the survey by the NAWHERC found that none of the Service Units contacted had Mifeprex™ in stock. Nine percent of the pharmacists said that they would be able to make Mifeprex™ available if a doctor would prescribe it. Nine percent of the pharmacists stated that Mifeprex™ would not be considered a reasonable treatment option for patients at their clinics. Mifeprex™ is a drug that ends early-stage pregnancies by blocking a hormone necessary for pregnancy to continue. The drug works in combination with another medicine, misoprostol. Mifeprex™ can be used to induce abortion during the first seven weeks of pregnancy, and it is effective in 92-95% of cases.  A woman using this option makes three visits to a doctor’s office or clinic over a two-week period. Mifeprex™ is an uncomplicated way to end a pregnancy, as facilities for surgery are not needed. Statistical data from the Centers for Disease Control and Prevention (CDC) show that in 1998, 36% of all legal abortions throughout the United States were performed during the first 7 weeks 5 of pregnancy.xii These data from the CDC suggest that Mifeprex™ could be a viable option for a significant number of Native American women seeking abortion services. In particular, the use of Mifeprex™ might improve Native American women’s access to abortion services in areas where IHS facilities are not equipped for surgical abortion procedures.xiii In the survey conducted by the NAWHERC, only 5% of the IHS Service Units contacted performed abortion procedures at their facilities. The survey additionally demonstrated that none of these Service Units had Mifeprex™ readily available for patients’ use. Given the fact that Mifeprex™ is relatively easy to administer to patients, as it does not require surgical facilities, the use of this drug by IHS Service Units could give more Native American women access to the abortion services to which they are legally entitled under the Hyde Amendment.

The federal abortion funding ban effectively denies Native Americans the right to choose.
Asetoyer, 03 (Charon Asetoyer is the Executive Director of the Native Women's Health Education Resource Center, “Native women's group questions IHS enforcement of Hyde Amendment.” 1/1/03, http://www.thefreelibrary.com/Native+women's+group+questions+IHS+enforcement+of+Hyde+Amendment.-a0100200196)
Native American women, being largely low-income and depending on the Indian Health Service (IHS), suffer dually from the Hyde Amendment, which limits federal funding of abortions to cases of rape, incest, or life endangerment, and which is inconsistently applied by IHS according to the Native American Women's Health Education Resource Center (NAWHERC). NAWHERC, along with representatives from the National Abortion Federation (NAF), held a briefing in Washington Oct. 23, telling legislative staffers that of all the IHS Service Units surveyed in it's new study, 62 percent "stated that in cases where the woman's life is endangered by the pregnancy, they do not provide either abortion services or funding." In "Indigenous Women's Reproductive Rights: The Indian Health Service and It's Inconsistent Application of the Hyde Amendment," NAWHERC also points out the lack of correlation between the high rates of violence against Native American women and the fact that IHS, according to it's own data, has performed a total of only 25 pregnancy terminations nationwide in the past twenty years. "The contradiction is horrendous," Charon Asetoyer, Executive Director of NAWHERC told NAR. "This has been an issue for a long time, it's just that nobody has taken the time to look at the numbers. Up until recently, when we did this study, we couldn't do anything more than suspect that this was going on. We had no idea how bad the situation was." Tony Kendrick, Director of IHS Public Affairs, told NAR that IHS policy follows a 1996 agency memo sent by former IHS Director Michael Trujillo, which states that federal funding of abortions is allowed only in cases of rape, incest, or life endangerment.

Abortion restrictions continue the genocidal drive to eliminate Native Americans.
Silliman, 04 (Jael Miriam Silliman is an Associate Professor of Women's Studies at the University of Iowa and the author of the new book Jewish Portraits, Indian Frames: Women's Narratives from a Diaspora of Hope. Undivided Rights, pg105)

"It is because of a Native American woman's sex that she is hunted down and slaughtered, in fact, singled out, because she has the potential through childbirth to assure the continuance of the people."1 The colonizers killed Native American women and children as part of a strategy to conquer, subdue, and destroy Indian nations and take control of their lands. Andrew Jackson recommended that after massacres, the troops should systematically kill Indian women and children to complete the extermination of Native peoples.2 Thus, for Native American women the issues of cultural survival, land rights, and reproductive rights cannot be separated. The US government justified the conquest of the Native peoples by calling its invasions a "civilizing mission." Indians were perceived as savages to be tamed and brought under Christian influences. This justification was also predicated upon the perceived "sexual perversity"3 of Native peoples. Native women's sexualty was perceived as a threat to the political order,4 making it necessary to control their fertility. Involuntary sterilization, the promotion of unsafe and long-acting contraceptives, and the denial of federal funding for abortion are part of a long history of attempts to destroy Native cultures and Native peoples Native American efforts to reassert sovereignty over their lands are inextricably tied to their efforts to reassert control over their reproduction.

Hyde endorses racist and classist connotations of choice, marginalizing women of color, specifically Native Americans.
Clark 05 (Andrea, Assistant Professor of American Culture and Women's Studies at the University of Michigan, “Beyond Pro-Choice Versus Pro-Life: Women of Color and Reproductive Justice,” NWSA Journal 17.1, pgs. 119-140)

The pro-choice camp claims a position that offers more choices for women making decisions about their reproductive lives. A variety of scholars and activists have critiqued the choice paradigm because it rests on essentially individualist, consumerist notions of "free" choice that do not take into consideration all the social, economic, and political conditions that frame the so-called choices that women are forced to make (Patchesky 1990; [End Page 127] Smith 1999; Solinger 2001). Solinger further contends that in the 1960s and 1970s, abortion rights advocates initially used the term "rights" rather than choice; rights are understood as those benefits owed to all those who are human regardless of access to special resources. By contrast, argues Solinger, the concept of choice is connected to possession of resources, thus creating a hierarchy among women based on who is capable of making legitimate choices (2001, 6). Consequently, since under a capitalist system, those with resources are granted more choices, it is not inconsistent to withdraw reproductive rights choices from poor women through legislation such as the Hyde Amendment (which restricts federal funding for abortion) or family caps for TANF (Temporary Assistance for Needy Families) recipients.4 Solinger's argument can be demonstrated in the writings of Planned Parenthood. In 1960, Planned Parenthood commissioned a study which concluded that poor and working-class families lacked the rationality to do family planning, and that this lack of "rationality and early family planning as middle-class couples" was "embodied in the particular personalities, world views, and ways of life" of the poor themselves (Rainwater 1960, 5, 167). As Solinger states: "Choice" also became a symbol of middle-class women's arrival as independent consumers. Middle-class women could afford to choose. They had earned the right to choose motherhood, if they liked. According to many Americans, however, when choice was associated with poor women, it became a symbol of illegitimacy. Poor women had not earned the right to choose. (2001, 199-200) What Solinger's analysis suggests is that, ironically, while the pro-choice camp contends that the pro-life position diminishes the rights of women in favor of "fetal" rights; the pro-choice position actually does not ascribe inherent rights to women either. Rather, women are viewed as having reproductive choices if they can afford them or if they are deemed legitimate choice-makers. William Saletan's (1998) history of the evolution of the pro-choice paradigm illustrates the extent to which this paradigm is a conservative one. Saletan contends that pro-choice strategists, generally affiliated with National Abortion and Reproductive Rights Action League (NARAL), intentionally rejected a rights-based framework in favor of one that focused on privacy from big government. That is, government should not intervene in the woman's right to decide if she wants to have children. This approach appealed to those with libertarian sensibilities who otherwise might have had no sympathy with feminist causes. The impact of this strategy was that it enabled the pro-choice side to keep Roe v. Wade intact—but only in the most narrow sense. This strategy undermined any attempt to achieve a broader pro-choice agenda because the strategy could be used against a broader agenda. For instance, the argument that government should not be involved in reproductive rights decisions could also be used by pro-life advocates against federal funding for abortions (Saletan 2003). Consequently, Saletan argues, "Liberals have not won the struggle for abortion rights. Conservatives have" (1998, 114). Furthermore, this narrow approach has contributed to some pro-choice organizations, such as Planned Parenthood and NARAL, often developing strategies that marginalize women of color. Both supported the Freedom of Choice Act in the early 1990s that retained the Hyde Amendment (Saletan 2003). The Hyde Amendment, besides discriminating against poor women by denying federal funding for abortion services, discriminates against American Indian women who largely obtain healthcare through Indian Health Services, a federal agency. One of NARAL's petitions stated: "The Freedom of Choice Act (FOCA) will secure the original vision of Roe v. Wade, giving all women reproductive freedom and securing that right for future generations [emphasis mine]."5 Apparently, poor women and indigenous women do not qualify as "women."6




Repealing the Hyde Amendment represents leadership and a commitment to reproductive rights
CFRR, 9
(Center For Reproductive Rights, http://reproductiverights.org/en/press-room/obama-budget-ignores-healthcare-needs-of-millions-of-women-but-rejects-wasteful-abstinenc)

The Center for Reproductive Rights is deeply disappointed with President Obama's failure to strike government funding restrictions on abortion, particularly the Hyde Amendment, from his proposed budget for 2010. The budget does, however, propose defunding abstinence-only sex education and creating programs aimed at reducing teen pregnancy. The Hyde Amendment bans federal funding for abortion in the Medicaid program except under extremely limited circumstances. The President’s budget abandons the millions of women who rely on Medicaid and other federal programs for health services, including federal employees and their spouses and dependents, women served by Indian Health Service, women in the Peace Corps and in federal prisons. It appears to clear the way for the District of Columbia to use its public funds for abortion. "At a time in our nation’s history when Americans at every income level are losing their jobs and their health benefits, guaranteeing access to affordable, quality healthcare, including reproductive healthcare, is imperative," stated Nancy Northup, president of the Center for Reproductive Rights, responding to the abortion funding restrictions maintained in the budget.  "For millions of women, federal programs are their only means of getting healthcare.  Abortion is the only medically necessary health service excluded from Medicaid coverage.  Failure to provide that service—a service that only women need—is discrimination." Northup continued, "President Obama made clear during the election that he opposes the Hyde Amendment. And for good reason—over a third of women who rely on Medicaid and are seeking an abortion have been prevented from exercising their constitutional right to an abortion. Hyde unjustly impedes women’s access to timely, quality healthcare and disproportionately harms those women who already face significant barriers to obtaining services. Sound public health policy means protecting the wellbeing of all women." The Center is calling on Congress to step up and eliminate all restrictions on abortion funding, which would demonstrate much needed U.S. leadership and commitment to the human rights principles at the heart of reproductive rights – dignity, equality, and the ability to make reproductive decisions freely, without coercion or discrimination.

Medicaid costs will skyrocket
Lee, 9
(Mara, Scripps Howard News Service, Paul Miller Fellow, April 2009, “About Medicaid,” National Press Foundation, http://www.nationalpress.org/info-url_nocat3519/info-url_nocat_show.htm?doc_id=398831)

Medicaid costs are expected to grow rapidly over the next two decades as the population ages. Medicaid takes over when the patient's cash runs out, and since most people cannot afford bills of $60,000 a year for a nursing home, Medicaid pays for about half of all nursing home bills. Medicare, by contrast, only covers 100 days of nursing home care immediately after a hospital visit.  States control costs for Medicaid by deciding what services will be covered and who will be eligible. Congress also tries to limit spending on the entitlement program by cutting payments to nursing homes and doctors. Both can be a good source for stories. For instance, when Ohio was going to eliminate dental coverage for Medicaid, my paper showed how severely mentally retarded adults needed sedatives to manage their appointments, and featured one man who would have to go without care.  CMS says there are many reasons Medicaid spending keeps growing so fast (it's projected to grow 8 percent a year), such as:      * More eligible people because of population growth, recessions, and federal mandates;     * More very old and disabled people needing extensive long-term care;     * Technological advances that keep more very premature babies and other critically ill or severely injured people alive. These people often need very costly care for the rest of their lives, and     * Health care costs and drug costs that grow faster than inflation.


Medicaid reimbursement rate freezes are causing hospitals to accumulate unrecouped costs
Kaiser Health News, 9
(Kaiser Health News, June 3, 2009, “Low Medicare Reimbursement Rates Hurt Hospitals in Iowa And California,” http://www.kaiserhealthnews.org/Daily-Reports/2009/June/03/Low-Medicare-Rates-Hurt-Hospitals.aspx)

The Times-Standard in Northern California also reported on cost issues and wage freezes at St. Joseph Health System in Humboldt County and across California that were caused in part by low reimbursement rates for Medicare and Medi-Cal patients. "As of June 2008, more than half the state's hospitals reported that they were operating at a loss, according to a California Hospital Association survey. And, due to the current recession, things have likely just gotten worse," The Times-Standard reports. "California's reimbursement rate for Medicare and Medi-Cal patients falls far below the costs hospitals incur providing services to those patients, leaving hospitals to take the losses," the paper notes. It adds that "hospitals only receive 78 cents in state reimbursements for every dollar they spend treating Medicare and Medi-Cal patients. With the state's unemployment rate hanging around 11 percent, hospitals are likely to see more and more Medicare and Medi-Cal patients, and consequently incur more losses" (Greenson, 6/3).

States will cut corners
Pear, 4
(Robert Pear, February 16, 2004, “U.S. NEARS CLASH WITH GOVERNORS ON MEDICAID COST” New York Times, http://www.nytimes.com/2004/02/16/us/us-nears-clash-with-governors-on-medicaid-cost.html)

The Bush administration is headed for a confrontation with states over the financing of Medicaid, the nation's largest health program, as federal officials crack down on arrangements used by many states to shift costs to the federal government.  The federal action comes as states, struggling with severe fiscal problems, are cutting benefits and restricting eligibility for the program, which serves 50 million low-income people each year.  Federal officials and auditors contend that states use creative bookkeeping and other ploys to obtain large amounts of federal Medicaid money without paying their share.


States are cutting benefits
Kaiser, 4
(Kaiser Commission on Medicaid and the Uninsured; Vernon Smith, Ph.D., Rekha Ramesh, Kathleen Gifford, Eileen Ellis, Health Management Associates and Robin Rudowitz and Molly O’Malley, Kaiser Commission on Medicaid and the Uninsured, October 2004, “The Continuing Medicaid Budget Challenge: State Medicaid Spending Growth and Cost Containment in Fiscal Years 2004 and 2005: Results from a 50-State Survey,” http://www.kff.org/medicaid/7190.cfm)

In general, the benefit reductions in 2004 and 2005 focused on restricting, reducing or eliminating “optional” services, which states offer at their discretion. These restrictions, reductions and eliminations focused primarily on Medicaid benefits for adults (including, in most cases, elderly and disabled beneficiaries).  A few states implemented benefit limits that affected children, such as subjecting certain therapies to prior authorization.  In FY 2004, a total of 19 states cut or restricted benefits. Six of these states cut or restricted adult dental benefits and four states cut or restricted adult vision benefits and three states cut or restricted hearing services. Seven states eliminated or limited optional services for adults, including chiropractic services, podiatry services, psychological services, physical and occupational therapy and personal care services; 4 states eliminated some or all of these services altogether while the other 3 limited the amount of services that Medicaid would pay for.25 In FY 2004, a total of 12 states expanded benefits or restored (fully or partially) previous cuts or restrictions.


____ BROADBAND

This must start with federal broadband expansion
Lloyd 7 [Mark, Mark Lloyd is a Senior Fellow at the Center for American Progress and an Adjunct Professor of Public Policy at Georgetown University. A communications attorney and award-winning broadcast journalist, Lloyd is the recent author of Prologue to a Farce: Communication and Democracy in America, published by the University of Illinois Press. He received his undergraduate degree from the University of Michigan and his law degree from Georgetown University. “The Wiring of Rural America,” June 7 http://www.americanprogress.org/issues/2007/06/lloyd_testimony.html]

We must reinstate the Technology Opportunity Program run by the National Telecommunications and Information Administration that the Bush administration eliminated. Encouraging public private partnerships to both deploy and develop new applications for advanced communications technologies was smart policy. Canada largely adopted that policy while we cut

back. That’s how they jumped ahead of us. In New Brunswick, a largely rural Canadian province, the government of Canada provided up to $16.5 million, the government of New Brunswick investing $12.5 million, and the telecommunications company invested $15.6 million in the New Brunswick Broadband Initiative. They finished six months ahead of schedule and are reporting that 90 percent of New Brunswickers in 327 communities have access to truly high-speed broadband service. [viii]  In addition, instead of capping the universal service program we must continue to protect and advance it. Despite the Chicken Little cries of “uncontrolled growth,” the universal service program is working to connect school and libraries and hospitals and small business in rural America. Much of the expansion of deployment has occurred because of the e-rate and other universal service programs. As Sen. Ted Stevens (R-AK) has argued, capping universal service is “an ostrich approach.”[ix] 
Despite the ongoing attacks on the so-called Gore Tax, the Universal Service program is one of the few parts of the 1996 Telecommunications Act that actually works. Over 90 percent of schools and libraries are connected and helping millions of Americans connect to advanced telecommunications service. And the rural portion of the universal service program, the Rural Utilities Service and the Rural Telephone Bank have been working effectively for 50 years to ensure service to communities ignored by the big telecommunications carriers. Universal Service needs to be extended, not capped. We need to make sure that broadband is provided, not only through traditional wireline, but through wireless terrestrial and satellite service as well.
There is a continuing academic debate over Robert Metcalfe’s law on the value of networks. The importance of communications services that actually connect to a wide range of other communications services should be a no-brainer. But we don’t have to limit ourselves to recent observations about the obvious fact that the public importance of a communications system grows as you connect more members of the public to the system. This is not a new insight. It is in fact an insight with deep roots in our system of government.  The historian Richard John reminds us that in 1787 Dr. Benjamin Rush argued for federal investment in a communications system “to distribute knowledge of every kind through every part of the United States.” Five years later James Madison pushed through Congress and President George Washington signed the Post Office Act of 1792, reversing the British colonial policies of postal service as a way to generate revenue and establishing a “service first” set of postal policies to ensure that all Americans had access to the most advanced communications operation of its day.[x]    What Rush and Madison and Washington were concerned about was how to make sure that a government of the people, by the people and for the people actually worked. And so they established a system of universal postal service that became the largest and most advanced the world had ever known. What the founders understood is still true today. If we are to make our democracy work all Americans need access to the most advanced tools to communicate with each other about public policy.    Connecting all Americans to the most advanced communications service is important for business, health care, and education, and it is fundamental for civic participation. Rural Americans do not represent only a need, they represent a resource. We need the energy and ideas and active engagement of our small towns and rural communities in our national discussion. Our federal policies should ensure not only that rural America sees and hears the world, but that the world has an opportunity to see and hear and benefit from rural America. Today that means two-way, real-time interactive communication of voice, data, and high-definition video.

Specifically, Congress should include broadband in Life Line and Link Up
Feinberg 3/12/09 [By Andrew Feinberg, Deputy Editor, BroadbandCensus.com, “Congress, Industry Execs Agree on Broadband in Revamped Universal Service Fund,” http://broadbandcensus.com/2009/03/congress-industry-execs-agree-on-broadband-in-revamped-universal-service-fund/]

The Obama administration’s priority in broadband deployment injected an undercurrent of excitement into a Thursday hearing of the House Energy and Commerce Subcommittee on Communications, Technology, the Internet.  While the hearing was scheduled to be focused on reforming the universal service fund high-cost program, both members and witness spent much of the hearing debating how best to use the fund to deploy broadband internet access to all Americans.  “Broadband has emerged as a critical part of our telecommunications infrastructure,” said Chairman Rick Boucher, D-Va. “New funding sources must be tapped” in order to bring access to unserved areas, he said.  “Broadband is to communications today what electricity and telephone service were 100 years ago,” Boucher said. And while he acknowledged the impact of $7.2 billion in stimulus funding for broadband was a subject for debate, Boucher reiterated his view that broadband is “clearly deserving…of universal service fund support.”  But Ranking Member Cliff Stearns, R-Fla., said the stimulus plans made expansion of the fund irrelevant. Instead of expanding the USF, Stearns suggested examining the successes and failures of the stimulus program while it is implemented.  Congress should focus efforts on reducing waste and fraud in current USF programs and adding a cap prevent more “uncontrolled growth” of the fund, Stearns said.  “Throwing money at this crumbling program makes no sense,” he said. Instead of more subsides, Stearns suggested using “market-based, technology-neutral dsystems” to encourage broadband deployment.  Industry leaders were in agreement on Boucher’s plan for expanding the USF to include broadband service. “The core principle of competitive telecommunications for every American remains an important and worthy goal,” said U.S. Cellular Chairman LeRoy Carlson. “[T]he proper role of [the USF] must be to ensure that [rural] areas have modern, high quality telecommunications infrastructure” that is both feature and price comparable with their urban and suburban counterparts, he said.”  Broadband and mobile wireless services are two ‘must-have’ functionalities consumers expect and demand for home and business, Carlson declared,” whether they live in urban or rural areas. “I believe a reformed program can effectively…address those problems, and if tailored correctly, can even be complimented by leveraging the [broadband stimulus funds],” he said.  “A central goal of this program must be to provide rural citizens with access to high quality mobile voice and broadband services, everywhere that people live, work and travel,” said Carlson.  Verizon executive vice president Tom Tauke told the subcommittee he believes that consumers, industry and policymakers agree that modern and affordable communications services are “a prerequisite for economic growth, and an essential platform to address major social challenges.”  But the high-cost fund “remains focused on yesteryear’s technology,” Tauke said. “Attempts to fit new technologies into a telecom framework.” This process has not allowed the fund to meet its “fundamental objective: providing universal service.”  Qwest Communications Executive Vice President Robert Davis agreed for the need to reform the fund to allow for new technologies. “The grants for broadband deployment that will be provided by the [stimulus program] are a start,” he said, “but no one believes that this money will result in ubiquitous deployment of [broadband] to currently underserved areas.” There remains a crucial role for universal service funding,” David declared.  Adopting broadband as part of universal service would also resolve questions on how to stop what some lawmakers described as “runaway” increases in USF fees. AT&T vice president Joel Lubin suggested that moving from charging consumers based on a portion of their bill to a per-number charge.  While Lubin acknowledged revenues paid into the fund from telephone network access charges might temporarily decrease under such a plan, he predicted that the drop would be inevitable as more Americans move to voice over internet protocol (VoIP) services.  The increasing number of phone numbers used by consumers in next-generation technologies such as mobile phones, VoIP lines, and multi-line business systems would more than make up for the temporary drop, Lubin said.  “Broadband is a disruptive technology that redefines the game,” Lubin said. “Local calling areas are now the whole world.” A broadband based USF program would eliminate access charges while providing “more capability, without the complexity of old narrowband pipes”  Free Press research director Derek Turner noted both “critics and defenders of the high-cost fund all agree that broadband is the essential communications infrastructure of the 21st Century.” When USF was created in 1996, “internet access was an application that used telephony as an infrastructure,” he said.  By contrast, Turner said in today’s world, “telephony is one of the many applications that are supported by broadband infrastructure.” And while the FCC can take steps to modernize the USF regulatory structure, Turner emphasized that “meaningful and lasting reform” can come only from congressional action. “Achieving this goal…will require the complete upending of the status quo and direct confrontation of difficult and politically challenging choices,” he said.  But there When Boucher asked the panel if the law should explicitly allow USF to cover broadband, there was no disagreement that the 1996 Telecommunications Act should be changed to allow USF funding to explicitly cover broadband services.  was some disagreement over whether a “USF 2.0,” as one witness put it, should be limited to wireline services only. While Davis said a program should be “technology neutral” once speed and price targets had been determined, Carlson said that both were equally important – and that wireline and wireless could be subjected to different speed requirements.  And while Turner acknowledged wireless could have a role in reducing costs, he wasn’t convinced. “I’m not sure if checking Facebook while driving at 70 miles per hour is [needed in USF programs]. But Tauke pointed out that fixed and mobile wireless have different use cases and potentials. Rep. John Shadegg, R-Ariz., agreed, calling the two technologies “a different ballgame.”  The Federal Communications Commission is currently accepting comments on a proposal to expand the USF-funded Life Line and Link Up programs to include broadband services. In response to a question from Rep. G.K. Butterfield, D-N.C., Tauke said he didn’t support the proposal in its current form.  Tauke later said in an interview that Verizon believes it is important for all Americans to have access to broadband and that USF should be included, but he could not offer specific alternatives to the Life Line/Link Up proposal except to suggest the program be technology-neutral.

State-level telecommunications efforts fail – only a strong federal action will develop a strong infrastructure

Teske 95 Associate Professor of Political Science at the State University of New York, and an Affiliated Research Fellow at the Columbia University Institute for Tele-Information [Paul, American Regulatory Federalism and Telecommunications Infrastructure, pg. 5-6]

CRITICISM OF STATE REGULATION Part of the reasons for examining the dual structure of U.S. regulation is to consider whether or not it promotes effective regulatory policy and industry development. Some argue that it is a superior system that has stood the test of time. Critics of the current two-tiered structure, on the other hand, suggest that 50 states regulating telecommunication leads to a fragmented national system, reduced service quality, incapability, and unwieldy constrains on companies that are needed to carry the U.S. competitive banner abroad in international markets. Such critics also point out that before AT&T was dismantled it played a coordinating role around the country that no single institution, public or private, plays today. Ken Robinson, a top policy advisor to the heads of the Department of Commerce's National Telecommunications and Information Administration (NTIA) and the FCC, framed this question: "It is difficult to argue that state regulation is useful for advancing our national goals for these firms operating in global markets....How likely is it that state regulation will remain relevant in this century?" (Teske, 1987, p. 6).Such critics suspect that state regulatory agencies are not equipped with adequate expertise to evaluate these difficult policy choices and will inevitably make the most politically expedient, short-run choices. Robinson noted further: "It has certainly been true at the federal level for 20 years that state regulators have been viewed as poor relations....Federal agencies have viewed them with suspicion and guarded distrust" (teske, 1987, p. 6).Noll (1986) argued that federal and state regulators are fundamentally in conflict. According to Noll, state regulators seek mainly to hold local rates down for political reasons, whereas the FCC would like to eliminate subsidies so that competitors can fight on a level playing field. Noll (1986) suggested: "In short, the FCC, to the extent it is legally and politically free to do so, should behave as if it were in serious conflict with state regulators over the ultimate aim of telecommunications policy" (p. 12) To some extent, the FCC has followed Noll's advice in recent years.Noll (1989) went even further in his criticisms: "In the long run the telecommunications system might better serve society's objectives if, as in broadcasting, state regulation played no role at all: and as a practical matter the jurisdictional boundary between state and federal authorities is now quite blurry, so that debate about where it should be drawn is timely" (p. 18).

State action leads to a disparate patchwork of infrastructure – only centralized action solves

Sicker 05 Associate Professor of Computer Science at the University of Colorado at Boulder [Douglas C., “The End of Federalism in Telecommunication Regulations?” Northwestern Journal of Technology and Intellectual Property Spring http://www.law.northwestern.edu/journals/njtip/v3/n2/3/]
I.    Introduction ¶ 1 For most of the last century, only a few questioned the sacrosanct and sovereign role of states in telecommunications regulation. In the wake of the 1996 Telecom Act1 and the rise of the Internet, some commentators and policymakers are just starting to challenge this view, but none has emphasized how the changes in technology—as opposed to economics or policy—warrants such a re-examination. By analyzing the changing nature of telecommunications networks themselves, this paper provides a further basis for re-thinking this out-dated regulatory model.  ¶ 2         This evolving debate asks what role states should play versus the federal government in regulating modern communications networks.2 The typical argument takes place, on one side, with those that believe deferring to the states leads to a disparate patchwork of laws not well suited to modern communications. On the other side, there are those who believe that the regulatory authority should lie with the states, presumably closer to the people it affects.3 This debate is not new. As far back as 1969, then-Circuit Judge, later Chief Justice, Burger showed strong support for federal preeminence in stating that: "Any other determination would tend to fragment the regulation of a communications activity which cannot be regulated on any realistic basis except by a central authority; fifty states and myriad local authorities cannot effectively deal with bits and pieces of what is really a unified system of communication."4  ¶ 3         More recently, Federal Communications Commission ("FCC") Chairman Michael Powell echoed a similar perspective in a statement concerning the "Triennial Review" Order. As Chairman Powell remarked,  [t]he nation will now embark on 51 major state proceedings to evaluate what elements will be unbundled and made available to competitors. These decisions will be litigated through 51 different federal district courts. These 51 cases will likely be decided in multiple ways - some upholding the state, some overturning the state and little chance of regulatory and legal harmony among them at the end of the day.5  ¶ 4         Thus, Powell signaled a new government era in telecommunications that embraced a traditional style of federalism in what was traditionally viewed as a national undertaking.  ¶ 5         However, no one within this debate has critically examined this issue with respect to the technical evolution of the network; nor have they considered the impact of these laws on the subsequent operations of the network. While Noll points out that technical and economic distinction between federal and state jurisdictions are a fiction,6 in this paper I attempt to provide the analytical assessment to indicate the nature of that fiction. This paper articulates these issues and the trends associated with the evolution of technology and the associated network and service architectures. While this paper focuses on technology, it is not my intention to trivialize the complex interplay of technology, economics, and policy. Instead, I will demonstrate how technology is making traditional jurisdictional distinctions less tenable.  ¶ 6         This paper will focus upon six well-known technology trends that are influencing the evolution of the network:  (1)    the cost of "communicating" is becoming more distance insensitive;  (2)    the networks and the services that ride on these networks are becoming more modular;  (3)    packet-routed networks are becoming more prevalent than circuit-switched networks;  (4)    the application (e.g., voice) is becoming more independent and separate from the network;  (5)    geographic boundaries are irrelevant to emerging technology; and,  (6)    intelligence and functions are migrating away from the central office (the delocalization of the central office).  ¶ 7         These trends are continuing to have a profound impact on the evolution of the network and especially the services and applications provided over these networks. As I will later describe in detail, voice over packet service differs substantially from traditional voice service, and these differences are causing (and will continue to cause) substantial regulatory difficulty.  ¶ 8         Modern telecommunications networks are evolving in ways that render local and state authority over many telecommunications policy decisions less justifiable than they were in the past. There are a number of timely policy consequences that should be realized as the network continues to delocalize. First, the standards applied to network elements continue to change primarily due to technical evolution. For example, local switching and operator services can be done as cheaply and easily from out-of-state as from within. Second, traditional economic regulations like tariff-based pricing and LATA-based pricing do not make sense in a VoIP world. Simply put, modern networks (and the services offered over them) are delocalizing in design, operations, traffic and cost characteristics.7 Further, the benefits from a modernized network are undermined by policies that attempt to make a distinction between local and non-local aspects of the network, particularly as this relates to the services carried on these networks.8


State and local school systems have a different definition of “multicultural”-They perpetuate their same shallow, stereotypical analysis we try to remove to solve the divide

Gorski 7
(Paul C., Founder, EdChange Assistant Professor, Graduate School of Education Hamline University, Insisting on Digital Equity: Reframing the Dominant Discourse
on Multicultural Education and Technology, January 2007, http://74.125.93.132/search?q=cache:8l6l66k1JHgJ:www.edchange.org/publications/digital-equity.pdf+%22digital+divide%22+federal+government+%22multicultural+education%22&cd=2&hl=en&ct=clnk&gl=us)
Although definitions of multicultural education in the U.S. vary, a review of scholarship by the field’s leading and pioneering voices (Nieto, 1995; 2000; Sleeter, 1996; 2003; Grant & Sleeter, 1998; Banks, 2004) reveals a critical point of agreement: Multicultural education, at its heart, is social reconstructionist in nature, a movement to identify and eliminate the inequities and injustices that plague our schools, societies, and world. So although individual educational practices, programs, or resources may be consistent with or reflective of multicultural education philosophy, authentic multicultural education is achieved only through systemic and comprehensive school reform—through the identification and elimination of racism, classism, sexism, heterosexism, and other inequitable distributions of privilege and power. In other words, multicultural education’s chief concerns are equity and social justice. Unfortunately, most of the policies, practices, programs, and literature that pass as multicultural education seem concerned more with celebrating the joys of diversity or learning about cultures than about equity and social justice (Jackson, 2003; Nieto, 2000; Gorski, 2006). As a result, much of what people call “multicultural education” results more in supporting stereotypes and sustaining inequities than demolishing them (Díaz- Rico, 1998; Cochran-Smith, 2004; Gorski, 2006). For example, many U.S. schools sponsor “multicultural” assemblies, guest speakers, food festivals, craft fairs, and other feel-good diversity programs, but very few demonstrate a deep, consistent commitment to uncovering, much less eliminating, the oppressive conditions that pervade the education system. Likewise, many local U.S. school systems host “multicultural” conferences or professional development workshops, but very few dedicate to addressing the systemic inequities in educational opportunity and access between their wealthiest and poorest students. And all indications are that this depoliticizing of multicultural education will grow worse before getting better. This is due, in part, to an overall rightward shift in U.S. politics which, in turn, has spawned a myriad of education policy hostile to multicultural education. The result: standardization, privatization, corporatization, high-stakes testing, and millions of teachers feeling pressured to abandon any activism or classroom practices that do not prepare their students for federal- and state-mandated tests.

The federal and state governments have empirically worked together to solve the divide. Disads to the permutation are inevitable because it’s on the books

Bissell 4
(Therese, J.D., University of Illinois College of Law, 2004. THE DIGITAL DIVIDE DILEMMA: PRESERVING NATIVE AMERICAN CULTURE WHILE INCREASING ACCESS TO INFORMATION TECHNOLOGY ON RESERVATIONS, The Board of Trustees of the University of Illinois
University of Illinois Journal of Law, Technology & Policy, 2004)
2. Universal Service and the Telecommunications Act of 1996   "Universal service" is the term used to refer to the public policy initiative designed to provide access to telecommunications services for all Americans, especially those in high-cost rural areas. n54 Basically, universal service is a mix of state and federal programs designed to reach the goal of affordable access to telephone and telecommunications services through the use of subsidies. n55 The idea of universal service is not new. The preamble to the Communications Act of 1934 first discussed the idea of what is now known as universal service. n56 The Telecommunications Act of 1996 ("1996 Act") is the modern statutory basis for the idea of universal service. n57 Prior to its enactment, various subsidies collected from long-distance companies and other service providers funded universal service, so the primary purposes of the 1996 Act were to implement a competitive market system and provide congressional support for the universal service program. n58  [*137]  The 1996 Act makes a commitment to ensure that rural customers, such as Native Americans on reservations, receive the same benefits as those in urban areas by encouraging competition in high-cost rural areas. The 1996 Act mandates that:    consumers in all regions of the Nation, including low-income consumers and those in rural, insular, and high cost areas, should have access to telecommunications and information services ... that are reasonably comparable to those services provided in urban areas and that are available at rates that are reasonably comparable to rates charged for similar services in urban areas. n59   The goal of providing telecommunications services to Native American reservations is also based on additional provisions of the 1996 Act. n60 In addition, two federal universal service programs provide financial assistance to low-income telephone subscribers and help ensure that low-income households can afford telephone service. In 1987, the Link-Up America program was established to help low-income households pay the initial costs of commencing telephone service. n61 The Lifeline Assistance Program, established in 1984, provides low-income households with discounts on their monthly cost of telephone service. n62 In 2000, the FCC expanded both of these programs to address the needs of individuals living on tribal lands. n63 According to the FCC, there were nearly 52,000 tribal Lifeline Assistance subscribers in 2001, up from around 18,000 in 2000. n64 There were also nearly 18,500 tribal Link-Up Assistance subscribers in 2001 compared to 2000 the prior year. n65


Counterplan gets rolled back-State legislatures don’t want to set up Broadband

Scarria 7 Executive Director of the Albany Law Journal of Science & Technology [Anthony, “Municipal Broadband: The Rush to Legislate” Albany Law Journal of Science & Technology, 17 Alb. L.J. Sci. & Tech. 233]
A. State Legislation Prohibiting or Limiting Localities' Right to Provide Broadband Services to Residents State legislatures across the country have had legislation introduced or have now passed legislation prohibiting or restricting local governments from becoming involved in providing wireless broadband services. According to the Baller Herbst Law Group, the representatives for American Public Power Association (APPA), 59 seventeen states have enacted laws that provide barriers for towns and cities attempting to enter the wireless broadband market. 60 Those States are Arkansas, Colorado, Florida, Louisiana, Michigan, Missouri, Minnesota, Nebraska, Nevada, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Washington and Wisconsin. 61Political subdivisions in Pennsylvania "may not provide to the public for compensation any telecommunications services, including advanced and broadband services, within the service territory of a local exchange telecommunications company operating under a network modernization plan." 62 An exception exists under the Pennsylvania law, which essentially allows a local government to offer services so long as the local telecommunications carriers consent. 63 The drafting of such  [*243]  legislation was assisted by Verizon lobbyists. 64 Verizon has spent more than $ 3 million on its lobbying effort in Pennsylvania. 65Texas has enacted what is likely the most complete ban on municipal networks. According to the APPA, "Texas bars municipalities and municipal electric utilities from offering telecommunications services to the public either directly or indirectly through a private telecommunications provider." 66 Nevada has also placed a ban on offering municipal services, but only affecting municipalities with populations of over 25,000 and counties with a population in excess of 50,000. 67While it may appear that municipalities in these states have a viable challenge under Section 253 of the Telecommunications Act of 1996, 68 the Supreme Court in Nixon v. Missouri Municipal League held that municipalities seeking to enter the telecommunications market are not afforded the same protection given to private entities. 69 As such, a state is free to restrict its own political subdivision from offering wireless Internet services to residents. 70


Federal action key to broadband leadership—only way to access competitiveness
Rintels 8 [Jonathan, President and Executive Director of the Center for Creative Voices in Media, “USING TECHNOLOGY AND INNOVATION TO ADDRESS OUR NATION’S CRITICAL CHALLENGES,” Benton Foundation, http://www.ntia.doc.gov/broadbandgrants/comments/1EA6.pdf]

Persuasive research indicates that connecting our nation to broadband will bring remarkable economic, social, cultural, personal, and other benefits to our citizens. Citing this research, a bipartisan chorus of America's leaders has for years advocated the deployment across our nation of robust and affordable broadband access to the Internet. Taken together, the rhetoric and research tell a compelling story; that in the Digital Age, universal, affordable, and robust broadband is the key to our nation's citizens reaching for - and achieving - the American Dream.
Yet, America has failed to deploy universal, affordable, and robust broadband. Compared to many of the other industrialized nations against which we compete in the increasingly interconnected global economy, our nation has steadily declined in rankings of broadband quality, availability, and price.
This failure is the result of a clear absence of strong federal leadership. "Broadband is no one's responsibility," Tim Wu has observed, "and the buck keeps getting passed between industry, Congress, the White House, and the [Federal Communications Commission]."6
Illustrating the lack of federal leadership, President George W. Bush in 2004 established as one of his Administration's goals "universal, affordable access for broadband technology by the year 2007," citing such significant benefits as a stronger, more competitive, and efficient economy; better pay and productivity for America's workers; improved health care; more educational and training opportunities; enhanced homeland security; and other benefits, noting that "[t]he spread of broadband will not only help industry, it'll help the quality of life of our citizens."7
As the year 2007 came to a close, the Bush Administration announced that the President's goal had been accomplished - all Americans had access to affordable broadband. Unfortunately, however, the Administration's claim turned out to be hollow and disingenuous; based on the near-universal availability of the same slow, expensive, and weather-dependent satellite "broadband"8 that had already been available back in 2004 when the President established his goal.9
The bottom line is that without strong federal leadership, deployment of robust and affordable broadband that would help all Americans realize the American Dream remains just that - a dream.
Our New Sputnik Moment
In October 1957, as the Soviet Union's Sputnik satellite sailed across the night sky, America suddenly realized it was no longer the unchallenged global leader in science and telecommunications. Strong federal leadership answered this challenge. A post-Sputnik sense of urgency resulted in stunning technological achievements - from landing a man on the moon, to building up the nation's nascent semiconductor and computer industries, to laying the foundations for what we know today as the Internet.
Today, no new satellite orbits the earth to sound the alarm to Americans. But our nation is once again facing a serious challenge to its global technological leadership, as well as its economic competitiveness. In an interconnected world made "flat," in Thomas Friedman's well-turned phrase,10 by broadband, America's competitors are executing well-conceived and -financed national strategies to dramatically increase their competitive advantage in broadband over the United States, which has no national broadband strategy.
A comprehensive review of the relative ranking of the United States versus the rest of the developed world concludes concludes unequivocally that "[t]he United States is behind in broadband deployment, speed and price. Despite what some advocates and analysts claim, the United States is behind in broadband performance and its rank has been falling since 2001."11 From a ranking of 4th in 2001 among the 30 Organization for Economic Co-operation and Development (OECD) countries in broadband penetration, the United States has "steadily fallen" to 15th in 2007. America also ranks 15th among OECD countries in broadband speed, averaging 4.9 Mbps, and 11th in the cost of broadband per Mbps.12
Most of the leading nations of Asia and Europe have adopted their own national broadband strategies and are aggressively building out their broadband, often utilizing ultra-fast 100 Mbps fiber-to-the-home connections that are over 100 times faster than the FCC's newly revised classification of "basic broadband" speed. Such fiber connections, similar to Verizon's FiOS project now being deployed in many cities in its service area, render obsolete the cable and DSL broadband connections that provide an average speed of 4.9 Mbps and dominate broadband service in the United States.
Faster broadband in other nations is "pushing open doors to Internet innovation that are likely to remain closed for years to come in much of the United States."
In Japan, most citizens have access to broadband connections that are 8 to 30 times as fast as those available in the United States, yet cost less per month. Broadcast-quality TV over the Internet, high-definition teleconferencing, remote telemedicine, and advanced telecommuting are all not merely possible, but commonplace in many other countries today.13
In the United States, however, the widespread availability of broadband robust enough to power these applications is years away. Indeed, what many Americans think of as "broadband" is in many other countries too slow and feeble to even be called "broadband."14 And,

ominously, "the United States is likely to fall farther and farther behind the leading Asian and European countries on most key measures of success in broadband deployment."15
Adding to concerns over the state of broadband in America is the fact that our nation's growth rate in broadband adoption has tapered off to near zero, likely due to the nation's faltering economy and the high cost of broadband. For Americans who live in households with incomes under $20,000 annually, broadband penetration has actually fallen to 25 percent in early 2008 compared to 28 percent a year earlier.16 These are households that could benefit dramatically from the continuing education, job training, and jobsearch opportunities that access to broadband provides, as is described below.
The bottom line is that our nation is far from the goal of universal deployment of robust and affordable broadband that would enhance our competitiveness versus many other industrialized nations. As many nations boldly strategize their rapid advance into the Digital Age by energetically embracing and exploiting the potential of broadband, America is being left behind. This is our nation's new Sputnik moment. It demands strong federal leadership.

Federal leadership solves terrorism and natural disaster preparedness 
Rintels 8 [Jonathan, President and Executive Director of the Center for Creative Voices in Media, “USING TECHNOLOGY AND INNOVATION TO ADDRESS OUR NATION’S CRITICAL CHALLENGES,” Benton Foundation, http://www.ntia.doc.gov/broadbandgrants/comments/1EA6.pdf]

Professor Jon M. Peha of Carnegie Mellon University, an expert on public safety communications systems, recently testified before Congress about the compelling public safety and homeland security rationale for a national broadband infrastructure:
When public safety communication systems fail, people can die. We had seen this occur after the 9/11 attacks, after Hurricane Katrina, and in countless large and small emergencies throughout the country. Many of these tragic failures are avoidable.
In addition to suffering from much-discussed interoperability problems, the communication systems used by public safety are less dependable than they should be, less secure than they should be, and less spectrally efficient than they should be. Ironically, they are also more expensive than they should be, which means taxpayers pay extra for systems that are unnecessarily prone to failure.125
Instead, Peha told Congress: "First responders should have a single nationwide broadband communications system with technology that is based on open standards. This requires federal leadership."126
The kind of leadership needed today was on display in 1956 when the federal government, in the National Interstate and Defense Highways Act, signed enthusiastically into law by President Eisenhower, committed to building a nationwide network of world-class, high-speed interstate superhighways to better provide for public safety and homeland security.127 Today, in the Digital Age, for those same reasons, the federal government must exert that same kind of leadership to ensure the standards, shared services, and connections to a new world-class infrastructure of 21st-century telecommunications networks.
"All Americans need access to advanced telecommunications services in the 21st century," Lloyd writes, "just as they needed access to an advanced highway system in the 20th century." This is particularly true for all emergency organizations meeting critical public needs. Just as we connected schools to broadband at the end of the last century, we need to hook up the more than 100,000 emergency agencies in the nation. "Katrina and 9/11 remind us that access to advanced telecommunications service is a public need. We need national leadership to remind us of this, and insist on policies that address public needs."


Only the USFG solves our terrorism advantage – state action leads to duplication and incomplete coverage
Ascher 2001 - MD, FACP, Adjunct Professor Infectious Disease Division Department of Internal Medicine at UC David (Michael S., edited by Joseph Rosen MD and Charles Lucey MD/JD/MPH, Institute for Security Technology Studies at Dartmouth, "Challenges In Coordinating The Response To Bioterrorism", http://www.dartmouth.edu/~engs05/md/whitepapers/Emerging_Tech/ETech.pdf#page=294, WEA)
The overall impact of a bioterrorist attack will be determined by the balance between fac-  tors inherent in the threat organism (infectivity, pathogenicity, communicability, and antibiotic  susceptibility) and the response of the public health system (disease detection, organism identifi-  cation, antibiotic therapy or immunization, and environmental mitigation).  Although organism  factors can be anticipated and responses tailored to likely possibilities, it is clear that organisms  can be engineered to escape conventional measures.  This is a serious problem in its own right,  but the larger issue that the community must face is that the myriad components of the response  system are very poorly organized at this time.  Unless this situation is rectified, in a real event, a  fragmented and incomplete response would likely occur with clear adverse consequences on the  public’s health.
The reasons for the failure of coordination of the response system are numerous.  First, as  highlighted in the recent National Commission on Terrorism report, is the absence of overall  Federal leadership to coordinate funding, to ensure total coverage and to prevent duplication.  At  present, one component may feel that its activities are appropriate, yet it maybe merely duplicat-  ing another independent entity’s mission, and leaving major gaps in the overall system.  One  example is the focus by the National Guard Civil Support Teams on developing field laboratory  capability for biological threats while at the same time the U.S. Public Health Service, through  the CDC, has an initiative to make state-of-the-art laboratory testing available on short notice to  any jurisdiction within the U.S.  These two programs are just beginning to talk to each other and  it is not clear that the National Guard program will be required at all once the CDC program is  up and running.  While this duplication of activities in the laboratory arena has occurred, neither  the CDC nor the National Guard has begun to think about systems to actually deliver and admin-  ister therapeutics to the site of an event.  This is clearly the most serious hole among several in  the overall response plan.

States fail—without federal oversight cohesiveness will collapse.
Spivack 2005 - PhD, Economist at the Economic Assessment Office of the US Advanced Technology Program and National Institute of Standards and Technology for the US Dept of Commerce (Richard N., "Innovation and Telehealth and a role for the government", in Future of Intelligent and Extelligen Health Environment ed. Renata G. Bushko, IOS Press, http://www.atp.nist.gov/eao/innov_telehealth_role_gov_2004.pdf, WEA)
 With a few exceptions, little effort or coordination has yet been directed toward the  “front end” identification of research, clinical healthcare or homeland security requirements  for telehealth. This is not unexpected, however, since the focus of healthcare is healing and  not technology.  The healthcare industry is largely disaggregated, and providers focus on  their own services and patients rather than on national needs or priorities. Issues such as  reimbursement and the availability of clinical studies would facilitate provider’s decisions  regarding technology needs. In addition, increased attention to homeland security has  underscored a need supported by President Bush that the technology be multi-use.19   The events of September 11, 2001 reinforce the concept that telehealth technology  must meet the primary requirements of being both multi-use and interoperable.  To  accomplish these requirements most effectively and efficiently, homeland security and  clinical healthcare needs must be integrated at every possible level, locally, regionally and  nationally. As a first step a needs assessment process will not only identify current “gaps,”  but will also identify technology and information needs not currently being addressed and  which require additional effort and/or investment in research, development, testing, and  evaluation. 

Fed key—state patchwork prevents interoperability.
Will and Powell 2009 - Kelley School of Business at Indiana University (John W. Hill and Philip Powell, "The national healthcare science: is ehealth a solution?" ScienceDirect, WEA) *NOTE: HIPAA = the Health Insurance Portability and Accountability Act

Making matters far worse, federal patient privacy  regulation in the form of HIPAA merely represents a  floor on which states have built their own privacy  rules (Brailer, 2005), and the existing patchwork of  state laws will make it very difficult to achieve inter-  operability among HCPs across state lines (Murray,  1999). For example, Georgia and Florida have laws  that preclude a HCP from viewing laboratory test  results unless the HCP is responsible for having or-  dered the tests (Dart, 2006). One study of approxi-  mately 1,500 state statutes covering patient privacy  indicated that almost all were more stringent than  the privacy criteria imposed by HIPAA (Dart, 2006).  Another legal barrier to a NHIN is that of federal  anti-self-referral and anti-kickback statutes laws  that have hindered the development of healthcare  IT, and led to poor coordination and a lack of standardization (Shortliffe, 2005). HCPs are governed by  both types of statutes, and violations are serious–—in  some instances, even criminal (Harris, 2003). The  Government Accountability Office (GAO, 2004) has  identified both anti-kickback and Stark laws as bar-  riers to eHealth, as uncertainty over whether vari-  ous shared eHealth arrangements might violate  these laws could cause hesitancy among providers  who would otherwise participate. Lack of IT inte-  gration between hospitals and private physician  practices is one outcome of self-referral prohibi-  tions and anti-kickback laws (Terry, 2006). New safe  harbors are laudable steps in the right direction, but  they do not remove all concerns about potential  self-referral and anti-kickback liability in the con-  text of furnished and received items, and services  dealing with electronic prescribing and electronic  health records (Hill et al., 2007).

Interoperability is key to solvency.
Kennedy et al 1995 - the entire Technology Assessment Board of the 103rd Congress (July, "U.S. Congress, Office of Technology Assessment, Wireless Technologies and the National Information Infrastructre", OTA-ITC-622, DC 2o4o2-9328, ISBN 0-16-048180-5, Lexis Congressional, WEA)

A lack of standards, or the proliferation of mul-  tiple standards, may undermine the Nil goal of in-  terconnectivity. For example, the current analog  cellular telephone standard specifies how a cellu-  lar phone can "talk" to the cellular network. The  fact that the United States settled on one standard  for analog cellular telephones many years ago en-  sures that any phone will work with any cellular  network. Today, however, two digital cellular  standards are being deployed and up to seven stan-  dards are being considered for PCS systems. As a  result, it is likely that all phones will not work with  all networks (see chapter 6).
The current situation is different from the past  because the process of setting standards has be-  come very difficult. Historical standards-setting  processes have undergone tremendous change  since the breakup of AT&T in 1984. The FCC has  largely backed away from aggressive standards-  setting, preferring to let industry and/or the mar-  ketplace set standards; however, the intense  competition that is expected to characterize Nil  services puts the process of cooperative standards-  setting in question. The FCC approach to HDTV  is an exception to current practice (see chapter 5).  The federal government could play a stronger role  in setting standards for interconnection and inter-  operability, but it is unclear what that role should  be. Individual circumstances call for different  government responses--there is no well-defined  set of procedures that will work in  all cases. Some  companies prefer a "hands-oft" approach by gov-emiment, while others would like the government  to at least set goals or even deadlines for stan-  dards. This idiosyncratic, flexible approach to  standards-setting is likely to continue.

Fed key—the counterplan doesn’t remove inhibiting federal policies and state action fails to build a national healthcare infrastructure.
Schmeida and McNeal 2007 - *PhD, Senior Nurse Researcher at the Cleveland Clinic and **PhD, Assistant Professor at the U of Illinois in the Dept of Political Studies (Mary Schmeida and Ramona S. McNeal, "The Telehealth Divide: Disparities in Searching Public Health Information Online", Journal of Health Care for the Poor and Underserved Volume 18 No. 3, August 2007, pp.637-647, WEA)

Government activity advancing and regulating telehealth. There is activity advancing and regulating telehealth on every government level. The federal government has taken an active role by creating a legal environment to enable the expansion of activities, and by funding telehealth research projects and programs in the National Aeronautic and Space Administration, the Department of Defense, and the Medicare and Medicaid programs. The federal goal is to build a national information infrastructure for the expansion of e‑government services, including expansion into rural and other underserved regions.19 However, federal legislation on improving health care service delivery has not been aligned with the national goal for expanding the use of information technology to health care and has not been able to keep pace with the dramatic changes in the industry. The states have picked up where the federal government leaves off, assuming an innovative position by passing telehealth regulatory and administrative reform laws. These laws provide a foundation for telehealth expansion to rural and underserved people, and may provide health care reform to reduce service costs while improving effectiveness.
Federal activities advancing telehealth. The federal government is a key actor in advancing the use of telehealth,19 creating a legal environment for its expansion. In 1996, Congress passed the Telecommunications Act of 1996, which served as a blueprint for changes in the telecommunication industry promoting telehealth incentives for practitioners by deferring high rural communication transmissions costs.20 Following the Balanced Budget Act of 1997, which expanded reimbursement options for telehealth practitioners, Congress introduced many other related bills. These include the Medicare, Medicaid, and SCHIP [State Children’s Health Insurance Program] Benefits Improvement and Beneficiary Protection Act of 2000, which made additional geographic areas eligible for reimbursements.21 In 2001, the Rural Health Care Improvement Act of 2001 addressed health care disparities disfavoring rural areas by amending the Public Health Service Act, the Internal Revenue Code of 1986, and Medicare.8 The Medicare Telehealth Validation Act of 2001 expanded access to Medicare telehealth.22 In 2005, the Health Technology to Enhance Quality Act of 2005 advanced health information technology infrastructure development.23
Although federal legislation focused on improving service delivery and Medicare  reimbursement, much of this legislation lags behind the dramatic changes in the tele communication industry and is not aligned with the goals of Medicare and Medicaid  telehealth practitioners. The Health Care Financing Administration reimbursement  rules and sections of the Balanced Budget Act of 1997 concerning who is allowed  payment for telehealth,5 for example, are incompatible with the practical operation of  most telehealth networks. In addition, a lack of information regarding the true costs  of expanding telehealth has led to guesstimates by the Congressional Budget Office,  restraining innovative efforts at mandating broad changes in regulations on the fed eral level. Furthermore, state professional organizations, such as pharmaceutical and  medical boards, have requested that legislation expanding federal regulatory powers  on the pharmaceutical industry be dropped.24 These actors restrain federal efforts at  passing Internet protective consumer regulations, delaying federal involvement in some  regulatory issues.
 

States fundamentally cannot cooperate over telemedicine—the counterplan does not fiat competence.
TAO 2004 - independent study headed by the Telemedicine Association of Oregon, a nonprofit public benefits fund (last revised 1/16/2004, "Benefits of Telemedicine", http://www.ortcc.org/PDF/BenefitsofTelemedicine.pdf, WEA)

• Interstate licensure  Telemedicine holds great potential to expand service to medically underserved populations and improve their access to health  care. Yet, when patients and practitioners are located in separate states the issue of practitioner licensure arises. State-level  licensure laws that regulate interstate telemedicine practice are not uniform from state to state, in part because of the varying  political climate. Like any other type of statute, these laws have been shaped by their respective stakeholders, and can be  considered either restrictive or reciprocal. A number of states have not passed an interstate telemedicine licensure law and  therefore do not fall neatly into either category.19 

Empirically, states have been ineffective at telemed policies.
Waters 6/8/2009 - nationally recognized expert in telehealth policy and partner in the Health Law Department and chairman of the Government and Regulatory Affairs Practice Group at Drinker Biddle & Reath (Robert J., Roll Call, "Waters: Telemedicine boosts access to needed care", http://www.rollcall.com/features/Mission-Ahead_Health-Care/ma_healthcare/35540-1.html, WEA)

Telemedicine is an important component of the future of health care reform and is the answer to many problems facing our health care system, such as cost and access to care. As Congress and the administration work to make health care accessible to all Americans, telehealth must be part of this dialogue. Given the benefits of telemedicine, many people may wonder why more hospitals and physicians are not utilizing these services. There are major barriers facing health care providers. First, there is a lack of consistent and comprehensive reimbursement policy for telehealth services. Initially, to address reimbursement issues relating to telemedicine, Congress passed provisions within the Balanced Budget Act of 1997 that mandated Medicare reimbursements for telehealth services and funded telehealth demonstration projects. Three years later, Congress expanded Medicare reimbursement policy through the Benefits Improvements and Protection Act. Unfortunately, BIPA still limited reimbursement for telehealth services to certain geographic areas and specific types of originating sites. While 27 states provide Medicaid reimbursement for telehealth services, many states still do not have comprehensive Medicaid reimbursement policies covering telehealth.

Federal coordination is key to check freeloading.
Will and Powell 2009 - Kelley School of Business at Indiana University (John W. Hill and Philip Powell, "The national healthcare science: is ehealth a solution?" ScienceDirect, WEA)

The free-rider problem can only be overcome  when the opportunity cost of shirking is greater than  the expected benefit. Imposition of a shirking pen-  alty requires a coordinating authority, such as  the federal government. In contrast with the rest  of the U.S. healthcare system, the Veteran’s Health Administration (VHA) now enjoys a seamless infor-  mation system that fully supports EMRs in ways  previously described. The system has enabled the  VHA to increase productivity by 6% per year. Starting  in 1995, the VHA organizationally transformed itself  from a traditional family of hospitals focused on  delivery of acute care into an integrated health  system focused on the health maintenance of its  members. Measuring the performance of regional  systems and holding managers accountable shifted  organizational culture toward one of best practice  adoption and standardization of care (Evans, Nichol,  & Perlin, 2006). Managers have an incentive to  systematically integrate IT into work flow in this  type of environment. In this context, shirking  amounts to the failure of a regional system to  implement IT protocols in an effective enough  way to improve performance measures. The penalty  is the embarrassment of a low ranking against peer  regions and possible job loss for top level admin-  istrators.


States and NGOs fail--they're too disconnected and decentralized to help in a crisis.
Ascher 2001 - MD, FACP, Adjunct Professor Infectious Disease Division Department of Internal Medicine at UC David (Michael S., edited by Joseph Rosen MD and Charles Lucey MD/JD/MPH, Institute for Security Technology Studies at Dartmouth, "Challenges In Coordinating The Response To Bioterrorism", http://www.dartmouth.edu/~engs05/md/whitepapers/Emerging_Tech/ETech.pdf#page=294, WEA)

There are parallels in the other component activities such as disease surveillance and  emergency medical response where multiple Federal, State, and local initiatives are disconnected  from each other.  As referenced in the recent report of the National Committee on Terrorism, until  overall planning, including all budgets, are under the control of one party, chaos will continue to  reign.  A further political problem occurs when the group that might be considered most critical  to the response to bioterrorism, public health, tries to get attention and funding from government  sources.  Congress almost certainly believes that the combination of the Nunn-Lugar-Domenici  funding, the National Guard program, the National Disaster Medical Systems, the U.S. Marines  CBIRF, the CDC program and the FBI "flyaway" program must be able to deal with a crisis.  If  all these pieces had been designed from the start to fit together and forced to work together, that  might indeed be the case, but instead we have duplicative programs with large holes remaining.


Federal broadband expansion is key to enhancing democracy and ensuring that all Americans have access to communications technology.
Lloyd 7 [Mark, Senior Fellow at the Center for American Progress and an Adjunct Professor of Public Policy at Georgetown University, “The Wiring of Rural America,” June 7 http://www.americanprogress.org/issues/2007/06/lloyd_testimony.html]

We must reinstate the Technology Opportunity Program run by the National Telecommunications and Information Administration that the Bush administration eliminated. Encouraging public private partnerships to both deploy and develop new applications for advanced communications technologies was smart policy. Canada largely adopted that policy while we cut back. That’s how they jumped ahead of us. In New Brunswick, a largely rural Canadian province, the government of Canada provided up to $16.5 million, the government of New Brunswick investing $12.5 million, and the telecommunications company invested $15.6 million in the New Brunswick Broadband Initiative. They finished six months ahead of schedule and are reporting that 90 percent of New Brunswickers in 327 communities have access to truly high-speed broadband service. [viii]  In addition, instead of capping the universal service program we must continue to protect and advance it. Despite the Chicken Little cries of “uncontrolled growth,” the universal service program is working to connect school and libraries and hospitals and small business in rural America. Much of the expansion of deployment has occurred because of the e-rate and other universal service programs. As Sen. Ted Stevens (R-AK) has argued, capping universal service is “an ostrich approach.”[ix]    Despite the ongoing attacks on the so-called Gore Tax, the Universal Service program is one of the few parts of the 1996 Telecommunications Act that actually works. Over 90 percent of schools and libraries are connected and helping millions of Americans connect to advanced telecommunications service. And the rural portion of the universal service program, the Rural Utilities Service and the Rural Telephone Bank have been working effectively for 50 years to ensure service to communities ignored by the big telecommunications carriers. Universal Service needs to be extended, not capped. We need to make sure that broadband is provided, not only through traditional wireline, but through wireless terrestrial and satellite service as well.  There is a continuing academic debate over Robert Metcalfe’s law on the value of networks. The importance of communications services that actually connect to a wide range of other communications services should be a no-brainer. But we don’t have to limit ourselves to recent observations about the obvious fact that the public importance of a communications system grows as you connect more members of the public to the system. This is not a new insight. It is in fact an insight with deep roots in our system of government.  The historian Richard John reminds us that in 1787 Dr. Benjamin Rush argued for federal investment in a communications system “to distribute knowledge of every kind through every part of the United States.” Five years later James Madison pushed through Congress and President George Washington signed the Post Office Act of 1792, reversing the British colonial policies of postal service as a way to generate revenue and establishing a “service first” set of postal policies to ensure that all Americans had access to the most advanced communications operation of its day.[x]    What Rush and Madison and Washington were concerned about was how to make sure that a government of the people, by the people and for the people actually worked. And so they established a system of universal postal service that became the largest and most advanced the world had ever known. What the founders understood is still true today. If we are to make our democracy work all Americans need access to the most advanced tools to communicate with each other about public policy.    Connecting all Americans to the most advanced communications service is important for business, health care, and education, and it is fundamental for civic participation. Rural Americans do not represent only a need, they represent a resource. We need the energy and ideas and active engagement of our small towns and rural communities in our national discussion. Our federal policies should ensure not only that rural America sees and hears the world, but that the world has an opportunity to see and hear and benefit from rural America. Today that means two-way, real-time interactive communication of voice, data, and high-definition video.



Broadband used for national security is the domain of the federal government
Holt & Galligan 8—*Policy analyst for the Public Utility Research Center at the University of Florida and **Assistant Director, information management, Kansas Legislative Research Department (Lynne Holt & Mary Galligan, “State and Federal Policies to Accelerate Broadband Deployment: A Policy Checklist,” Lexis-Nexis Universe)

The fourth critical area for broadband deployment is national safety and security.  4. National safety and security  National safety and homeland security measures rely on interoperable broadband networks that cross state borders to respond to emergencies and major natural disasters. n111 Much of the information used to alert and protect Americans is now posted on federal agency Web sites. n112 Additionally,    broadband is used for national security purposes, which by definition is the domain of the federal government. For example, the ability of the National Security Agency to eavesdrop on international communications in the aftermath of September 11 was made possible through broadband communications. n113  Local government agencies are responsible for broadcasting local public safety communications, which are often facilitated by high-speed broadband facilities. n114 For example, a "virtual command center" in Anaheim, California supports an integrated law enforcement and public safety system that can be accessed remotely via broadband. n115 Additionally, there is support for a nationwide  [*161]  broadband public safety network that local public safety agencies can access. n116

State action on telehealth isn’t a sign of innovation—leading states score poorly.
Schmeida and McNeal 2007 - *PhD, Senior Nurse Researcher at the Cleveland Clinic and **PhD, Assistant Professor at the U of Illinois in the Dept of Political Studies (Mary Schmeida and Ramona S. McNeal, "The Telehealth Divide: Disparities in Searching Public Health Information Online", Journal of Health Care for the Poor and Underserved Volume 18 No. 3, August 2007, pp.637-647, WEA)

640 The telehealth divide  Nebraska, California, and Kansas rank as early adopters of laws fostering telehealth,  and other states have followed their example. State innovation in telehealth does not  conform to the pattern of policy innovation usually seen. Neither of the commonly used  indices of state policy innovation24,33–34 describes the findings on telehealth innovation;  most otherwise leading states score relatively poorly on general measures of telehealth  policy innovation (with the exception of California). States that rank as innovators in  telehealth are less populous and rural, poorer, and less industrialized.35


Congressional Incentives are key to solve.
Kruger & Gilroy 8 [*Lennard G. Kruger Specialist in Science and Technology Policy Resources, Science, and Industry Division, AND ** Angele A. Gilroy Specialist in Telecommunications Resources, Science, and Industry Division, “Broadband Internet Access and the Digital Divide: Federal Assistance Programs,” June 4, http://www.nationalaglawcenter.org/assets/crs/RL30719.pdf ]

On January 31, 2008, NTIA released a report, entitled, Networked Nation:  Broadband in America, 2007.48  According to NTIA, the report showed “that the Administration’s technology, regulatory, and fiscal policies have stimulated  innovation and competition, and encouraged investment in the U.S. broadband  market contributing to significantly increased accessibility of broadband services.”49  Some policymakers in Congress have disagreed with the Administration’s  assessment and assert that the federal government should play a more active role to  avoid a “digital divide” in broadband access, and that legislation is necessary to  ensure fair competition and timely broadband deployment.  Bills have been  introduced into past Congresses (and have been introduced in the 110th Congress)  seeking to provide federal financial assistance for broadband deployment in the form  of grants, loans, subsidies, and/or tax credits.  

FCC action solves—it funds infrastructure and networking, pilot projects prove.
American Academy of Family Physicians 2006 - one of the world's largest nonprofit health associations (10/18, "Telemedicine, broadband access could grow under pilot program", http://www.aafp.org/online/en/home/publications/news/news-now/professional-issues/20061018fccpilot.html, WEA)

Rural family physicians soon may be joining their urban counterparts in projects to increase broadband telemedicine capabilities. Those projects would result from a Federal Communications Commission initiative to increase the use of telemedicine by improving rural physicians' access to broadband telecommunications systems.
The FCC announced in late September it would use its rural health care, or RHC, funding mechanism for the projects. Under a pilot program, the agency would provide up to 85 percent of the cost of constructing state or regional telecommunications networks, including "any necessary network design studies." It also would fund up to 85 percent of the costs of connecting to Internet2, a dedicated nationwide backbone that links users to government research institutions and academic, public and private health care institutions.
The FCC announcement about the pilot program (PDF file: 14 pages / 166 KB. More about PDFs.) calls for project proposals from public and nonprofit health care providers to build and connect to statewide and regional broadband networks that can help provide health care services.


State governments’ broadband projects have been embarrassing and expensive failures due to lack of private support and experience
Berg 7—Research Fellow with the Institute of Public Affairs and Editor of the IPA Review (Chris Berg, “Broadband projects an embarrassing, expensive failure,” Aug 22, 2007 Institute of Public Affairs, http://www.ipa.org.au/news/1461/broadband-projects-an-embarrassing-expensive-failure)

Broadband projects an embarrassing, expensive failure  Media, Telecommunications and IT Unit | | Chris Berg crikey.com.au 22nd August, 2007  Perhaps John Howard is right - State Governments are stupid. When NSW Premier Morris Iemma announced its ambitious program to blanket Sydney with WiFi coverage, providing it for free to consumers, he explicitly referred to a San Franciscan project as one to emulate.  But it is becoming increasingly apparent that the Californian project is imploding. US internet provider EarthLink may pull out of San Francisco's municipal WiFi project. Australian governments should take note - local politicians are not always the best investors in communications technology.  After the ACCC had torpedoed Telstra's proposal to build a Fibre-to-the-node network late last year -- but before the major federal parties had announced their intentions to simply pay for the high-speed networks themselves -- State governments one by one proposed their own solutions to the broadband controversy.  Leading the charge, Peter Beattie proposed that a private firm finance, build and operate a fibre-to-the-home network in Brisbane, but this was little more than a wishful press release.  Other states drew on overseas broadband proposals. Western Australia's $1 billion fibre proposal was modelled on Alberta's SuperNet. By all accounts, the Canadian network has been a relative success, but both SuperNet and the WA plan focus on building network backbone to essential services rather than piping internet direct to consumers.  Certainly, there are a wide range of international comparisons to call upon. Particularly in the United States, local governments are taking it upon themselves to get into the broadband business, with or without private support. But the experience has been rocky.  Local WiFi projects are often underutilised, underperforming, and expensive. Local councils may assume that free broadband would be popular, but one citywide project in Orlando, Florida was shut down in 2005 when the city realised that only 27 people were using the service per day.  Uptake rates have been more positive in other cities, but are in the range of one to two percent of the population, comparing poorly with the forecasted demand of between 15 and 30 percent.  The most high-profile network - and one which Iemma praised when announcing the Sydney plan - has also been the biggest debacle. San Francisco's joint venture with EarthLink and Google is no closer to deployment than when it was announced in 2005. Indeed, the project's failure was abundantly clear at the time when the NSW government was examining it.  The Google-EarthLink plan has been derailed by political theatre and contractual disputes. And even if EarthLink doesn't pull out, the network speeds offered will be a paltry 300kbps - a speed which has been widely derided in Australia as 'fraudband'. Contrast this with the 60 mbps nationwide fibre-to-the-home network that Verizon is investing in at a cost of US$18 billion.  It is tempting for politicians to offer things to their constituents for free, especially something as popular as broadband. But local government broadband projects are proving to be an embarrassing, expensive failure.

State service availability and subscription rates complicates broadband deployment--the federal government is key to universal access
Holt & Galligan 8—*Policy analyst for the Public Utility Research Center at the University of Florida and **Assistant Director, information management, Kansas Legislative Research Department (Lynne Holt & Mary Galligan, “State and Federal Policies to Accelerate Broadband Deployment: A Policy Checklist,” Lexis-Nexis Universe)

THE BROADBAND DEPLOYMENT GAP BETWEEN URBAN AND RURAL AREAS  Since 1998, the FCC has conducted several inquiries to measure broadband deployment. n18 Each concluded with the observation that deployment was "reasonable and timely on a general, nationwide basis." n19 The most recent inquiry from March 2008 observed that the most sparsely populated zip codes continued to lag behind those with the greatest population density, n20 although the Commission also noted that the gap has shrunk over time--for example the difference has fallen from 25.5% in June 2004 to 9.2% in June 2007. n21  However, because the Commission measures broadband by the availability of the service, not by the number of connections, the difference may be severely understated. n22 For example, the most recent report from the Pew Internet  [*146]  & American Life Project shows that 55% of all adult Americans have high-speed Internet connections in their homes. n23 However, the percentage of home broadband users ranges from 38% in rural communities to 60% in suburban communities and 57% in urban communities. n24 As measured by the project, the gap between rural and urban residents served by broadband is 19%.  Furthermore, a study conducted by the Government Accountability Office ("GAO") also found a gap between subscription rates of households located in rural and urban areas. n25 Based on a 2005 survey, the GAO found that 29% of urban households, 28% of suburban households, and 17% of rural households subscribed to broadband service. n26 This phenomenon is exemplified by the difference between state-wide broadband subscription rates in states with a large portion of residents living in urban areas, and those with a large portion of residents living in rural areas. n27 For example, in New Jersey, the state with the one of the largest urban populations, there is a greater percentage of broadband subscribers than in Mississippi, the state with one of the largest rural populations. n28  The rural, suburban, and urban distinction is more apparent in studies of broadband subscription rates and deployment within states. For example, a  [*147]  report on broadband connectivity and computer ownership in Minnesota households found that at the end of 2006, the number of Minnesota rural households with a broadband connection was approximately 39.7%, while approximately 57% of metro-area households had a broadband connection. n29 A survey prepared by the New York State Department of Public Service found that 10% of high-speed Internet subscribers lived in rural areas, 46% lived in suburban areas or small towns, and 44% lived in urban areas or cities. n30 Also, an analysis conducted by the Tennessee Broadband Task Force in the fall of 2005 found that there was significant broadband deployment in urban areas of the state "but assessment of deployment in rural areas is difficult." n31  The various means of analyzing broadband service availability and subscription rates within states and throughout the country complicates the task of determining what aspects of deployment the government should target. n32 For instance, the government needs to determine if it should be responsible for reducing or eliminating the gap in broadband deployment, subscriptions, or both; to what extent the gap should be reduced; and the proper means for minimizing the gap. n33 Moreover, results of the analysis raise the question of the appropriate role of governments in removing barriers to accessing services. n34 Without accurate data on broadband deployment and adoption, policymakers cannot determine the optimal policies for promoting broadband deployment. Therefore, any state or federal policy aimed at encouraging broadband deployment must begin with an accurate measurement of the current level of deployment and adoption.   [*148] 

Link-Up is independent of state action—only federal entitlement solves
Newman 3—Professer of Political Science at UC Berkely (Abraham Newman, , “When Opportunity Knocks: Economic Liberalisation and Stealth Welfare in the  United States,” http://www18.georgetown.edu/data/people/aln24/publication-12374.pdf)

A major innovation in universal service occurred in 1987. Under pressure from consumer and poverty groups asserting that instalment costs constituted a serious barrier to access and labour mobility, the FCC created Link-up which  pays for half of initial service fees up to $30. Between 1987 and 1996, 4.6 million  connections had been made. A unique feature of Link-up, paid through  surcharges on long-distance services, was that it was not contingent on state  participation. Unlike Lifeline, Link-up created a federal entitlement independent  of state action (Eriksson, 1998).

States simply do not have the money to fund broadband
CQ Weekly 8 [Elizabeth Wasserman, CQ Staff, July 7, “High Speed Internet: Who Gets Waved Into the Fast Lane?” http://library.cqpress.com.proxy.lib.umich.edu/cqweekly/weeklyreport110-000002911200]

Many telecommunications companies support private-public partnerships to extend broadband to hard-to-reach communities. This strategy was pioneered by a group called Connect Kentucky, which worked with the public and private sectors to map areas of that state covered by broadband providers, generate interest in broadband and technology among communities and residents, and help providers target the rollout of services in Kentucky.
The group says between 80 percent and 90 percent of its funding is from public sources, typically state grants or appropriations, and that goes to pay for mapping broadband access, research and community-based efforts to drum up interest in broadband and computer technologies. Telecom providers pay for the rollout of broadband to communities that need and want these services, based on Connect Kentucky’s research. In Kentucky, over a three-year-period, the program costs were $7 million while private investment in broadband exceeded $750 million, the group says. It has now started similar programs in Tennessee, Ohio, West Virginia and other states under the brand of Connected Nation.
“In Kentucky, by most technology-related metrics, we were literally at the bottom of the barrel compared to other states,” said Brian Mefford, CEO of Connected Nation. “When we started out, only 60 percent of homes had the ability to get broadband. Today, that number is up to 96 percent and closing in on 100 percent.”
Other communities have determined that they can’t go it alone. The e-NC Authority, which was created by the North Carolina state assembly in 2000 to bring broadband to all 100 counties, has helped increase broadband penetration statewide by 10 percent and in rural counties by 14 percent. But it still has further to go to bring what many believe will be an essential service for the 21st century to the rest of the state. And, like many, it’s looking to Washington for help, helping fuel the broadband debate.

State and federal partnerships solve best—community knowledge and funding concerns
Holt & Galligan 8—*Policy analyst for the Public Utility Research Center at the University of Florida and **Assistant Director, information management, Kansas Legislative Research Department (Lynne Holt & Mary Galligan, “State and Federal Policies to Accelerate Broadband Deployment: A Policy Checklist,” Lexis-Nexis Universe)

FEDERAL AND STATE PERSPECTIVES FOR BROADBAND DEPLOYMENT  Policymakers at the federal and state level have carved out at least four discrete areas for which broadband deployment is critical: healthcare; education; economic development, specifically, job retention and growth; and the safety and security of United States citizens. n63 Telemedicine and telehealth services are critical in rural areas where the population faces the challenge of traveling long distances for routine healthcare. n64 Broadband impacts education by enabling distance learning programs and providing educational resources that might otherwise not be available to rural residents. n65 Economic competitiveness is also a serious concern to rural communities with shrinking populations. n66 In these communities, broadband services often are part of statewide economic development strategies. n67 Additionally, federal, state, and local governments have created systems to inform and protect residents against local and national safety threats or natural disasters. n68 Increasingly, broadband is an essential  [*153]  component of these systems. n69  Despite shared interest in these critical areas, state policymakers differ from federal policymakers in their perspectives on the appropriate policies for increasing broadband deployment for three primary reasons. First, state policymakers are attuned to their communities' demand for education and healthcare services. State policymakers are also better positioned to measure their communities' access to services, and whether the necessary workforce exists in the state to meet the communities' needs. n70 Second, state legislators must respond to community needs as articulated by the electorate in a much more nuanced manner than the federal government. n71 Third, many states face significant budgetary constraints that the federal government does not. The differing perspectives between federal and state regulators affect: (1) the relative significance placed on international comparative broadband rankings versus inter-and intra-state broadband rankings; and (2) the nature of the policy framework for broadband deployment and access based on the comparative needs of critical areas.

Federal and state partnerships are key to achieving national objectives shared by the states
Holt & Galligan 8—*Policy analyst for the Public Utility Research Center at the University of Florida and **Assistant Director, information management, Kansas Legislative Research Department (Lynne Holt & Mary Galligan, “State and Federal Policies to Accelerate Broadband Deployment: A Policy Checklist,” Lexis-Nexis Universe)

Nature of the Policy Framework  Federal policymakers are responsible for developing a framework for broadband deployment for the entire nation that responds to overarching national concerns. n79 The federal government partners with state governments and private sector providers to spur broadband deployment in rural areas in order to achieve national objectives shared by states. n80 As noted, shared federal and state government interests in broadband deployment include four critical applications--healthcare, education, employment, and homeland security.  1. Healthcare services  Healthcare costs in the United States increased between 2000 and 2007 from $ 1.2 trillion to $ 1.9 trillion, reflecting 14.4% of the GDP. n81 Consequently, federal and state governments face the challenge of containing healthcare costs, while ensuring that rural and remote regions have access to medical services. Rural communities experience a general shortage of healthcare--20% of the nation's population lives in rural areas, but rural areas only have 9% of the physicians. n82 Compared to urban areas, federally supported community health  [*156]  centers in rural areas have a difficult time recruiting primary care physicians. n83 Despite barriers to implementation, telemedicine and telehealth are viable delivery systems for expanding access to healthcare and containing healthcare costs in rural communities.


Permutation solves best—federal-state partnerships are key due to different goals and perspectives
Holt & Galligan 8—*Policy analyst for the Public Utility Research Center at the University of Florida and **Assistant Director, information management, Kansas Legislative Research Department (Lynne Holt & Mary Galligan, “State and Federal Policies to Accelerate Broadband Deployment: A Policy Checklist,” Lexis-Nexis Universe)

THE EVOLVING FEDERAL-STATE PARTNERSHIP  Section 254 of the 1996 Act articulates Congress' recognition that telecommunications services and broadband services should be available to all Americans regardless of where they live. n35 Section 706(a) of the 1996 Act supports ubiquitous deployment of broadband services. n36 Also, section 706(b) underscores Congress' commitment to eliminate barriers to ubiquitous deployment of broadband services. n37 State governments have partnered with the federal government to attempt to eliminate barriers to broadband deployment and access. n38  As of 2002, twenty-one states had universal service funds that enabled companies that received high-cost support to deploy broadband facilities in rural areas. n39 In 2007, the Federal-State Joint Board on Universal Service ("Joint Board"), a board composed of FCC Commissioners, state utility commissioners, and a consumer advocate representative, n40 issued a Recommended Decision acknowledging that federal high-cost Universal Service Fund ("USF") support is extensively used to deploy broadband infrastructure in rural areas. n41 The Joint Board also recognized the importance of the federal-state partnership. n42 Specifically, the Joint Board recommended the creation of a "Broadband Fund" within the federal USF that would allocate funds to states to issue grants for the construction of broadband facilities in unserved areas. n43 The Joint Board  [*149]  did not propose a specific methodology for allocating funds to individual states but suggested "that a major input factor should be the number of residents of each state who are unable to purchase terrestrial broadband Internet service at their residences." n44 In order to direct USF support to broadband service, the Joint Board requested that the FCC include broadband in the list of services eligible for USF support pursuant to section 254 of the 1996 Act. n45 While the Commission has not acted on the Joint Board's proposal, some states have modified their own support mechanisms to encourage broadband deployment. n46  Several states have crafted incentives both to spur broadband deployment in unserved or underserved regions, and to encourage broadband use. n47 For example, four states--Tennessee, Kentucky, Arkansas, and Illinois--enacted legislation in recent years to encourage broadband deployment. n48 In addition to deployment objectives, some of these states also seek to encourage broadband use. Illinois' statute provides incentives to stimulate demand and computer literacy. n49 Arkansas' statute provides grants for establishing Connect Arkansas, a program aimed at facilitating "[b]roadband education so that the citizens of every home and business in Arkansas can take full advantage of broadband services." n50 The state policies addressing issues other than infrastructure deployment recognize that broadband adoption may require a multifaceted strategy. n51 As a complementary strategy for other efforts to improve access to broadband, the National Association of Regulatory Utility Commissioners  [*150]  ("NARUC"), adopted a policy statement promoting Information and Communication Technologies ("ICT") Digital Literacy. n52 While the FCC has not acted on the Joint Board's recommendations to promote broadband through USF support, it has taken deregulatory actions that are intended to spur deployment of broadband. n53  Perhaps most significantly, the FCC has designated various types of broadband services as "information services," n54 including: cable modem service, digital subscriber line service, broadband over power line, and wireless broadband Internet access. n55 The designation of a service as an information service does  [*151]  not preclude FCC jurisdiction. n56

States have succeeded in implementing Broadband programs, even with little funding – Proven by Connect Kentucky. However federal support is key to solve.
Durbin, 7 – US Senator from Illinois, Assistant Majority Leader (Dick, Dick Durbin’s Website, “FLOOR STATEMENT: INCREASING BROADBAND ACCESS TO IMPROVE COMPETITIVENESS” 4/27/07, http://durbin.senate.gov/showRelease.cfm?releaseId=280899)

Similarly, on a statewide basis in Kentucky, these types of partnerships have come together to form a public-private partnership called Connect Kentucky.  Since its formation in 2001, Connect Kentucky has brought state government, providers, technology companies, and economic development units together to build one of the most innovative organizations in the country.  Connect Kentucky has built incredibly detailed maps and spread throughout the state building demand through their eCommunity Leadership Teams.  Just last year, broadband access increased 28 percent in the state.  On a budget of only a couple million dollars per year, this organization has become a driving force of economic development and telehealth and education in the State of Kentucky.   These two models show me what’s possible for the future of broadband in this country.  Facilitating these entities with federal support is an essential step that will move us in the direction of more access to broadband, and better service for lower prices.  For these reasons, I am today announcing that I am introducing the Connect the Nation Act of 2007.  



CP links to ptx—normal means is getting federal money
UPI 9 [“California seeks $1 billion for broadband,” May 5 Lexis]

California wants $1 billion in federal stimulus money to bring high-speed Internet access to every household in the state, officials said.  The Sacramento Bee reported Tuesday that 45 percent of California residents lack broadband connections in their homes because of geography, disabilities, poor English language skills or poverty.  Proponents of the plan say the money will help close the digital divide in the nation's most populous state.

States pay for it by obtaining federal money
TMC News 9 [Broadband growth gets support from state government: High-speed Internet means more than just surfing Web, June 1, http://www.tmcnet.com/usubmit/2009/06/01/4204451.htm]

So the grants offered through the stimulus funds can give providers incentives to run their lines.
Two West Virginia lawmakers, Irving said, have been key in obtaining federal funding for broadband access: Rep. Alan Mollohan and Sen. Jay Rockefeller.

LinkUp is under federal jurisdiction—CP links to NB or they don’t solve
Newman 3 [ABRAHAM, Prof Political Science @ UCBerk, “When Opportunity Knocks: Economic Liberalisation and Stealth Welfare in the  United States,” Jnl Soc. Pol., 32, 2, 179–197, http://journals.cambridge.org/action/displayFulltext?type=1&fid=148278&jid=JSP&volumeId=32&issueId=02&aid=148277]

The ten years following the initial adoption of Lifeline service proved quite  eventful in terms of telecommunications social policy. Lifeline was repeatedly extended as service line charges rose, even though no evidence existed that access  was threatened by price increases. In addition to the amount of benefits, the types  of services covered expanded. By 1996, over 5 million households participated in the original Lifeline assistance program. Two evolutions were particularly important to support consolidation. First, benefits were given to new populations in 1987 and 1996 that broadened the constituencies of universal service. Second,  the technology considered vital under universal service evolved from minimal  access to progressively more advanced technology.  A major innovation in universal service occurred in 1987. Under pressure  from consumer and poverty groups asserting that installment costs constituted a serious barrier to access and labor mobility, the FCC created Link-up which  pays for half of initial service fees up to $30. Between 1987 and 1996, 4.6 million  connections had been made. A unique feature of Link-up, paid through  surcharges on long-distance services, was that it was not contingent on state  participation. Unlike Lifeline, Link-up created a federal entitlement independent of state action(Eriksson,1998). 

States suck
Scott & Turner 9 [Ben Scott, Policy Director, Derek Turner, Research Director of Free Press, “In the Matter of A National Broadband Plan for Our Future,” June 8 http://www.freepress.net/files/FP_National_broadband_plan.pdf]

Finally, the FCC must use the national broadband plan to establish the agency as the pre-eminent authority and resource for all broadband market data. States all over the country have undertaken efforts to map out broadband deployment and adoption, often at great and unnecessary expense. In many cases, these public-private efforts are conducted in a manner that places more focus on private, rather than public, concerns. The data generated from these efforts is often nontransparent and nonverifiable. The FCC should conclude efforts begun in 2008 to reform its own data gathering practices, so it has the information needed to make the right policy decisions. But just as good data enables the FCC to make informed decisions, so too can it empower consumers to make smart decisions. Thus the FCC should make as much of its broadband data publicly accessible as possible.

State governments will fail—federal broadband is key
Brennan 2k [Tim Brennan Professor, Policy Sciences and EconomicsUniversity of Maryland, Baltimore County Senior Fellow Resources for the Future, “Policy Federalism and Regulating Broadband Internet Access,” 10/19/00 http://www.icfc.ilstu.edu/icfcpapers00/brennan1.PDF]

But just as market failures may warrant government restriction of individual decisions, so too might similar failures warrant having central governments preempt local government authority. The preceding discussion suggests three factors to consider: • Inefficiently low information: Weighing the costs and benefits of open access in one lo- cality may involve duplicating costs associated with similar analyses in other localities. The benefits to any one locality of developing its analysis may understate the social bene-fits of the associated informational “public goods.” Hence, left to their own devices, lo-cal governments might do a less effective job than a central government that perhaps has better incentives to weigh properly the pros and cons of a particular policy. In effect, in-formation may create a scale economy in governance, in that the average costs of analyz-ing policies may fall as the size of the jurisdiction increases.
Transborder inefficiencies: The costs and benefits of a local government’s actions may fall not on solely on those within its jurisdiction. As the Parker “raisin cartel” case above shows, a state may be able to exercise monopoly power against those outside its jurisdic-tion. In addition, it may be able to impose external costs outside its boundaries, e.g., by siting polluting power plants just upwind from adjoining states. 63 In thinking about these transborder effects, it is important here as in other policy settings to distinguish efficiency effects from “pecuniary externalities.” A local policy choice may make one firm better off and another worse off, just as purchasing decisions do in the market. But only if there is market power or an unpriced cost or benefit is there an opportunity to realize a net eco-nomic gain through a policy intervention. 64 • Political failure: A third justification for federal preemption of local authority is if there is some reason toe believe that the local decision did not adequately reflect the views of its constituents. Defining “adequately” here is not easy, particularly if we want to restrict our attention to process rather than substance. 65 One could justify federal laws against local corruption. More broadly would be requirements, akin to those in the Midcal case discussed above, that the local action be “clearly articulated and actively supervised,” in order to instill confidence that the local government is doing what its constituents want. Reluctance to defer to local authorities may well be the result of beliefs that local gov-ernments are more prone to nepotism or back-room bargaining than the federal govern-ment.


Feds preempt broadband policy
Brennan 2k [Tim Brennan Professor, Policy Sciences and EconomicsUniversity of Maryland, Baltimore County Senior Fellow Resources for the Future, “Policy Federalism and Regulating Broadband Internet Access,” 10/19/00 http://www.icfc.ilstu.edu/icfcpapers00/brennan1.PDF]

Much of this local authority has been preempted by federal legislation, especially the Cable Communications Policy Act of 1984 (Pub. L. 98-549, known also as the 1984 Cable Act), that stripped localities of the ability to “regulate” cable rates or, viewed another way, to hold winners of franchise competitions to the terms of their bids. Federal legislation also limits how much lo-cal governments can collect from cable systems via “franchise fees.” However, and perhaps partly because of this loss of direct authority over rates, the localities have attempted to exercise their authority over cable in other ways. Most notable here is the exercise of their authority over whether a cable franchise can be transferred from its current owner to a different company fol-lowing an acquisition of the former by the latter, e.g., AT&T’s takeover of TCI.

Federal Signal is key to investors – only action from Washington ends investment stalemate
Rintels ‘8    (Jonathan Rintels is the Executive Director of the Center for Creative Voices in Media, a nonprofit organization – An Action Plan for America Using Technology and innovation to address our nation’s critical challenges https://www.policyarchive.org/bitstream/handle/10207/11811/Benton_Foundation_Action_Plan.pdf?sequence=1)
By promoting both the supply of and the demand for broadband, a well-conceived NBS will establish a “virtuous circle” in which an increased supply of robust and affordable broadband stimulates creation of applications that produce wide-ranging, valuable social benefits that then cause citizens to demand even more robust and affordable broadband; which in turn stimulates greater investment in more robust broadband; which then stimulates the creation of even more beneficial applications that cause citizens to demand even more robust and affordable broadband. Strong federal leadership, expressed in a comprehensive NBS, is crucial to ending the stand-off between those ready to invest in the deployment of robust broadband when great technologies and applications emerge to take advantage of it, and those ready to invest in transforming technologies and applications and who are waiting for robust broadband to be built out.
(  ) State Action shatters the broadband market:
Action wouldn’t stay uniform over time, and – even if it did – reporting to 50 regulators would jack the industry.
Goldberg ‘9    (Neal M. Goldberg, Comments Before the FEDERAL COMMUNICATIONS COMMISSION in the Matter of “A National Broadband Plan for Our Future: -- GN Docket No. 09-51 -- National Cable & Telecommunications Association -- June 8th)
Shaped by market forces rather than state and local regulatory requirements, the deployment of broadband has spread at a remarkable pace, demonstrating that the absence of regulation can and will serve consumer welfare. Nevertheless, state and local governments continue to propose a wide range of regulations – from billing rules, collections requirements, speed warranties, customer service requirements, local privacy rules, filing and notice provisions, network architecture requirements, pricing and promotional requirements as well as additional taxes and fees – that would form a patchwork of unmanageable rules. Congress, the Commission and the courts have consistently confirmed that the Communications Act prohibits the imposition of local franchising and fee requirements, or any other state or local regulation of the provision of information services without explicit Commission authority,108 limiting localities’ involvement to the management of facilities in the public rights-of-way. Nevertheless, each time a new broadband service is introduced – Wi-Fi being a recent example – there are numerous state and local governments that seek to require new and separate authorizations from providers – and the payment of new fees – as a condition of offering these services.109 As the Commission has recognized,110 the interstate character of broadband services makes complying with numerous state or local regulatory regimes impracticable, if not impossible. Broadband networks often are not designed to follow state boundaries, and engineering them to meet different requirements on a state-by-state basis is not always possible. Complying with inconsistent regulatory schemes, such as varying requirements for service quality and reliability, also could require the installation of additional equipment locally, and perhaps additional personnel. All of these changes would undermine the efficiency of the network, making the service less valuable to the public. The imposition of inconsistent state regulatory regimes also would interfere with or even prevent providers from efficiently providing various capabilities without regard to location, because tailoring them to meet the particular requirements of each state would be impossible, given their accessibility via the Internet. And any such requirements inevitably will raise costs. Frequently, such regulations are imposed on only a select group of broadband providers, using a particular platform or technology, leading to higher costs for some competitors and depriving consumers of a more meaningful choice among them. Even if the state or local governments are not successful in imposing those requirements, the time and expense involved in addressing and resolving these requests greatly slows broadband network deployment and the roll-out of new broadband services to consumers. For all of these reasons, the Commission should affirm its exclusive jurisdiction over all broadband services, and explicitly preempt state and local regulation, except for generally applicable consumer protection laws to which any business operating in a state is subject.    
State broadband policy has a poor track record
Berg ‘7     (Chris Berg, Research Fellow with the Institute of Public Affairs and Editor of the IPA Review, “Broadband projects an embarrassing, expensive failure,” Aug 22nd, Institute of Public Affairs, http://www.ipa.org.au/news/1461/broadband-projects-an-embarrassing-expensive-failure)
But it is becoming increasingly apparent that the Californian project is imploding. US internet provider EarthLink may pull out of San Francisco's municipal WiFi project. Australian governments should take note - local politicians are not always the best investors in communications technology. After the ACCC had torpedoed Telstra's proposal to build a Fibre-to-the-node network late last year -- but before the major federal parties had announced their intentions to simply pay for the high-speed networks themselves -- State governments one by one proposed their own solutions to the broadband controversy. Leading the charge, Peter Beattie proposed that a private firm finance, build and operate a fibre-to-the-home network in Brisbane, but this was little more than a wishful press release. Other states drew on overseas broadband proposals. Western Australia's $1 billion fibre proposal was modelled on Alberta's SuperNet. By all accounts, the Canadian network has been a relative success, but both SuperNet and the WA plan focus on building network backbone to essential services rather than piping internet direct to consumers. Certainly, there are a wide range of international comparisons to call upon. Particularly in the United States, local governments are taking it upon themselves to get into the broadband business, with or without private support. But the experience has been rocky. Local WiFi projects are often underutilised, underperforming, and expensive. Local councils may assume that free broadband would be popular, but one citywide project in Orlando, Florida was shut down in 2005 when the city realised that only 27 people were using the service per day. Uptake rates have been more positive in other cities, but are in the range of one to two percent of the population, comparing poorly with the forecasted demand of between 15 and 30 percent. The most high-profile network - and one which Iemma praised when announcing the Sydney plan - has also been the biggest debacle. San Francisco's joint venture with EarthLink and Google is no closer to deployment than when it was announced in 2005. Indeed, the project's failure was abundantly clear at the time when the NSW government was examining it. The Google-EarthLink plan has been derailed by political theatre and contractual disputes. And even if EarthLink doesn't pull out, the network speeds offered will be a paltry 300kbps - a speed which has been widely derided in Australia as 'fraudband'. Contrast this with the 60 mbps nationwide fibre-to-the-home network that Verizon is investing in at a cost of US$18 billion. It is tempting for politicians to offer things to their constituents for free, especially something as popular as broadband. But local government broadband projects are proving to be an embarrassing, expensive failure.
_____ CITIZENSHIP

Multiple sites of resistance are critical to democratic empowerment in the face of sovereignty

Connolly 7 (William E., Johns Hopkins, Wolin, Superpower, and Christianity, Theory and Event 10:1, 7/1/9) JLR
I agree with Wolin that fugitive democracy is both an indispensable source of energy for pluralism and equality during hard times and that it is also ripe for hijacking by ugly, repressive forces. I merely add that in such a world positive democratic movements on behalf of egalitarianism, ecology and diversity must be active at several sites, including local involvement, country-wide social movements, direct pressure on corporate structures and church organizations, participation in national party politics, and cross-state citizen networks to press Superpower from inside and outside at the same time. It is if and when actions at these multiple sites resonate together that the prospects for positive democratic achievement improve.

b. Allowing for each state to implement its own policies reifies borders and the discrimination that immigrants currently field in the healthcare system – federal action is key.

2. Perm Do both: Effective policy must begin with federal action

Park 4 (Seam, J.D. Candidate, Florida State University College of Law, Georgetown Immigration Law Journal, AOO)
Legislative reform can help solve the numerous problems associated with illegal immigrants and their inability to access health care. Reform must start with the federal government by repealing legislation that bans state officials from preventing their state officials from sharing information with the INS. Next, states must utilize this regained authority and pass limited cooperation ordinances in order to provide security for illegal immigrants that desire to access care. Finally, states should utilize their authority and pass legislation providing, at least, prenatal care and treatment for chronic and debilitating diseases. It should be duly noted that legislative reform is not going to be a "cure-all" for every problem associated with illegal immigrants and their ability to access and receive proper health care by any means. However, legislative reform would provide part of the solution to arguably the most important problem regarding health care for the illegal immigrants, barriers to access.

Only double solvency matters – Universal resistance to line drawing is critical to restoring the political against bare life – Their CP exccludes the aff, making the meaning to life inarticulable

Edkins & Pin-Fat 5 (Jenny, University of Wales Aberystwyth, and Véronique, University of Manchester, “Through the Wire: Relations of Power and Relations of Violence,” Journal of International Studies, Vol.34 No.1, pg 12-14, AD: 6-30-09) JLR
The grammar of sovereign power cannot be resisted by challenging or fighting over where the lines are drawn. Whilst, of course, this is a strategy that can be deployed, it is not a challenge to sovereign power
per se as it still tacitly or even explicitly accepts that lines must be drawn somewhere (and preferably more inclusively). Although such strategies contest the violence of sovereign power’s drawing of a particular line, they risk replicating such violence in demanding the line be drawn differently. This is because such forms of challenge fail to refuse sovereign power’s line-drawing ‘ethos’, an ethos which, as Agamben points out, renders us all now homines sacri or bare life.

Supreme Court will strike down

Neill 2 (Alexander, St. Mary's University School of Law, Candidate for J.D., May 2003,  St. Mary’s Law Review on Minority Issues, lexis, AD: 6-30-09) NS
In 1971, the United States Supreme Court issued a landmark decision regarding the rights of illegal immigrants. Graham v. Richardson n57 involved Pennsylvania and Arizona laws that conditioned the receipt of welfare benefits on the possession of United States citizenship or residence in the United States for a specific number of years. n58 The court reasoned that because the law made classifications based on alienage and national origin, they were "inherently suspect and subject to close judicial  [*416]  scrutiny." n59 Applying this strict scrutiny standard, the court struck down the state laws as violating the Equal Protection Clause of the Fourteenth Amendment. n60 The court also stated that the state laws were in conflict with powers delegated solely to the federal government. n61 The significance of the Graham decision is the recognition that illegal immigrants are protected by the Constitution. However, the extent of this protection remained largely undefined. n62

5. Federal funding restrictions means states can’t afford coverage

Ortega 9 (Adrianne Ortega, Boston University School of Law, 2009; M.P.H., Boston University School of Public Health, 2006; ã2009, “And Health Care For All: Immigrants in the Shadow of the Promise of Universal Health Care”, American Journal of Law and Medicine, 35 Am. J. L. and Med. 185, DA: 6/30/09) AOS
Besides harming immigrants themselves, lack of non-citizen health care coverage burdens the hospitals and states that absorb the costs of treating undocumented immigrants.  n26 Federal law shifts the burden of covering immigrants' health care to the states by prohibiting states from caring for  [*188]  non-citizens with federal funds, but allowing them to pass laws and independently fund health care for non-citizens.  n27 Twenty-two states affirmatively provide health care to immigrants by supplementing federal health care funding with state funds - particularly for prenatal care and the SCHIP children's health insurance program.  n28 Most of the states that have extended coverage are those with historically high rates of immigration.  n29 Many financially strained hospitals have resorted to repatriating undocumented patients to their home countries.  n30 These hospitals transport immigrant patients who cannot pay their hospital bills back to their native countries without federal oversight or regulation.  n31 Faced with a tension between humane treatment of patients and the financial bottom-line, hospitals effectively sentence non-citizen patients to death. 
a. State action is racist-moral imperative for federal action

Hull 97 (Elizabeth, Graduate Faculty of the New School for Social Research at Rutgers, “The Unkindest Cuts: The 1996 Welfare Reform Act’s Impact on Resident Aliens”, 33 Gonz. L. Rev. 471, AOO)
Also, the Court found the two schemes objectionable because they required the states to determine for themselves the immigration status of anyone seeking benefits—a requirement, significantly, which the Welfare Reform Act also imposes.169 Determining a person's immigration status is the sole prerogative of the federal government, not only because doing so is a technical and sensitive process, but also because, if states assumed this responsibility they would inevitably make erroneous determinations and thus contravene the constitution's requirement that there be a "uniform rule."' There is, finally, a morally imperative reason for restricting states' activities: individual states are more susceptible to xenophobia than the federal government. This is because aliens tend to congregate in particular communities, possibly generating localized anti-alien movements that could give rise to legislation adverse to their interests."'

California policies to provide social services to immigrants is unpopular AND would expend lots of money-federal incorporation is essential to California involvement

Park 4 (Seam, J.D. Candidate, Florida State University College of Law, Georgetown Immigration Law Journal, AOO)
Illegal immigrants placed significant burdens upon state and local governments because they were often left with the financial burden of providing essential social services to a needy, indigent population.  n19 Among these burdens in-cluded providing health care to illegal immigrants.  n20 States became increasingly impatient and hostile towards the fed-eral government because their inability to control the borders resulted in greater spending and  [*572]  cost in providing illegal immigrants with health care and other social services.  n21 California and Texas, states with high numbers of ille-gal immigrants, raised complaints that providing social services for illegal immigrants was hindering their ability to "provide necessary services to the rest of their residents."  n22
California's reaction to its citizens' negative public opinion regarding illegal immigrants, in conjunction with a statewide recession, came in the form of Proposition 187. The rationale for passing Proposition 187 was that:
The People of California "found and declared" that they had "suffered . . . economic hardship caused by the presence of illegal aliens in the state" and that they had "suffered . . . personal injury and damage by the criminal conduct of illegal aliens in the state." Californians thus "declared their intention to pro-vide for cooperation between their agencies of state and local government with the federal government, and to establish a system of required notification by and between such agencies to prevent illegal aliens in the United States from receiving benefits or public services in the State of California."  n23




___ COMMUNITY HEALTH CARE

Aff or perm solves best. CP alone fails:  Federal health funding would boost regional planning across state lines. This regional pre-planning increases solvency during a crisis. Prefer out specific solvency.

Koh, Professor of Public Health, Harvard, ‘6

[Howard Koh is Harvey V. Fineberg Professor of the Practice of Public Health and Director of the Harvard School of Public Health Center for Public Health Preparedness. He graduated from Yale College and Yale Medical School; received a Master of Public Health from Boston University; joined the faculty there; and, in 1997, was appointed the Commissioner of Public Health for the Commonwealth of Massachusetts–a position he held for six years.  Preparing for Pandemics," with Barry R. Bloom and Joseph Boyd Martin, This presentation was given at the 1899th Stated Meeting, held at the House of the Academy on March 8, 2006. Bulletin of the American Academy, summer 2006. Pages 28-35]

Planning can be enhanced by working at the regional level. This can be challenging in states such as Massachusetts, where there are 351 cities and towns but no county or regional form of public-health structure. With the recent infusion of federal preparedness related funds, many states have emphasized the public-health opportunity offered by regional planning. For example, fire departments have long benefited from mutual-aid agreements. In the event of a major fire in one town, colleagues from neighboring cities and towns in the region can join in to help. For public-health officials in cities and towns, such agreements are still in a state of evolution. Regional planning can offer an efficient way for adjoining hospitals, emergency-medical services, and public-safety organizations to build a common web of protection. Each community and region must know how to report cases to state and federal authorities; administer prophylaxis or vaccines on a community-wide basis; obtain more personal protective equipment for community members; and effectively communicate information in a timely and transparent manner that builds trust.
3. No CP solvency – Coordination: States don’t coordinate to track pandemics, federal government key to solving – that’s our Gayle ‘7 from 1AC solvency
4. States cannot solve harms: Large number of shots for swine flu vaccine will overwhelm state agencies.

Bloomberg  6-26-09 [Bloomberg is regarded as a premier site for news and financial information, By Tom Randal, “Swine Flu Multiple-Shot Vaccine May Overwhelm States,” http://www.bloomberg.com/apps/news?pid=20601124&sid=axzjhgp27HJ8  Date Accessed: July 10, 2009]

The vaccine being developed to combat a pandemic of swine flu will require multiple shots to provide immunity from the new virus, and the added immunizations may overwhelm U.S. state agencies, health officials said. Two injections will be required three weeks apart for swine flu, also known as H1N1, and a third will be needed for seasonal flu, health officials said at a meeting today at the U.S. Centers for Disease Control and Prevention, in Atlanta. Children younger than 9 years old will need four shots, the CDC said. “Public health departments are under-funded and will get fatigued,” said William Schaffner, an influenza expert at Vanderbilt University School of Medicine in Nashville, Tennessee, in an interview at the flu conference. “One shot probably gives you very little immunity, 10 to 20 percent at most.” No Decision  Because swine flu is a new virus, most people have no natural immunity. The first shot provides an initial exposure, and the second shot boosts antibody levels in the body, Schaffner said.

California is broke. Budget deficit there means huge cuts in health programs. Cali just could not enact the policy.

Coast News 6-18-09 [by Gideon Marcus, "Community clinics rally against funding cuts," June 18, 2009, Coast News (California),
http://www.thecoastnews.com/pages/full_story?page_label=home_coast&id=2753713-Community+clinics+rally+against+funding+cuts&widget=push&article-Community%20clinics%20rally%20against%20funding%20cuts%20=&instance=coast_more_news&open=& download date: 6-19-09]

With California’s budget deficit now above $24 billion, Sacramento is looking at cutting public health. Four of San Diego County’s community health centers, representing more than 200,000 patients annually, banded together for a joint press conference at North County Health Services, or NCHS, June 11, to protest a proposal by Gov. Arnold Schwarzenegger to eliminate several programs which subsidize health costs for the poor and uninsured.
Community health centers provide care and education, particularly for those who would not otherwise have access to it. The governor presented plans in May to reduce Medi-CAL as well as cut SCHIP Healthy Families program, the Expanded Access to Primary Care program and state-funded HIV/AIDS screening, testing and prevention. This would leave thousands uninsured in San Diego County alone, and drain vital monies from health center coffers, conference speakers said. “We will see these families suffering,” Vista Community Clinic CEO Barbara Mannino said. “They will have to make a choice between having a roof over their children’s heads, putting food on the table, or providing health care cover for their children.” “We have a fragile safety net right now that will become even more fragile if the cuts go through,” CEO of Neighborhood Healthcare Tracy Reams said. “What it comes down to is the only way to keep the doors open is to reduce services.” Several speakers made the point that although cutting health coverage might save money in the short run, costs would ultimately run much higher. Patients who no longer could afford preventative clinic visits would find themselves accumulating tremendous emergency room bills later on. Dr. Kevin Ellis, medical director for NCHS, said that this would not only lead to financial hardships for uninsured patients, but many would not be able to pay for the treatment they received which would cause hospitals to raise rates. This would drive up insurance costs for the already insured. “What would have cost $150 for three visits at a clinic could end up costing the system tens of thousands of dollars,” NCHS President and CEO Irma Cota said. “It’s prudent to retain these programs not just from the financial sense but also the ... quality of life.”Another concern brought up was N1H1 Swine Flu, which the World Health Organization had classified as a pandemic on the day of the conference. NCHS was swamped with thousands of patients in May during the last outbreak, and Cota warned that community health centers would be ill-equipped to deal with another should the cuts go through.



___ DISASTERS/KATRINA

Federal and state cooperation is the most effective strategy
Raymond A. Biering, Counsel for the San Luis Obispo County Air Pollution Control District, and Brian S. Biering, former Executive Fellow in the California Resources Agency, 08, “Massachusetts vs. EPA: Rescuing Icarus with Environmental Federalism” U Oregon Journal of Environmental Law and Litigation, Lexis
 
In the final analysis, the issue is not simply a choice between federal and state approaches to address climate change, but rather, whether federal and state approaches can be harmonized to complement each other. Most modern federal environmental laws contemplate concurrent federal and state roles. The relationship between the federal and state standards with regard to air pollution under the CAA was discussed above. n161 In view of the importance and immediacy of the climate change problem, and especially in view of the significant state and regional efforts that have occurred to date, it is neither necessary nor wise for federal law to completely preempt and prevent state and regional initiatives addressing climate change. While the global nature of the issue argues for a more uniform approach to its resolution, ultimately, a well-conceived federal and state "federalist" program that incorporates coordination of the programs that work best and preempts those that either do not work or are better handled on a national level, is our most viable approach for effectively and expeditiously addressing climate change problems in our time.


Only the federal government has the resources to rebuild Katrina – The government should be held responsible for their blatant disply of racism
Giroux 6 (Henry A, Doctorate from Carnegie-Mellon “Reading Hurricane Katrina: Race, Class, and the Biopolitics of Disposability” College Literature, Summer 2006)
Soon after Hurricane Katrina hit the Gulf Coast, the consequences of the long legacy of attacking big government and bleeding the social and public service sectors of the state became glaringly evident as did a government that displayed a "staggering indifference to human suffering" (Herbert 2005). Hurricane Katrina made it abundantly clear that only the government had the power, resources, and authority to address complex undertakings such as dealing with the totality of the economic, environmental, cultural, [End Page 174] and social destruction that impacted the Gulf Coast. Given the Bush administration's disdain for the legacy of the New Deal, important government agencies were viewed scornfully as oversized entitlement programs, stripped of their power, and served up as a dumping ground to provide lucrative administrative jobs for political hacks who were often unqualified to lead such agencies. Not only was FEMA downsized and placed under the Department of Homeland Security but its role in disaster planning and preparation was subordinated to the all-inclusive goal of fighting terrorists. While it was virtually impossible to miss the total failure of the government response in the aftermath of Katrina, what many people saw as incompetence or failed national leadership was more than that. Something more systemic and deep-rooted was revealed in the wake of Katrina—namely, that the state no longer provided a safety net for the poor, sick, elderly, and homeless. Instead, it had been transformed into a punishing institution intent on dismantling the welfare state and treating the homeless, unemployed, illiterate, and disabled as dispensable populations to be managed, criminalized, and made to disappear into prisons, ghettos, and the black hole of despair.




___GANG PREVENTION

Federal government is needed to have success—this proves only the permutation or case alone is preferable to solve the 1ac impacts

Malcolm L. Russell-Einhorn, J.D., is associate director of the Center for Institutional Reform and the Informal Sector at the University of Maryland. Fighting Urban Crime: The Evolution of Federal-Local Collaboration, US Department of Justice. December 2003 http://www.ncjrs.gov/txtfiles1/nij/197040.txt accessed June 6, 2009

  The impact of collaboration on urban communities is hard to ascertain because of how difficult   it is to link changes in crime to specific law enforcement activities.[14] Anecdotally, however,   researchers found that collaborations have had considerable success, particularly against gangs.   Collaborative work led to the disruption or breakup of several long-entrenched gangs in the   three cities studied. Reductions in violent crime have been attributed partly to aggressive   firearms prosecutions by task forces. In many prosecutions, violent recidivists and gang   members were convicted of one or more gun crimes and given substantial sentences.      Study interviewees also noted how the use of Federal firearms charges in prosecuting   particularly dangerous individuals and gangs encouraged the criminal community to keep guns   off the street.[15]      Operationally, interjurisdictional collaboration appears to have promoted better problem solving   and intelligence sharing, as well as improved officer safety. It has also permitted specialization   against particular targets (such as gangs, airport drug interdiction, or drug-related homicides)   and increased funding to pay for informants, evidence, and overtime, which facilitates long-term   investigations and around-the-clock surveillance.[16]      More formally organized collaborations seem to work best. Too much informality and   insufficient clarity of mission can create uncertainty, weaken commitment, and impair   operations.[17] Evidence also suggests that successful Federal-local law enforcement   collaborations usually have       o  High-level agency commitment and sustained funding.      o  Clear ultimate legal authority in one agency and use of interagency MOUs and written   paperwork protocols to promote clarity of roles and responsibilities.      o  Joint Federal-local leadership on executive or control boards and at the operating level.      o  Where possible, co-location of Federal and local law enforcement personnel to promote   loyalty and teamwork.

The nature of crimes, intelligence and legal set ups demand collaboration

Malcolm L. Russell-Einhorn, J.D., is associate director of the Center for Institutional Reform and the Informal Sector at the University of Maryland. Fighting Urban Crime: The Evolution of Federal-Local Collaboration, US Department of Justice. December 2003 http://www.ncjrs.gov/txtfiles1/nij/197040.txt accessed June 6, 2009

Although some incentives to collaborate may diminish (such as a local need for sophisticated   equipment), others will remain. For example, the trend toward examining crime problems   multidimensionally and preventively--a feature of community-oriented policing--relies heavily on   collaboration to access local intelligence. At the same time, the existence of longer sentences for   many Federal crimes will continue to make collaboration attractive for many local jurisdictions.      Most federally led collaborations involve long-term investigations of criminal organizations.   These organizations are less hierarchical and more diversified and technologically savvy than in   the past, which can blur easy distinctions between high-level criminal activity and street crime.   Federal-local collaboration against such criminal networks is more advantageous than ever.

Federal prosecution is a necessary component – the counterplan can’t use—counterplan ensures prosecutions won’t go as smoothly delaying or even preventing solvency

Malcolm L. Russell-Einhorn, J.D., is associate director of the Center for Institutional Reform and the Informal Sector at the University of Maryland. Fighting Urban Crime: The Evolution of Federal-Local Collaboration, US Department of Justice. December 2003 http://www.ncjrs.gov/txtfiles1/nij/197040.txt accessed June 6, 2009

Prosecution under Federal criminal statutes offers several powerful advantages:      Federal Grand Jury. This body can be called at any time, can be kept in action for as long as 3   years, can hear hearsay evidence, and is armed with national subpoena power. State grand   juries have a shorter duration, "no hearsay" rules, and limited subpoena power.      Immunity. Limited immunity for a grand jury witness conferred by Federal prosecutors does not   impede later prosecution of the witness for perjury, obstruction of justice, or contempt. Most   States only have blanket transactional immunity, which provides less flexibility and leverage   against potential witnesses.      Search Warrants. Federal standards for obtaining a search warrant are generally lower than   those of most States.      Preventive Detention. The Federal bail statute provides for preventive detention in a range of   circumstances. State laws do not have such provisions.      Electronic Surveillance. Most States require a higher burden of proof for wiretaps than the   Federal Government.      Witness Protection. In contrast to the well-developed Federal Witness Protection Program,   most States do not have such a program.      Accomplice Testimony. Federal rules permit conviction on the basis of an accomplice's   uncorroborated testimony. State rules generally do not.      Discovery. Federal rules provide that a statement by a government witness need not be made   available to the defense until the witness has testified at trial. Also, the defense has no   entitlement to a witness list before trial or to interview government witnesses prior to trial. Most   State rules provide otherwise.,


Federal and local law enforcement can work together

Malcolm Russell-Einhorn ; Shawn Ward ; AND Amy Seeherman. Federal-Local Law Enforcement Collaboration in Investigating and Prosecuting Urban Crime, 1982–1999: Drugs, Weapons, and Gangs, Abt Associates Inc. May 2000 http://www.ncjrs.gov/pdffiles1/nij/grants/201782.pdf accessed June 6, 2009

In fact, some evidence suggests that Federal and local law enforcement authorities have significantly diffused these potential tensions by relying on a number of practical mechanisms and organizational steps. Interviews with law enforcement personnel in three U.S. cities suggest that the potential problems noted above have been mitigated by the following: ·  Relative restraint in the actual exercise of Federal jurisdiction (due in large measure to frequent communication between Federal and local prosecutors about jurisdictional determinations and judicious allocation of limited Federal resources by U.S. Attorneys). ·  An expanded commitment by Federal authorities, through negotiated memoranda of understanding (MOUs) and special operational procedures, to ensure various degrees of shared leadership, decision-making, and information-sharing within Federally-led task forces and other collaborations, thereby ensuring significant local input into task force governance and a degree of accountability (albeit indirect) to local governments. ·  Increased Federal efforts to facilitate consensus-based coordination of collaborative as well as non-collaborative law enforcement activities carried out by Federal, state, and local law enforcement authorities in American cities.

____ GREEN JOBS

STATES CAN’T RUN THE PROGRAM: THEIR BUDGETS AND TAX REVENUES ARE TOO SMALL, AND ONLY A FEDERAL PROGRAM HAS ANY EFFECT ON DEFICITS AND PRICES.

[ELR = EMPLOYER OF LAST RESORT]

WRAY, 2000 (L. Randall, Professor of Economics at the University of Missouri-Kansas City, a Senior Research Associate at the Center for Full Employment and Price Stability, as well as a visiting Senior Scholar at the Jerome Levy Economics Institute of Bard College; “The Employer of Last Resort Approach to Full Employment,” Working Paper No. 9, July, http://www.cfeps.org/pubs/wp/wp9.html)

 State governments cannot run continuous deficits and would find that precisely when ELR is most needed, tax revenues would fall. Further, the price stabilizing features of ELR requires creation of a national labor buffer stock pool. For these reasons, the program should be nationally funded and should be subject to national standards regarding wages and benefits.


STATE SPENDING ON SOCIAL SERVICES DURING A RECESSION DESTROYS THE ECONOMY BY REQUIRING HIGHER TAXES TO MAKE UP THE REVENUE.

WRAY, 2 (L. Randall, Professor of Economics at the University of Missouri-Kansas City, a Senior Research Associate at the Center for Full Employment and Price Stability, as well as a visiting Senior Scholar at the Jerome Levy Economics Institute of Bard College; “The Perfect Fiscal Storm,” Policy Note No. 02/05, http://www.cfeps.org/pubs/pn/pn0205.html)

Turning to the state level, states were faced with more responsibility, especially for social programs like welfare and Medicaid. However, all but one state is restricted by statutes or constitutions to running balanced budgets. The problem is that state revenue is strongly pro-cyclical, increasing in a boom and falling in recession. And this is a big problem when the states are increasingly responsible for types of spending that need to rise in recession—like welfare and Medicaid. What States typically do is to cut taxes and increase spending in a boom—which helps to fuel the boom—and then raise taxes and cut spending in a recession—adding to the depressionary forces that generate the recession. States have also come to rely more heavily on regressive taxes—especially taxes on consumption, while like the Federal government they give tax credits and inducements to encourage saving. This depresses spending, especially in recession when the regressive taxes on consumption are increased at exactly the time that households are trying to cut back spending to increase rainy day funds.






___HEAD START

Federal leadership needed to make appropriate changes; states variance is to wide

Stebbins 09 (Helene, Project Coordinator, National Center on Children in Poverty; THE IMPORTANCE OF EARLY CHILDHOOD DEVELOPMENT HEARING  before  the  COMMITTEE ON EDUCATION AND LABOR U.S. House of Representatives MARCH 17, 2009  http://www.gpoaccess.gov/congress/house/education/index.html)

Increasingly, policymakers understand that the   foundation for learning and healthy development is established   between birth and age five. But too often, the response to this   knowledge is narrow, focusing on only one program or funding   stream.      My work seeks to raise the level of debate by offering a   menu of policy options broken into three areas that young   children need in order to become well-educated, self-sufficient   adults. They need, first, regular visits to the doctor, even   when they are healthy. Second, stimulating early learning   opportunities, and third, stable, nurturing families who have  enough resources and parenting skills to meet their children's   needs.      Now, think about these three dimensions as three legs of a   stool. Strong public policies in each of these areas are   essential to balance the stool and provide a stable foundation   for healthy development and learning.      In your briefing materials, you will find a copy of your   state's early childhood profile. It looks something like this.   We update these monthly, and the most recent profile can be   downloaded from our website at NCCP.org. Each page of the   profile represents one leg of the stool, with policy choices   that promote access as well as quality.      If we look at the profiles collectively, we see a lot of   wobbly stools for early childhood development. Let me give you   a few examples.      First, the health leg of the stool. Forty-four states   provide access to public health insurance for young children in   low-income families. However, many of the children who are   eligible for Medicaid are not receiving the dental and health   screenings that are recommended by doctors and that can prevent   or reduce costly problems in the future. In 45 states, one-  third of eligible children ages three to five never receive an   annual check-up.      Second leg--early learning. While access to state-funded   pre-Kindergarten is growing, access to quality early care and   education, from birth to school entry, is still inadequate.   Child care licensing requirements are not promoting the kind of   nurturing care that we know promotes school readiness. Only   eight states meet recommended standards for toddlers, and only   15 meet them for 4-year-old children.      As the graph on page three of the profile shows, many young   children eligible for enrollment in the major early childhood   programs cannot access them, and access for infants and   toddlers is especially limited. For example, a program like   Early Head Start, with rigorous evaluations showing its   effectiveness, serves less than 3 percent of the eligible   population.      Third leg--parents. State efforts to promote family   economic security are uneven. About half of the states raise   the minimum wage and half exempt families from poverty from   state income taxes. Most low income working parents are not   eligible for public health insurance, and only six states   provide paid family leave so mothers can stay home with their   newborn and establish that strong nurturing relationship.      If we expect parents to be their children's first and best   teachers, then we have to provide the economic and parenting   supports that allow them to do so.      There are many choices that can help balance the three-  legged stool of early childhood policy. My work focuses on   state policies, but federal resource allocations and   regulations shape many of these policies. My work shows the   tremendous variation in the policy choices that states make,   but federal policies can help level the playing field so   children have access to quality supports and services   regardless of where they are born.      Today, we have a window of opportunity for federal   leadership to stabilize and strengthen the three-legged stool   as a result of the reauthorization of SCHIP, the additional   funding in the Recovery Act, and the potential for early   learning challenge grants. As you consider the federal role,   please remember that learning begins at birth, that 1 year of   pre-Kindergarten is not enough, and that vulnerable children   have the most to gain from public policies that support their   early development.      Let me close by saying it is time to stop debating the   importance of the early childhood years. Neuroscience research   shows that the brain develops at an unprecedented pace during   the first year of life. Social science research shows children   who experience high quality, nurturing environments starting at   birth are better prepared to succeed when they enter school,   and economic analyses show positive returns in investments from   early intervention programs, especially those that target the   most vulnerable children.      The research is solid. Let us stop debating this and start   debating the policy response.

Coordination between state and federal offices is key; Georgia proves

Robinson 09 (Holly, Commissioner, Georgia Dept. of Early Care & Learning; THE IMPORTANCE OF EARLY CHILDHOOD DEVELOPMENT HEARING  before  the  COMMITTEE ON EDUCATION AND LABOR U.S. House of Representatives MARCH 17, 2009  http://www.gpoaccess.gov/congress/house/education/index.html)

In 2008 and 2009, Georgia's pre-K program, which is one of   the preeminent programs in the United States, was entering its   15th year. The Georgia pre-K program was established in 1993,   and it is solely funded by the Georgia Lottery for Education.   More than 860,000 pre-K students have been served since 1993,   and one million will be served this fall, this September, and   we are very, very excited about our one millionth child to be   served in the Georgia pre-K program.      We have comprehensive standards for our classroom. We have   a statewide child assessment program that is based on the work   of Dr. Michael's work. We have on-site classroom monitoring,   and we have a resource coordination program. So it is a very   solid, research-based program in the state of Georgia.      The program, most uniquely, is a voluntary universal   program. Parents have a choice whether they want to send their   child to this program or not. But if they do, it is a fully   funded program. Children must live in Georgia, be age eligible,   and we serve now almost 60 percent of the children in Georgia.   When we finish this year, because the governor has put 3,000   more new slots in for this year, so we will be serving the next   school year 82,000 children.      It is also a public-private program, where many of our   providers are private mom-and-pop shops or some of the large   chains and our public school system. We also work with the   military, with the technical college system, with charter   schools, with university lab schools, so we really reach across   the entire state.      There has been a lot of discussion as whether a program   should be targeted or universal, and we have a lot of research   and backup that will show us that our heterogeneous program is   a strong program and is effective for all of the students. Our   program is a full day. It is 180 days per year as a regular   school year, 5 days per week. Our teachers are credentialed.   Over 80 percent of them now have degrees in early or elementary   childhood, and the final 20 percent have associates degrees.      We measure up to quality in our state program. we have nine   out of 10 of the quality standards that NEER requires. But our   statewide program is driven by standards and by child   assessment that is focused on standards as well.      One of the major things we do, since it is part of my   department, as well, that is we work very closely with Head   Start. We have a full collaboration with the Head Start office,   the regional Head Start office. We have signed a joint letter   of agreement between myself and the regional Head Start   manager, the federal appointee, so that the Head Start   providers across the state see that this is a viable   partnership.      And what we have done is we have moved many of the 4-year-  olds that were served by Head Start into the Georgia pre-K   program, thereby serving more 3-year-olds in the state in Head   Start. Those 4-year-olds that move into the Head Start program   to Georgia pre-K still receive the wrap-around services from   Head Start. So what this enables us to do is serve more   children in quality programs across the state of Georgia.      In conclusion, I would just like to say three things. We   base all of our programs in Bright From The Start on   accountability and academic achievements based on data and   research. I believe we need flexibility to meet the individual   needs of the state, because in our state, for example, we have   a very large, well-funded pre-K program which would have   different needs than other states.      And finally, I would like to just mention that Georgia, as   one of three states that has a full education department for   early learning zero to five, it would be very, very helpful to   us if you all would help instruct the U.S. Department of   Education that we are a fully fledged department, because we   cannot apply for competitive grants, funds don't flow--even if   they are zero-to-five funds--do not flow to us in our   department.      We don't get any direct dollars. All of the dollars that   are zero-to-five for the state of Georgia flow either to our K-  12 department or to our Department of Human Resources, and then   I have to get my little percentages from them, with overheads   and such subtracted. So it would be very helpful if the United   States Department of Education would recognize those states   that do have a fully-fledged Department of Early Learning.      The other two states that have Departments of Early   Learning are Massachusetts and Washington State, and we have   all worked together and met together and discussed this, and I   know it is something that would make a great deal of difference   to us.      As far as the Georgia pre-K program is concerned, one of   the things that we talk about all the time is that it is a   program that serves now, by next year, almost 60 percent of our   students. We are at 58 percent this year, serving just over   79,000 students. But what we do is we talk about it being a   market-driven program. Since it is a voluntary universal   program, it will never be 100 percent, because there will be   some parents that choose a half-day program for their children   or choose a religious school for their program.      So what we are trying to do in Georgia is be sure that our   waiting lists are going down, that our number of slots, our   number of children served are going up so that, hopefully   within a few years, we will be meeting our market demand, and   we will be serving as many children as we possibly can in   Georgia.  

The federal government needs to take the lead in supporting early childhood education
 
Kildee 2009,(Hon. Dale E., Chairman, Subcommittee on Early Childhood, Elementary and Secondary Education IMPROVING EARLY CHILDHOOD DEVELOPMENT POLICIES AND PRACTICES; HEARING before the SUBCOMMITTEE ON EARLY CHILDHOOD, ELEMENTARY AND SECONDARY EDUCATION COMMITTEE ON EDUCATION AND LABOR; MARCH 19,;
http://www.gpoaccess.gov/congress/house/education/index.html                                     

Last month, in his address to a joint session of Congress,    President Obama set a goal of ensuring that every child has    access to a complete, competitive education from birth forward.    That is why Congress and President Obama worked together to    increase funding by $2.3 billion for Head Start and Early Head    Start and $2.1 billion for the Child Care and Development Block    Grant in the American Recovery and Reinvestment Act and the    recent 2009 appropriations bill, because those investments will    preserve and create jobs and improve access and quality for the    children who need those programs.       That is why I was so pleased to see that President Obama's    budget will commit significant new resources to early    childhood, because the federal budget should reflect our values    as a nation. And that is just what the president's budget will    do. Now, you can judge an individual by how that individual    spends his or her money. And you can judge government by how    that government spends the taxpayers' money.       And that is why I look forward to this committee working    with the president to help parents and other educators make the    early years of children's lives nurturing and enriching. Just    about an hour and a half ago, I held Addison Kildee in my    arms--she is 11 months old--and gave her a little kiss and came    off to work. My son had dropped her off for daycare today at    our house.       Because ensuring that children and their families have    access to high-quality, comprehensive services that help the    children develop cognitively, physically, socially and    emotionally enables them to succeed in school and in life.    Children who receive quality early childhood education and    development services do better in reading and math and are more    likely to graduate from high school, attend college and hold    higher paying jobs. The support and security that these    services provide infants, toddlers and young children help    their brains develop in the early years and set the    foundation--literally--for later development and learning.       Those early stimulations--sound, sight, touch--actually lay    down, the physical circuitry of the brain. In 1965 when Head    Start was enacted, those people were very prophetic. They    didn't really realize what we know now about the physical    development of the brain. But they wrote a Head Start bill that    really helped that so much. And now later on, we find out the    importance of that stimulation for the actual laying down the    circuitry of the brain.       We took some important steps last Congress. We authorized    the Head Start Act to prioritize teaching quality and Early    Head Start, among other things. I was proud to introduce that    bipartisan reauthorization along with Chairman Miller and    Governor Castle and Mr. Ehlers from Michigan and others. The    committee also reported my colleague Ms. Hirono's PRE-K Act.       But as we will hear today, meeting the goal that we share    with President Obama is about more than any one program, but    about ensuring that wherever children are, there are high    standards and the resources and accountability to ensure those    standards are met.


Only federally funded action ensures the streamlined and unified approach that is necessary
Dichter, Pennsylvania Department of Education and Public Welfare, Secretary for the Office of Child Development and Early learning deputy secretary, 3/23/09
(Harriet, Federal News Service, “Hearing Of the Subcommittee on Early Childhood, Elementary and Secondary Education of the House Committee on Education and Labor,” Lexis-Nexis, accessed 7-1-09, MC)

We have children at risk in every county, every city and every state in the U.S. New funding is needed to help close a staggering gap between those children, those at risk of school failure in particular, who are in our quality early learning programs and those who are not. We need to assure a public funding base for early education, just as we work to assure public funding commitment to K- 12.
What does that mean? I'll try to get to the end here. We have to significantly deepen our investment in our established federal programs and funding streams, but we also need to commit to new federal funding that will push a unified approach across all the early childhood programs, insist that the states have meaningful research- based standards and accountability based on nationally acceptable minimums. That will facilitate coherence in the programs and produce quality results, and I believe it can be done with sensitivity to state implementation needs.
The last point that I want to make has to do with the organization of the programs and the resources to have that happen. Our families really do not care, in my experience, what we call the programs. They just want to know, when they are enrolling their child in a program, that it is of good quality and it is responsive to their needs. And they do want to know, when we're using public dollars, that the dollars are efficient and well-leveraged.
As we mentioned, in Pennsylvania we solved this problem when we created my office. It has given us great access into both educational resources and health and human services. We have a single staff to do the work, a consistent framework across the programs. We have to find a way for the federal government to do the same.
In summary, there is not just one program that works. Children need this continuum of early learning services. We need a commitment to infants, toddlers and preschoolers alike. It is just fine to have programs with different names, different hours of service. It is objectionable, though, to have programs that don't have the same expectations for outcomes for children, the same standards for serving our children, the same expectations for performance and accountability and sufficient financing.

Immense amounts of money will be needed and states do not have a budget large enough to accommodate these massive expenditures.
Samuels, Education Week staff writer, 4-1-09
(Christina A., Education Week, “Stimulus Providing Big Funding Boost for Early Childhood;
Programs ramping up, with eye on expansion”, pg. 1, Lexis, accessed 7-1-09, LL)

The $787 billion American Recovery and Reinvestment Act provides $1 billion over two years for Head Start, an education and social-services program for 3- and 4-year-olds from low-income families that began in 1965. The 15-year-old Early Head Start program, which provides services to infants, toddlers, and pregnant women, will receive $1.1 billion over that period. Together, Head Start and Early Head Start received about $7 billion in fiscal 2008.
Federal child-care and child-development block grants, which are used in combination with state money to provide subsidies for families that need child care, will receive $2 billion in increased funding over two years. The program received about $2 billion in fiscal 2008.
Stimulus money for early-childhood programs is also contained in other funding streams. For instance, Part C and Section 619 of the Individuals with Disabilities Education Act--programs that serve children with disabilities from infancy to kindergarten age--are receiving $900 million.
In addition, the $13 billion in Title I stimulus money, which can be used for schools that have large populations of children from low-income families, can be used to pay for early-childhood programs.
The 139,000-student Montgomery County, Md., district in suburban Washington plans to use part of its $6.1 million in Title I stimulus money to pay for an expansion of its full-day Head Start programs. The growth means the district will go from 13 programs serving 260 children to 21 programs serving 420 students this coming fall.
Superintendent Jerry D. Weast said the expansion reflected research done in the district that shows students who attended high-quality Head Start programs outpaced their peers academically.
"When the stimulus money came, this was a no-brainer," Mr. Weast said. "You have to make your money targeted to get results." Concerns about the funding stream drying up "can't ... deter you from doing the right things for children," he said. Early Head Start is receiving a dramatic increase from the stimulus legislation, compared with its $689 million in funding in fiscal 2008. The money is expected to double the number of children and families served by the program. Early Head Start works with pregnant women and helps promote the development of very young children, but is still just a fraction of the size of the older Head Start program. About 95,000 families and children are served by Early Head Start, compared with 976,000 in Head Start programs.
Only about 3 percent of eligible women are currently served through Early Head Start, said Matthew Melmed, the executive director of Zero to Three, a nonprofit organization that supports professionals, policymakers and parents on issues related to infants and toddlers. Although the U.S. Department of Health and Human Services, which administers Head Start and Early Head Start, has not released guidance on how the Early Head Start money can be spent, Mr. Melmed anticipates that the aid will allow for the expansion of programs, as well as the creation of new ones. But some of the money also will be spent on improving programs. "If all this money ends up doing is filling a hole that existed before," Mr. Melmed said, "it will not move us toward the types of changes we're committed to seeing."
One early-childhood constituency to watch will be prekindergarten programs, said Sara Mead, a senior research fellow with the New America Foundation, a Washington think tank. While the bulk of stimulus dollars in education will flow through individual states' school finance formulas, prekindergarten programs are often funded through a different revenue source in state budgets.
That means prekindergarten programs could end up competing for resources along with other needs that are vying for governors' attention, Ms. Mead said.

Perm is a win for Obama – it makes good on his promise to cooperate with states on early education
Burke, Research Assistant in the Domestic Policy Studies Department at Heritage Foundation, 5-14-09
(Lindsey, State News Service, The Heritage Foundation, “Does Universal Preschool Improve Learning? Lessons for Georgia and Oklahoma”, pg. 1, Lexis, accessed 7-1-09, LL)

Campaigning for the presidency in 2008, Barack Obama pledged to help states implement taxpayer-funded universal preschool--preschool for all.[1] The President's early education plan, for which he has advocated spending up to $10 billion annually in federal expenditures, encourages states to provide preschool for every child.[2] As President, Obama reinforced his commitment to early education when he signed the American Recovery and Reinvestment Act of 2009, which provided $5 billion in funding for early childhood programs.[3] Furthermore, the President's Early Learning Challenge Grant program pledges additional support for early education initiatives, with the ultimate goal of supporting states' efforts to implement universal preschool for all three- and four-year-old children in the country, regardless of family income.[4] The 111th Congress will likely consider proposals to expand federal subsidies for early childhood programs. Four such proposals aim to establish taxpayer-funded universal preschool.

The permutation solves best – Expanded federal funding key to ensuring cross-program coordination and continuity of services for children
Ewen, Center for Law and Social Policy Child Care and Early Education director, 3-18-9
(Danielle, “Statement of Danielle Ewen Director, Child Care and Early Education Center for Law and Social Policy, Committee on House Appropriations Subcommittee on Labor, Health and Human Services, and Education, and Related Agencies”, CQ Congressional Testimony, Lexis, AFB)

These results are not surprising to the children and families who participate in Head Start and Early Head Start programs. The success of the programs is tied to a set of core beliefs that ensure that the needs of every child are met. Head Start providers are experts at forming community partnerships, engaging in coordination, and reaching out to new and diverse allies in their community. They also recognize the need for continual improvement. As a result, across the country, Head Start programs are partnering with state pre-kindergarten programs to provide high-quality full-day experiences for the children in the state programs. In Hamilton County Schools in Chattanooga, Tennessee, the school district uses Title I funds in conjunction with Head Start funds to expand the availability of high-quality classrooms. In these classrooms, Head Start funds ensure that the Performance Standards are met for the time children are in the program and Title I supports the instruction of a bachelor degreed teacher for the 6.5 hour day. In Birmingham, Alabama, the Head Start agency has taken another approach to partnerships. Recognizing that children are in a variety of settings when working families need full-day and -year child care, the agency has partnered with family child care providers to provide Head Start services in family child care homes. Child care providers are trained in the Head Start model and receive the full range of professional development and other supports; providers meet all of the Performance Standards for each child and are monitored on a regular basis.
Head Start and Early Head Start also partner with the child care subsidy program to help families access full-day and -year settings, but state shortfalls in funding for child care assistance means that parents of children who participate in Head Start and Early Head Start often cannot get help paying for child care for the rest of the day. Programs, or individual families, must turn to multiple funding sources to piece together a full- day, comprehensive program that meets the needs of working families. Yet, insufficient funding for the Child Care and Development Block Grant (CCDBG) limits the ability of many Head Start and Early Head Start programs and families to do so and ensure that the full range of children's and families' needs are met.


Counterplan can’t solve – Devolving control of Head Start responsibilities to the states weakens the comprehensive and complementary missions of Head Start
Schemo, New York Times, 3
(Diana Jean, New York Times, 2-12-3, “Head Start Plan Worries Supporters” http://www.nytimes.com/2003/02/12/nyregion/head-start-plan-worries-supporters.html?pagewanted=2, accessed 7-8-9)

At the Edward C. Mazique Head Start Center here, Giselle Galvez, a 3-year-old who can sing the alphabet and tell pink from purple, pops into the medical office for a routine physical. In the kitchen, cooks purée fresh food for the infants, while toddlers learn to eat family style. Behind a classroom door covered in red hearts for Valentine's Day, Annette Robinson teaches children not yet 2 that A is for airplane.
And, as Head Start directors learned to their dismay last week, B is for block grants.
Under a Bush administration proposal, Head Start, the preschool program serving nearly one million poor children, would become a block grant program. Direct control would go from the federal government to the nation's cash-strapped governors, who would meld Head Start with existing state programs.
Administration officials said the change would allow states to coordinate Head Start better with their own preschool programs, and would bolster its educational mission by moving its oversight to the federal Education Department from Health and Human Services. They describe the proposal as a logical extension of President Bush's No Child Left Behind Act, which aims to have every child reading by third grade.
But critics point to studies showing that Head Start is already successful in giving poor children an advantage when they reach school. The federal program's virtue, they say, lies in its comprehensive approach to preparing children for kindergarten, seeing to their health and nutrition while teaching them not only letters and numbers, but also how to play with other children and trust grownups.
''I don't believe a school is going to focus on those kinds of things,'' said Leslie Johnson, director of the Mazique Center. ''Those are life skills.''
Critics, including Sarah Greene, president of the National Head Start Association, also contend that turning Head Start into a block grant program could be the first step toward dismantling it, as governors slice off services to make federal money go further. Under a measure passed by referendum in Florida, Gov. Jeb Bush must provide preschool for all children by 2005. But voters did not say how the cash-strapped state would pay for it. In New York, which had been moving toward sending all 4-year-olds to preschool, Gov. George E. Pataki's latest budget eliminates universal preschool, and cuts back preschool for poor children.


State control over Head Start fails—program weakening, lack accountability, no enforcement
Lynch, Professor and Chair of Dept. of Economics at Washington University, 07
(Robert G., Economic Policy Institute, “Enriching Children, enriching the Nation: Public Investment in High Quality Prekindergarten” May, http://www.epi.org/publications/entry/book_enriching/#author, Accessed 6/30/09, MF)

Granting states control of Head Start funds could lead to an overall weakening of the program through a dilution of program features, a reduction in the number of children served and a loss of accountability. While the bill includes a requirement that the state continue to serve at least the current number of children in programs meeting the full Head Start standards and a retention of current comprehensive services, the bill does not have any means of enforcing the requirements.

States won’t solve – funding shortfalls would collapse services and result in hiking eligibility criteria
National Organization for Women, 2003
(“Bill Undermines Head Start Program,” July 9, http://www.now.org/lists/now-action-list/msg00108.html, Accessed: 6-2-09, RA)

H.R. 2210 (deceptively named "The School Readiness Act of 2003") would limit Head Start's ability to provide high quality child development programs to low-income children by allowing states to determine standards. Because states are in such financial difficulty, it is likely that many will cut services, lay off teachers and raise eligibility standards. The federal requirement that comprehensive services be provided to all Head Start children is an important underpinning in the program's celebrated success. Without this stimulating and nurturing experience, many Head Start children would simply not be ready to learn when they begin grade school. Numerous studies have shown that if a child is not succeeding by the third grade, she/he will continue to fall behind.

State programs empirically provide worse services than federal programs and federal technical assistance is actually key to local cooperation
Ewen, Director of Center for Law and Social Policy, 5
(Danielle, “Should States have More Control Over Head Start? Keeping the Focus on Quality,” CQ Researcher, Volume: 15 Number: 21, August 26, 2005, page # 701, SR).

A change in governance would not assure these outcomes. State control risks the loss of comprehensive services and less targeting of scarce federal resources to the children most at-risk. Most state pre-k programs have fewer resources per child, do not include comprehensive services, have lower standards and serve a smaller percentage of the eligible population than Head Start. Collaboration and strategic state-level planning among Head Start, education and child care programs, and additional funding for these activities can help achieve these outcomes. Federal technical assistance can share strategies that help state and local partners bridge differences in cost sharing, eligibility and program standards. The best solution for every child in Head Start is not a restructuring of governance, but rather a stronger commitment of resources and improvements in quality.


Without new strict federal standards, states will only direct new funding toward unregulated poor quality care.
NACCRRA, the National Association of Child Care Resource & Referral Agencies, 09
(NACCRRA, “Requiring Accountability” http://www.naccrra.org/policy/docs/2009/RequiringAccountability-March.pdf, accessed 7-1-09, ASR)

Research shows that high-quality child care can promote healthy child development and help children enter school better able to succeed. Yet within and among the states, there is a haphazard approach to child development. Despite low standards in many states, half the states use federal funds to pay for at least one-fifth of the children receiving federal subsidies to be in license exempt care (care that is legally operating but not subject to state licensing standards or regulation). For example, in Michigan, 66 percent of children receiving subsidies are in license-exempt care. In Oregon, 58 percent of children receiving subsidies are in license exempt care; in New York, it is 46 percent, and in Connecticut, it is 44 percent. There is little accountability with regard to state standards, but nothing is known about the quality of license-exempt care.


Federal leadership is key to returning childcare to the center of the agenda
Isaacs, Child and Family Policy Fellow at the Brookings Institution, 08
(Julia, The Brookings Institution, “Supporting Young Children and Families: An Investment Strategy that Pays, Winter, http://www.brookings.edu/articles/2008/winter_children_families_isaacs.aspx, accessed 6-27-09, PAK)

Despite this growing body of research on the importance of the early years on development and achievement, the federal government has provided little direct support to young children and families. However, there has been a significant change at the state government level, with a majority of states adopting public pre-kindergarten programs and other forms of early childhood intervention. In addition, attitudes toward public investment in the pivotal early childhood years are shifting, and the time is ripe for federal leadership in developing policies to support young children and their families as a key part of a domestic policy agenda. Below, I outline three policy proposals that have proved cost-effective and that can help to reduce burdens on young families.

Decentralization will cause venue shopping that prevents expansion of Head Start to new programs—constituents will fight for the status quo
Karch, University of Texas Political Science Assistance Professor, June 9, 2009
(Andrew, “Venue Shopping, Policy Feedback, and American Preschool Education,” The Journal of Policy History, Volume: 21, June 9, 2009, p. 41, MC)

When policies are established at the state or local level, officials with jurisdiction over them
Important public policy decisions are made in a variety of institutional settings in the United States, and this decentralization gives policy advocates an incentive to focus on the venue in which they are most likely to be successful. The phenomenon of venue shopping has long been recognized as a crucial element of the policymaking process, but less attention has been paid to its long-term consequences. 1 Recent scholarship on policy feedback, however, suggests that successful venue shopping may alter the terrain on which subsequent decisions are made. Advocates’ ability to achieve their objectives in a particular setting may affect temporally distant developments by creating constituencies with a stake in existing arrangements, in terms both of the government officials who are granted jurisdiction over policy decisions and of the program beneficiaries with a stake in the choices these officials make. This article assesses the long-term consequences of venue shopping by tracing the evolution of American preschool education. In December 1971, President Richard Nixon vetoed a bill that would have dramatically expanded the role of the national government in this policy area. Preschool advocates shifted gears, experiencing greater success at the state level and expanding the reach of less comprehensive national programs. The entrenchment of these programs influenced subsequent congressional debates over preschool education, as the officials who ran the programs and the constituencies who benefited from them appeared before Congress to defend the status quo. Thus the evolution of American preschool education suggests that successful venue shopping can affect the future possibilities for policy change.


Decentralization leads to pre-emption and failed policies
Karch, University of Texas Political Science Assistance Professor, June 9, 2009
(Andrew, “Venue Shopping, Policy Feedback, and American Preschool Education,” The Journal of Policy History, Volume: 21, June 9, 2009, p. 40, MC)

Policy feedback implies that successful venue shopping may have long term consequences. Constituencies that benefit from the decisions made in a specific institutional setting may work to ensure that future decisions are also made in that venue, because shifting the locus of decision-making responsibility to another setting may introduce an element of uncertainty that puts their previous gains at risk. Government officials with jurisdiction over a program may also work to preserve the status quo. These actors may be elected officials who view existing programs as an opportunity to credit claim or program administrators who want to protect their bureaucratic turf. As a result, successful venue shopping may affect future policymaking by causing the “filling up” or the “preemption” of a policy space. 13 Officials who favor policy change may find their options constrained by what previously transpired in other venues.

__ IMMIGRANT HEALTH CARE

Federal restrictions on assisted preventative care for immigrants are skyrocketing costs and depleting resources
Morgan Greenspon Staff Member, Annals of Health Law, 2008 (“The Emergency Medical Treatment and Active Labor Act and Sources of Funding.” 17 Ann. Health L. 309//ZE)
Fear of deportation is one of the major factors that influences whether an undocumented immigrant will decide to seek medical care. 24 Thus, a common concern in the safety net community is that undocumented aliens will not seek medical attention until their condition has deteriorated to the point that it becomes a medical emergency. 25 As a result, hospitals are potentially left uncompensated for the emergency care they are required to provide to indigent persons, which is much more expensive than simple preventative care. 26  EMTALA creates a financial anomaly in which hospitals can only seek federal reimbursement for medical emergencies, and not reimbursement for less expensive preventative care. Perhaps the best illustration of this may  [*313]  be the costs associated with pregnancy and childbirth. Under EMTALA, a hospital must treat a woman in labor, thereby allowing it to seek reimbursement from Emergency Medicaid for providing this care. 27 However, EMTALA does not include any provisions for prenatal care or family planning. 28 Ironically, under the current system, the federal government will reimburse a hospital for the much higher costs of emergency care, but not for the low costs associated with preventive care; thus, preventing access to primary and preventative care ultimately leads to higher health care costs. 29 Providing early intervention and preventative care would not only make better use of the healthcare system's scarce resources, but it is also medically preferable. 30  A. Emergency Medicaid   The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 prevents certain groups of legal immigrants, and all undocumented immigrants, from receiving Medicaid benefits. 31 However, aliens who would otherwise qualify for Medicaid, if not for their immigration status, remain eligible for Emergency Medicaid; 32 these undocumented aliens are entitled to receive emergency services that are necessary for the treatment of an emergency medical condition. 33 Thus, "the current legislation ... takes a back-end approach by providing illegal immigrants health care access by providing emergency services." 34  Under Emergency Medicaid, a hospital may be compensated for providing care to undocumented aliens experiencing a medical emergency such as childbirth, labor, or another condition that may threaten an individual's life. 35 However, if the patient does not qualify for Emergency Medicaid, then a hospital may go completely uncompensated. 36 Additionally, if the federal government would help  [*314]  fund preventative care, there is a good chance the overall amount of money spent on medical care for undocumented aliens would decrease "because it is more expensive to provide emergency care than it is to take a front-end approach by providing preventative care."

Current state and federal policies create a chilling effect that deter immigrants from seeking care
Susan Okie, M.D., 8/9/2007 (New England Journal of Medicine. “Immigrants and Health Care — At the Intersection of Two Broken Systems.” http://content.nejm.org/cgi/content/full/357/6/525//ZE)
The federal Medicaid program has always been restricted to U.S. citizens and legal residents, but recent federal and state laws designed to strengthen enforcement of eligibility rules have created new barriers, even for infants and children who are citizens, and have had a chilling effect on other programs providing health services for immigrants. The 2005 Deficit Reduction Act requires all persons applying for or renewing Medicaid coverage to provide proof of identity and U.S. citizenship. Since that law went into effect, at least eight states have reported dramatic declines in Medicaid enrollment, and some Medicaid-eligible infants and children have gone without immunizations and needed medical care because of delays in coverage.5

Immigrants are solely within federal jurisdiction – the states can’t regulate them
Swati Agrawal, Associate, Paul, Weiss, Rifkind, Wharton, & Garrison. B.A. 1992, University of Michigan; J.D. 1995, Yale Law School, (Trusts Betrayed: The Absent Federal Partner in Immigration Policy, Spring, 1996, San Diego Law Review)
The federal government enjoys a preeminent role in regulating domestic matters pertaining to aliens. In fact, it enjoys a freedom to take actions against immigrants - legal as well as illegal - that would likely be held inimical to principles of equal protection if applied to citizens, such as racial minorities.  n18 In contrast, state assertions of [*764]  power over immigration and alienage classifications are regarded by the courts as highly suspect, requiring review under a strict scrutiny standard.  n19 Naturally, the question of federal plenary power over immigration matters has raised many questions regarding the appropriate state role in making policies affecting immigrants within their borders.

States shoulder the costs now – only a change in federal policy restores the system
Adrianne Ortega, 2009 (J.D. Boston U, M.P.H. Boston U School of Public Health. “. . . And Health Care For All: Immigrants in the Shadow of the Promise of Universal Health Care.” 35 Am. J. L. and Med. 185//ZE)
Federal legislation creates a heavy burden on hospitals which then transfer social costs to the state. n96 Hospitals often treat non-citizen patients after stabilization in the emergency room while arranging an appropriate discharge. n97 Hospitals largely absorb the cost of this expensive treatment. n98 A recent survey estimated that hospitals are collectively spending about $ 2 billion a year in unpaid medical expenses to treat undocumented  [*196]  immigrants. n99 One hospital spent $ 1.5 million on one patient alone. n100 Sixty California hospitals were forced to close between 1993 and 2003 due to outstanding bills for services rendered. n101 400 emergency rooms closed between 1993 and 1998, and after the enactment of EMTALA, one of six trauma centers decertified. n102 In 2008, the California Medicaid program spent an estimated $ 20 million on about 460 patients. n103 In a New York City public nursing home, undocumented immigrants occupy roughly one fifth of 1,389 beds. n104  Hospitals transfer these financial burdens to the states in the form of social costs. n105 For example, if a hospital in an urban area must close for financial reasons, the individuals served by that hospital must seek treatment at other local hospitals. As one hospital administrator put it, "We're unable to provide adequate care for our own citizens . . . . A full bed is a full bed." n106 Closures, therefore, affect those in surrounding areas with insurance and become a social problem for the state. n107  The high cost of treating non-citizens after emergencies leads hospitals to go to great lengths to get rid of expensive, undocumented patients. n108 A recent New York Times article, Immigrants Facing Deportation by U.S. Hospitals, details the process by which United States hospitals are "repatriating the sick." n109 Tactics include flying or driving undocumented patients back to their country of origin. n110 Once a hospital repatriates a patient, the patient "is out of sight . . . out of mind" and the hospital fails to follow-up with the patient. n111 Startling statistics revealed in the article include:      Some 96 immigrants a year repatriated by St. Joseph's Hospital in Phoenix; 6 to 8 patients a year flown to their homelands from Broward General Medical Center in Fort Lauderdale, Fla.; 10 returned to Honduras from Chicago hospitals since early 2007; some 87 medical cases involving Mexican immigrants -- and 265 involving people injured crossing the border -- handled by the Mexican consulate in San Diego last year, most but not all of which ended in repatriation. n112   [*197]  Some label this type of international patient dumping a "death sentence," because most home countries lack the facilities to treat the patients' often complex diagnoses. n113 For example, a Phoenix hospital repatriated an uninsured farmworker, Antonio Torres, to Mexico when he was comatose and connected to a ventilator. n114 "For days, Torres languished in a busy emergency room . . . but his parents . . . found a hospital in California willing to treat him, loaded him in a donated ambulance, and drove him back to the United States as a potentially deadly infection raged through his system." n115 Antonio recovered and leads a healthy life today in Phoenix. n116 The hospital, St. Joseph's in Phoenix, repatriates six to eight patients per year. n117 The Vice-President of Scottsdale Healthcare in Arizona explained his view of the situation:      Somebody falls out of a walnut tree. They show up in our Trauma One center. We don't have any problem with treating or stabilizing them. It's the humane thing to do. That's not where the costs run up. The costs run up after they're moved out of the trauma unit into a regular bed. Nobody, no nursing home, wants to take them . . . . n118  The hospital that willingly admitted Antonio, El Centro Regional Medical Center in California, said "it never sends an immigrant over the border. 'We don't export patients . . . I can understand the frustrations of other hospitals but the flip side is the human being element.'" n119  These repatriation practices are largely unregulated by state or federal law. n120


The federal government has a moral obligation to extend healthcare to noncitizens
Melissa Marietta, International Social Science Review, 2006 (“Undocumented immigrants should receive social services.” http://findarticles.com/p/articles/mi_m0IMR/is_1-2_81/ai_n16599310/pg_4/ //ZE)
The denial of healthcare is not only bad policy, it is unrealistic, cruel, and violates medical ethics. Should an undocumented worker involved in an accident be denied healthcare and left in front of a hospital to die? Most physicians have ignored the laws and treated patients regardless of their immigration status. America has the moral obligation to care for those who reside here. Americans pride themselves on providing a moral compass for the rest of the world. They believe that every human life is precious and important. Denying any individual healthcare based on citizenship contradicts that belief.

Current federal policy creates a chilling effect that stops immigrants from seeking benefits
Neeraj Kaushal, Prof. Social Work @ Columbia, and Robert Kaestner, Prof Economics @ Chicago, June 2005 (“Welfare Reform and Health Insurance of Immigrants.” http://findarticles.com/p/articles/mi_m4149/is_3_40/ai_n14707711/?tag=content;col1)
The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) changed legal immigrants' access to public health insurance in two ways: directly, by denying Medicaid benefits to immigrants who arrived in the U.S. after August 1996, and indirectly, by denying or limiting immigrant participation in Temporary Aid to Needy Families (TANF), which is an important entry point into Medicaid. An explicit objective of Federal law was to restrict immigrant use of means-tested programs. However, many state governments responded to the immigrant provisions in PRWORA by creating substitute means-tested programs for those immigrants who were adversely affected by the Federal policy.  Despite this inclusive approach adopted by several states, immigrants' dependence on means-tested programs such as TANF, Medicaid, and Food Stamps fell sharply subsequent to the passage of the Federal law, raising concerns that the fear or stigma associated with PRWORA may have had a "chilling" effect, causing even those immigrants who were eligible for benefits not to seek them (Fix and Passel 1999). The decline was particularly noticeable for Medicaid, but its cause is unclear. The decline in Medicaid may have been a consequence of the provisions in PRWORA, or of the stigma attached to it; or the decline may have been the result of other factors such as the economic boom of the nineties. To date, research has not clearly established the relative importance of these or other causes.  If PROWRA was responsible for a decrease in immigrant health insurance coverage, it would most likely reduce health care utilization by poor immigrant families, and possibly adversely affect their health. However, if welfare reform induced immigrants to seek jobs that offered health insurance (reverse of crowd

Fear of deportation deters immigrants from seeking treatment
Seam Park, B.B.A., Emory University Georgetown Immigration Law Journal Spring, 2004, Lexis
Two federal statutes, Section 642 of the Immigration Reform Law n47, and  [*575]  Section 434 of the Welfare Reform Act n48, "expressly void federal, state and local laws from prohibiting state and local agencies from exchanging information with the Immigration and Naturalization Service ("INS"). n49 Section 434 of the Welfare Reform Act, entitled "Communication between State and Local Government Agencies and the Immigration Naturalization Service," was passed into law first. The Conference Report accompanying Section 434 of the Welfare Reform Act explained: continues These statutes, in effect, prevent states and their political subdivisions from prohibiting their state health care official from exchanging immigration information with the INS. Therefore, both health care officials and illegal immigrants are left in uncertainty because officials lack instructions regarding whether they should report the undocumented status of illegal patients; this situation confuses the patients themselves. n52 Consequently, illegal immigrants seeking any form of available health care will not know for certain whether their identities will be turned over to the INS, which could lead to potential deportation. The obvious consequence of this uncertainty is the deterrence of the illegal immigrant community in seeking access to available health care. The combined effect of these statues creates a situation in which illegal immigrants must fear potential deportation from seeking any form of health care. Thus, although the federal government provides illegal immigrants with health care services if their condition is for the treatment of an "emergency medical condition(s)" n53 or "assistance with respect to immunizable diseases and for testing and treatment of symptoms of communicable diseases," n54 they must remain fearful of potential deportation if they take advantage of these services.


The counterplan can’t solve – federal law requires states to verify the status of all individuals applying for Medicaid
California Health Advocates, ’06 (“Citizenship proof required for Medicaid Eligibility Beginning on July 1st”, June, http://www.cahealthadvocates.org/news/low-income/2006/citizenship.html, KH)

In addition, according to the CBPP report referenced above, a recent review by the federal government found that states’ existing policies to document citizenship are effective and that no new federal requirements are needed in this area. Federal law already requires immigrants who apply for Medicaid to provide proof of their legal immigration status. States demand such documents on their Medicaid applications and take other steps to verify immigrants’ legal status. When people apply as citizens, they normally attest, under penalty of perjury, that they are citizens, and states usually do not require documentation of citizenship on a routine basis. However, if there is any question about the citizenship of an applicant, almost all states require documentation of citizenship.

Disclosing status creates fear of deportation– forcing them to avoid care
Gunnar, 6 – Associate Professor of Surgery at Loyola University Stritch School of Medicine (William P. Gunnar, M.D., Annals of Health Law, “The Fundamental Law That Shapes the United States Health Care System: Is Universal Health Care Realistic Within the Established Paradigm?” Winter 2006, 15 Ann. Health L. 151, JMP)

Many illegal immigrants are concerned that federal authorities will discover their immigration status if they receive federal, state or local subsidies. n167 State legislation may not preempt access to information possessed by the Department of Homeland Security's Bureau of Citizenship and Immigration Service n168 regarding the immigration status of an alien in the United States, whether lawful or unlawful. n169 PRWORA requires that the United States Attorney General establish procedures by which a state or local government can verify immigration status at the time an alien applies for a federal, state, or local health care benefits. n170
Thus, the impact of PRWORA on aliens "not qualified" for federal benefits is considerable, as it limits benefits for health care to emergency medical conditions, immunizations, and treatment for communicable diseases. n171 Any state may elect to extend state and local benefits to this  [*171]  population at the state's sole expense; however, to date only three states have chosen to do so. n172 Furthermore, PRWORA deters access to health care for illegal immigrants through provisions that potentially initiate deportation proceedings. n173

And, if states don’t verify documentation then they lose important federal funding
Spencer, ’07 (Naomi, “Hundreds of thousand hit by anti-immigrant measure US Medicaid recpients denied benefits under proof of citizenship law” https://www.wsws.org/articles/2007/mar2007/medi-m21.shtml, International committee of the 4th, March 21, KH)

Medicaid, the government health coverage program for the poor, is jointly funded through federal and state-level budgets. Beyond meeting minimum federal standards for care and oversight, states are allowed certain flexibility in how the program is administered. However, states have been placed under significant pressure to comply with the documentation rules or have federal funding revoked.

This ensures no solvency in the current economic climate – only federal assistance can ensure that states provide sufficient care
Forys, 8 – Student at Loyola University Chicago School of Law and member of the Annals of Health law
(Tamara, Annals of Health Law, “Left Out in the Cold: How the United States' Healthcare System Excludes Immigrants,” Summer 2008, 17 Ann. Health L. 351, JMP)

E. State-Funded Programs
Many states provide health coverage for low income immigrant residents who are ineligible for federal programs. n53 In 2006, twenty-two states provided state-funded health coverage for some immigrants who were not eligible for federal assistance. n54 These state-funded programs are less expansive than their federal counterparts, but are a start to ensuring that everyone in the United States has adequate health coverage. Using state funds, Florida, Massachusetts, Rhode Island, and Washington, D.C. cover all children, no matter their immigration status. n55 California covers roughly one million noncitizens, most of whom do not qualify for federal aid. n56
California and other states that fund immigrant health care began doing so shortly after the 1996 passage of PRWORA. n57 This occurred during a time that most states had strong economies and budget surpluses; however, state-funded care for immigrants has been among the first programs cut as states went into debt due to the recession. n58 Under current state budget constraints, state governments cannot adequately provide for the healthcare needs of the immigrant population without more federal assistance.
IV. Conclusion
Most U.S. immigrants are unable to gain health insurance coverage through the employer-based private system and are often ineligible for federally-funded coverage. States have attempted to cover these ineligible immigrants, but with recent budget constraints, immigrants are inadequately covered by these programs. Since federal funding covers only emergency care for new and undocumented immigrants, some states have attempted to expand the meaning of emergency to better aid sick undocumented immigrants. Other states have begun to cover undocumented children with state funds and to provide prenatal care for undocumented mothers and their unborn children. Despite different programs designed to assist  [*359]  immigrants in obtaining health care, there are huge gaps in federal and state coverage for the immigrant population, which is the most underserved by the private sector.

Only a federal signal will reverse the ‘chilling effect’ caused by welfare exclusions – Individual state action just causes more confusion
Kaushal and Kaestner, 5 – * Associate Professor of social work, and Faculty Research Fellow at the National Bureau of Economic Research. A Research Fellow at IZA - the Institute for the Study of Labor - in Bonn, Germany ** a Professor in the University of Illinois at Chicago's Department of Economics and a member of the Institute of Government and Public Affairs. A Research Associate for the National Bureau of Economic Research.
(Neeraj and Robert, Heath Services Research, “Welfare Reform and Health Insurance of Immigrants,” June 2005, http://findarticles.com/p/articles/mi_m4149/is_3_40/ai_n14707711/?tag=content;col1)

The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) changed legal immigrants' access to public health insurance in two ways: directly, by denying Medicaid benefits to immigrants who arrived in the U.S. after August 1996, and indirectly, by denying or limiting immigrant participation in Temporary Aid to Needy Families (TANF), which is an important entry point into Medicaid. An explicit objective of Federal law was to restrict immigrant use of means-tested programs. However, many state governments responded to the immigrant provisions in PRWORA by creating substitute means-tested programs for those immigrants who were adversely affected by the Federal policy.
Despite this inclusive approach adopted by several states, immigrants' dependence on means-tested programs such as TANF, Medicaid, and Food Stamps fell sharply subsequent to the passage of the Federal law, raising concerns that the fear or stigma associated with PRWORA may have had a "chilling" effect, causing even those immigrants who were eligible for benefits not to seek them (Fix and Passel 1999). The decline was particularly noticeable for Medicaid, but its cause is unclear. The decline in Medicaid may have been a consequence of the provisions in PRWORA, or of the stigma attached to it; or the decline may have been the result of other factors such as the economic boom of the nineties. To date, research has not clearly established the relative importance of these or other causes.

The CP can’t solve – as budget pressures increase states will resort to both legal and illegal means to try and curtail eligibility
Ku and Perez, 8 – *Professor of Health Policy, the George Washington University School of Public Health and Health Services. ** Secretary of Labor, Licensing and Regulation in Maryland, and the former Director of the Office of Civil Rights at the U.S. Department of Health and Human Services
(Leighton, “Today’s Topics in Health Disparities- Immigration and Health care: What are Policy Choices?” 3-12-08, http://www.kaisernetwork.org/health_cast/uploaded_files/031208_tthd_transcript1.pdf)

TOM PEREZ, M.P.P., J.D.: And as Leighton correctly said, a number of states have, indeed, attempted to pick up the slack. In Maryland where I live they made the decision in the mid-‘90s after immigrant reform to provide with state-only dollars coverage for pregnant women and children.
But what you’re seeing also now—and this is a trend that’s not limited to immigrants—but as state budgets shrink, there are always efforts afoot to make eligibility more difficult, again, for including but not limited to immigrant populations. And some of the things that are being done are in my judgment regrettable but legal. Other things are, I think, regrettable and not legal.
And an example of the second category was a number of states that were as a condition of receipt of Medicaid or SCHIP requiring proof of the immigrant status of the entire family as opposed to the individual applicant. The only relevant question as it relates to immigration status is the applicant, him- or herself. And frequently in the SCHIP context, you have citizen children living in mixed families, and they only relevant question is the citizenship of that child, but frankly, I think many states were implementing this knowing full well that once that question was asked, it was going to chill participation.
So we need to be very mindful as state regulators and people, advocates that are concerned with accountability of ensuring that as states attempt to cut corners that they’re not running afoul of civil rights and other laws.


Federal laws create a substantial barrier to health access for immigrants by causing confusion and difficulties for States and the fear of deportation for immigrants
Park, 4 – J.D. Candidate, Florida State University College of Law
(Seam, Georgetown Immigration Law Journal, “Substantial Barriers in Illegal Immigrant Access to Publicly-Funded Health Care: Reasons and Recommendations for Change,” Spring 2004, 18 Geo. Immigr. L.J. 567, JMP)

C. Can States Truly Provide Care?
The Welfare Reform Act prohibits states from providing illegal immigrants with any "state or local benefit," n55 which includes any "health . . . benefit, or any other similar benefit for which payments or assistance are provided to an individual, household, or family eligibility unit by an agency of a State or local government or by appropriate funds of a State of local government." n56 However, the Welfare Reform Act gives states the ability to pass affirmative legislation providing illegal immigrants with state-funded preventive health care at their discretion. n57 States that desire to take advantage of this authority are faced with two problems. First, the Welfare Reform Act has made it difficult and confusing for states to provide illegal immigrants  [*577]  with state-funded preventive care, assuming they desire to exercise this option. The second problem is a subtle, familiar problem caused by Section 434 of the Welfare Reform Act and Section 642 of the Immigration Reform Law. n58 The problem is that illegal immigrants must remain fearful of having their having their undocumented status revealed to the INS, regardless of whether the federal or state government is providing the health care.
A recent Texas Attorney General's Advisory Opinion exemplifies the strict, confusing nature of the Welfare Reform Act's ffect on states trying to provide state-funded health care for illegal immigrants. n59 In the opinion, the Attorney General confronted the question of whether Texas county hospitals could provide discounted or free health care to residents of the county "without regard to their immigration or legal status." n60 The Attorney General decided that Texas hospitals were, in fact, obligated to check the immigration status of persons seeking preventative care at a discounted rate because 8 U.S.C. § 1621(d) preempts all local and state laws that provide services contrary to the provision. n61 Specifically, the law provides:
A state may provide that an alien who is not lawfully present in the United States is eligible for any State or local public benefit for which such alien would otherwise be ineligible under subsection (a) of this section only through the enactment of a State law after August 22, 1996, which affirmatively provides for such eligibility. n62
Therefore, unless the State of Texas passed legislation after August 22, 1996 that "affirmatively" made illegal immigrants eligible for access to state funded health care, the Welfare Reform Act prohibits illegal immigrants from receiving these state-funded health services. n63 After looking to the legislative history of a Texas house bill that amended the Indigent Health Care and Treatment Act, the Attorney General came to the conclusion that since the "Texas legislature did not include the citizenship language in the bill, it did not intend to provide preventive health care to illegal immigrants." n64 Texas county hospitals are, therefore, obligated to check the immigration status of persons seeking free or discounted preventive health care because these hospitals are prevented from providing such care to illegal immigrants. n65  [*578]  Furthermore, the opinion asserts that if county hospitals continue to provide such health care for illegal immigrants, they could be subject to federal funding sanctions. n66
Texas's situation exemplifies one of the numerous difficulties illegal immigrants now face in trying to access state-funded health care, especially if the state legislature does not expressly explain that it intends to "affirmatively" give eligibility for illegal immigrants seeking state-funded health care. Of course, this is assuming that states desire to provide health care services for illegal immigrants in the first place because many states have not yet passed legislation after August 22, 1996 n67 as required under the Welfare Reform Act. n68 Because Texas has such a large illegal immigrant population, n69 this opinion could be a sign of desperate times for these people; publicly funded health care may become nonexistent.
The second problem arises if a state successfully passes affirmative legislation providing illegal immigrants with state-funded preventive care. The problem is caused by Section 434 of the Welfare Reform Act and Section 642 of the Immigration Reform Law because these statutes ban any state or governmental entity from instructing their state health officials to prohibit the disclosure of the undocumented status of these illegal immigrants. Therefore, illegal immigrants must remain deterred from accessing preventive care that the state legislature has purposely made available because they are not provided with security against having state health care officials revealing their immigration status to the INS. Essentially, the federal government is giving with one hand, but taking with the other as the Welfare Reform Act allows states to pass legislation to provide illegal immigrants with preventive health care, but Section 434 of the Welfare Reform Act and Section 642 of the Immigration Reform Law nullify the effectiveness of this provision. These statutes prevent states from instructing their state health officials not to disclose immigration information to the INS.
Unless states can prohibit state health officials from disclosing this information, illegal immigrants must continue to remain fearful and uncertain about available health care, whether it is federally funded emergency services or treatment for communicable diseases, or state funded preventive care. Alternatively, if states were given the authority to provide state-funded  [*579]  preventive care and prohibit their health care officials from revealing the undocumented status of illegal immigrants to the INS, illegal immigrants would be able to access the available care without fearing potential deportation.
III. CURRENT AND POTENTIAL PROBLEMS CAUSED BY LEGISLATION
As a result of this legislation that essentially denies illegal immigrants access to health care or creates substantial barrier to its access, substantial problems have either been created or could potentially arise in the future. Of course, the problems discussed below are not an exhaustive list of problems that are created when a generally, poor and disadvantaged segment of the American society is denied reasonable access to health care. These problems, however, provide a range of perspective about how problems are not limited to the illegal immigrant population alone, but affect the rest of the general population as well.

The federal law prevents states from using even their own resources to fund services for unqualified immigrants
Fredriksson, 2000 – Associate Executive Director of the U.S. Committee for Refugees
(John, Georgetown Immigration Law Journal, “Bridging the Gap Between Rights and Responsibilities: Policy Changes Affecting Refugees and Immigrants in the United States Since 1996,” Spring 2000, 14 Geo. Immigr. L.J. 757, JMP)

Conversely, while the 1996 legislation gave states discretion to define eligibility and deny benefits to legal immigrants and refugees, it restricted states' flexibility and discretion to provide assistance and services to unqualified immigrants (as defined in the Welfare Act) and undocumented migrants. n51 Prior to 1996, while undocumented immigrants were, with the exception of medical emergency assistance and certain children's programs, ineligible for federal benefits, states had the authority to include unqualified immigrants in programs and services funded strictly with non-federal revenues. Since 1996, state discretion is thus exclusively restrictive: states may narrow immigrants' eligibility or deny qualified immigrants' access to benefits but are precluded from conferring benefits on undocumented immigrants, even if they wish to do so with their own funds. n52

Can’t solve any health advantage – forces difficult funding trade offs that results in reduced serves available to everyone
Knutson, 8 – Articles Editor of the Boston College Third World Law Journal
(Ryan, Boston College Third World Law Journal, “Deprivation of Care: Are Federal Laws Restricting the Provision of Medical Care to Immigrants Working as Planned?” Spring 2008, 28 B.C. Third World L.J. 401, JMP)
 
[*425]  The legislative history additionally illustrates the existence of a spirited opposition to PRWOA. n193 Opponents of the measure appeared to be most strongly moved by PRWOA's unfair targeting of legal immigrants. n194 Specifically, many lawmakers were troubled by the retroactive change in public benefits eligibility for legal immigrants who were on the path to citizenship. n195 Another significant concern for lawmakers was that PRWOA effectively shifted costs away from the federal government onto the states. n196 Senator Tom Daschle of South Dakota remarked that PRWOA "shift[s] the welfare problem to the states" and "tell[s] local taxpayers that they have to pick up the tab." n197 In a letter addressed to members of Congress, the National Association of Counties urged lawmakers to vote against PRWOA because of its potential to "shift costs and liabilities" and "create new unfunded mandates upon local governments." n198 Specifically, opponents asserted that this cost-shifting change in Medicaid would negatively impact local healthcare providers and the public's overall health. n199 The record indicates that hospitals feared the restriction on Medicaid would result in a loss of funds and a corresponding reduction in services available to everyone, citizens and non-citizens alike. n200 However, the funding crisis would especially affect those hospitals serving communities with large numbers of immigrants. n201 To fully understand the concept of cost-shifting, a brief examination of reimbursement mechanisms available to Medicaid hospitals is in order.

The Welfare Reform Act created new hurdles for states to provide health services and given states the leeway to restrict services
Park, 4 – J.D. Candidate, Florida State University College of Law
(Seam, Georgetown Immigration Law Journal, “Substantial Barriers in Illegal Immigrant Access to Publicly-Funded Health Care: Reasons and Recommendations for Change,” Spring 2004, 18 Geo. Immigr. L.J. 567, JMP)

Under the Welfare Reform Act, the federal government takes a "hands-off approach" when it comes to welfare plans for states. n39 Before Congress passed the Welfare Reform Act, "the federal government had sole responsibility for deciding which immigrants had access to which benefits. . . . The new federal welfare law, however, allowed states to bar noncitizens from their own cash, medical assistance programs . . ., which are funded with federal dollars." n40 The Welfare Reform Act has created minimal federal involvement with the welfare of illegal immigrants. The federal government has decided to take this passive approach because it determined that "it's not our role to make judgments on the substance of state programs." n41
Now, states, at their discretion, are free to offer or deny basic state-funded benefits to current and future immigrants, thus creating broad authority to establish or eliminate immigrant benefits. n42 The federal law has implicitly given the states the choice of "whether to create new state-funded substitute benefits for immigrants." n43 While the Welfare Reform Act gave states more freedom in developing benefits and programs for immigrants, it "narrowed the states' ability to make policy for unqualified aliens." n44 States now have "fewer options regarding illegal immigrants, mandating that they be barred from most federal, social, and local public benefits.'" n45 If states, at their own discretion, desire to "provide state and local benefits to undocumented and other unqualified immigrants -- even if they were providing these benefits before passage of [the Welfare Reform Act, they now] are required to pass a new law." n46 Therefore, the Welfare Reform Act has not only taken away federally funded preventive health care benefits for illegal immigrants, but has also made it difficult and confusing for states to provide illegal immigrants with state and local funded health care services, assuming they desire to exercise this option.

The counterplan will tradeoff with funding for infrastructure and education
Wood, 9 (Daniel Wood, The Christian Science Monitor, In Hard Times, Illegal Immigrants Lose Health Care, 3/24/09, http://www.csmonitor.com/2009/0324/p01s01-usec.html)

"The states and local governments tend to bear the brunt of illegal immigration," says Steve Camarota, statistician and demographer for CIS. Now, with revenues falling well short of predictions, services to undocumented immigrants are getting the ax in an effort to preserve other programs, from infrastructure to schools to the environment.
The cutbacks could potentially refire the debate over providing social services such as healthcare for illegal immigrants. In 2007, several state legislatures introduced bills that sought to limit social service benefits including healthcare to illegal immigrants. An LA Times/Bloomberg survey in December 2007 found that one in three Americans wanted to deny social services, including public schooling and emergency-room healthcare, to illegal immigrants.

Infrastructure investments are key to fight climate change
Knapp, 6/18 (Don Knapp, US Mayors: Infrastructure Key to Climate Fight, 6/18/09, http://www.icleiusa.org/blog/archive/2009/06/18/u-s-mayors-infrastructure-key-to-climate-fight

The results of Monday's survey of 140 U.S. mayors aren't too surprising. Cities' infrastructure budgets have taken a hit, and it couldn't have happened at a worse time. Investing in infrastructure, especially transportation infrastructure, as we all know, is a key to climate mitigation, and there are no shortage of opportunities.
The question now is, How will stimulus funds change this dilemma, once mayors and other local elected officials have cash in hand? Can targeted municipal spending on infrastructure and energy efficiency projects, despite cash-strapped general funds, make a real dent in overall emissions? That's a wait-and-see question.
Yet ever since local governments began the scramble to apply for their allocated funding through the American Recovery and Reinvestment Act (ARRA) passed, ICLEI's mantra, echoing the Department of Energy's, has been simple: Use the funds in a way that maximizes long-term benefits. Don't just fill potholes or retrofit individual buildings. Think long-term, think sustainably. Fund a vision to get people out of their cars and taking public transit to work. Fund a new city department that institutionalizes municipal energy efficiency work.
At ICLEI we've been eager to help spread these ideas and help local governments incorporate them into their strategies to spend ARRA funds. Right now we need a really big bullhorn.
But back to infrastructure, in particular: If you didn't click above to read the survey, produced by Siemens in partnership with the U.S. Conference of Mayors, here is a cut-and-paste of the first paragraph and its bullet points outlining the opportunities with infrastructure:
A survey of 140 mayors from 40 states also highlights concern over potential financial obstacles for infrastructure projects, according to a study sponsored by Siemens with the
U.S. Conference of Mayors.
A majority of cities (77%) report their infrastructure budget for 2009 has been adversely affected by the global economic crisis.
However, nearly two-thirds of all U.S. mayors surveyed believe that fighting climate change with technological innovation represents a “enormous” economic opportunity.
Optimizing the infrastructure of cities is considered a major way to address global warming and environmental protection.
Mayors of larger cities, in particular, viewed the expansion of public mass transit as a key way to fight climate change.

Climate Change is the greatest threat to human extinction. Far more likely to cause extinction than nuclear war because nuclear weapons have become more about precision than magnitude
The New York End Times 2006
(The New York End Times is a non-partisan, non-religious, non-ideological, free news filter. We monitor world trends and events as they pertain to two vital threats - war and extinction. We use a proprietary methodology to quantify movements between the extremes of war and peace, harmony and extinction.
http://newyorkendtimes.com/extinctionscale.asp)

We rate Global Climate Change as a greater threat for human extinction in this century. Most scientists forecast disruptions and dislocations, if current trends persist. The extinction danger is more likely if we alter an environmental process that causes harmful effects and leads to conditions that make the planet uninhabitable to humans. Considering that there is so much that is unknown about global systems, we consider climate change to be the greatest danger to human extinction. However, there is no evidence of imminent danger.
Nuclear war at some point in this century might happen. It is unlikely to cause human extinction though. While several countries have nuclear weapons, there are few with the firepower to annihilate the world. For those nations it would be suicidal to exercise that option. The pattern is that the more destructive technology a nation has, the more it tends towards rational behavior. Sophisticated precision weapons then become better tactical options. The bigger danger comes from nuclear weapons in the hands of terrorists with the help of a rogue state, such as North Korea. The size of such an explosion would not be sufficient to threaten humanity as a whole. Instead it could trigger a major war or even world war. Under this scenario human extinction would only be possible if other threats were present, such as disease and climate change. We monitor war separately. However we also need to incorporate the dangers here.


Federal law requires states to prove that individuals applying for Medicaid satisfy citizenship or immigration criteria
Kaiser Commission on Medicaid, ’07 (provides information and analysis on health care coverage and access for the low-income population, with a special focus on Medicaid’s role and coverage of the uninsured, “Medicaid and the Uninsured” January, http://www.allhealth.org/BriefingMaterials/Kaiser-CitizenshipDocumentation-keyfacts-635.pdf, KH)

Medicaid citizenship requirements
Under federal law, all U.S. citizens who meet Medicaid’s financial and non-financial eligibility criteria are entitled to Medicaid. Certain legal immigrants are also eligible. The Medicaid program has long required states to establish that individuals applying for Medicaid are U.S. citizens or satisfy the immigration restrictions. Prior to DRA, state Medicaid programs could determine citizenship by requiring applicants, under penalty of perjury, to attest to their citizenship in writing. All states except Montana, New Hampshire, New York, and Georgia used this self declaration option to establish U.S. citizenship.
New federal requirement to provide citizenship documents
The DRA introduced a new citizenship documentation requirement for U.S. citizens seeking Medicaid coverage. The law does not alter Medicaid eligibility criteria, but for U.S. citizens, it adds a new requirement to establish eligibility.
Under Section 6036 of the DRA, effective July 1, 2006, citizens applying for or renewing their Medicaid coverage must provide “satisfactory documentary evidence of citizenship or nationality.” The DRA specifies documents that are acceptable for this purpose and authorizes the HHS Secretary to designate additional acceptable documents. No federal matching funds are available for services provided to individuals who declare they are citizens or nationals unless the state obtains satisfactory evidence of their citizenship or determines that they are subject to a statutory exemption, discussed below.
The citizenship documentation requirement does not affect Medicaid rules relating to immigrants: most new legal immigrants are excluded from Medicaid during their first five years in the U.S. and undocumented immigrants remain eligible for Medicaid emergency services only.

States have to require Medicaid recipients to prove their citizenship or they lose federal funding
Rovner, ’06 (Julie, health policy correspondent for NPR, specializing in the politics of health care, NPR, http://www.npr.org/templates/story/story.php?storyId=5519069,

Starting July 1, states are supposed to require all Medicaid recipients to prove citizenship in order to get or keep their benefits. The provision is intended to purge Medicaid of illegal immigrants. But advocates for the poor have filed a lawsuit on behalf of citizens who simply lack needed documents.
And now some states say they can't implement the new rules in time and could face the loss of millions in federal funding.

Federal laws require documentation to verify citizenship and immigration status – this was designed to prevent undocumented immigrants from accessing Medicaid
Ryan, ’09 (Jennifer, National Health Policy Forum, “Citizenship Documents in Medicaid and CHIP”, May 26, http://www.nhpf.org/library/the-basics/Basics_CitizenshipMedicaidCHIP_05-26-09.pdf, KH)

The Deficit Reduction Act (DRA) of 2005 included a provision that requires individuals to provide proof of their U.S. citizenship and identity when applying for (or renewing) health coverage under the Medicaid program.1 In 2009, the Children’s Health Insurance Program Reauthorization Act (CHIPRA) extended the documentation requirement to children applying for the Children’s Health Insurance Program (CHIP). This paper reviews the parameters of the citizenship documentation requirement for Medicaid and CHIP eligibility and describes the mechanisms that are available to states for purposes of confirming applicants’ citizenship.
BACKGROUND
Since 1986, all individuals applying for Medicaid (and since 1997, for CHIP) benefits have been required to declare, under penalty of perjury, that they are U.S. citizens or that they have “satisfactory immigration status.”2 Noncitizens have also been required to present documentation that verifies their immigration status. Prior to the enactment of the DRA, states were permitted to accept an applicant’s written declaration of citizenship without providing specific documentation. According to a study conducted by the U.S. Department of Health and Human Services’ Office of the Inspector General (OIG), 47 states were accepting self-declaration of citizenship status in 2005.3
In 2005, Congress enacted the DRA, which requires U.S. citizens applying for or seeking to renew eligibility for Medicaid to present documentation that (i) proves their citizenship and (ii) documents personal identity. The DRA specified documents that are acceptable for purposes of demonstrating citizenship and identity, and it included exemptions for certain groups of individuals. The Medicaid citizenship documentation requirement became effective on July 1, 2006.
CHIPRA of 2009 extended the citizenship documentation requirement to the CHIP program. It also added new mechanisms states can use to obtain confirmation of citizenship for individuals applying for health coverage through Medicaid or CHIP.
The addition of the documentation requirement was intended to address perceptions that undocumented immigrants may have been inappropriately accessing Medicaid benefits.



Federal action is necessary to overcome racism and discrimination in immigrant health care now
Smith, 1 – Assistant Professor, Oregon Health Sciences University School of Nursing  (Linda S., Journal of Community Health Nursing, “Health of America's Newcomers,” Spring 2001, vol. 18, no. 1, EBSCO, JMP)

OPTIONS AND POSSIBLE SOLUTIONS FOR NEWCOMER HEALTH CARE
A disease anywhere is a problem everywhere. Global travel and migration means global transmission; diseases have no borders and no boundaries. Therefore, disease, illness, and health are universally important to everyone--no one is exempt. Many health care problems are not isolated nor confined by city, county, or state lines and can most effectively be resolved only at the federal level (L. S. Smith, 1997). When problems such as newcomer health are national problems, they demand national solution s and approaches (Litman, 1991). Given that states have had almost 2 decades of experience with the shift of control away from federal levels, it is essential that Americans ask whether the variances among states due to lack of federal standards has led to inequality among citizens of different states. Are these state variations confusing as well as unfair (Lipson, 1991)? Do these variances thwart efforts of networked relations among governmental levels ? More important, is there a usurping of the federal government's sole authority to regulate immigration?
Nobbe (1995) voiced this concern forcefully in an article when he predicted the chaotic tangle of fragmented health care due to block grant implementation. What safeguards, he asked, would ensure equitable distribution of funds ? "Block grants," he wrote, "seem the ultimate in buck-passing by a Congress unable to agree on much of anything substantive to do with healthcare reform" (p. 1).
In contrast, Medicare (the federal health insurance program for older people) has had a positive organizational structure. In 1965 it was a completely new program, administered entirely at the federal level. Medicaid, however, is subject to jealousies and whims of local and state boards (Litman, 1991). Though Medicaid is a health care program, it is linked with welfare. Medicaid also inappropriately includes care for nursing home placements and medical education--successfully removing funds away from women, children, and newcomers.
What I propose as potential solution s is not a dramatic overhaul of existing policy. It is, rather, a rethinking of important decisions, financial implications, and key players in the health care arena.
The federal government needs to impose itself back into a decision-making role regarding newcomer health care (L. S. Smith, 1997). This would be an important step and would be compatible with the charge of the federal system. In the past, the issue of states fights has been a shield for racism, prejudice, discrimination, and segregation (Elazar, 1990). Linkages need to be strengthened among the IOM, CDC, state and local health offices, and community health nurses who care for newcomer populations. Enhanced electronic data reporting, recording, retrieval, and dissemination mechanisms will be significant for improved newcomer health outcomes and patient satisfaction (Walker & Jaranson, 1999).



The counterplan will force Texas and Florida to institute a state income tax to compensate for considerable costs
Rao, 03 – a medical student at Texas Tech University Health Sciences Center, is a winner of the 2002 student essay contest sponsored by the Arizona Chapter of AAPS [ ‘From Privilege to Right: The Debate Over Medical Care for Immigrants”, Journal of American Physicians and Surgeons Volume 8 Number 1 Spring 2003 17]

However, development of a positive in rem obligation–that is, against society as a whole–to provide medical care imposes a direct cost burden, which typically fails to receive consideration in discussions of rights. Therein lies the fundamental problem with such a shift to creating this new “right.” Once the health care debate is framed as a moral obligation of society and is classified as a basic human right, it will not remain amenable to the consideration of costs.
Since the inception of Great Society, policies enhancing the role of government in medicine, medical provisions have remained a privilege, or a public benefit, guaranteed to those meeting eligibility requirements. By including undocumented immigrants as eligible recipients of state-funded care, the government effectively increases the patient pool to include virtually all inhabitants of the state.
The Welfare Reform Act was legislated with the intention of placing a higher burden on the ready acquisition of free health services and other goods. But, by sidestepping existing regulations and developing state remedies, individual states succumb to the notion that health care warrants status as the paramount entitlement worthy of creating a new-found societal duty of provision of care, while ignoring costs.
Moreover, further removal of the recognition of medical costs by the taxpayer can have a disastrous effect on public policy with states willing to spend unlimited sums of taxpayer money to fulfill the obligation. Taxpayers in border and immigration hub states will immediately recognize the increased financial burden of providing for a larger population. States such as Texas and Florida may have to alter existing tax structures and accept a state income tax, while other states accept even higher rates of local taxation.
If the pursuit of a universal right to health care is simply an outgrowth of American noblesse oblige, a basic right transcending costs, as proponents of the right claim, the purported exercise in humanity may be better served by building the health facilities and providing physicians on the other side of the US border.As noted in the filed demarche that spurred the Attorney General's action in Texas, it would just save immigrants the trip.
Conclusion
Supporters of unfettered health care access suggest compassion and equality are the driving factors of the movement for unlimited care for undocumented immigrants. However, invocation of the plight of the immigrant is merely a diversion of the debate on rights to health care.


The counterplan puts unique pressure on state budgets – especially in California – funding streams for health clinics are drying up because of financial concerns
MSNBC, 9 (“Recession cuts illegal immigrants’ health care; Calif. county among 1st to take drastic step, deny non-emergency services,” 3/15/2009, http://www.msnbc.msn.com/id/29706982/, JMP)

SACRAMENTO, Calif. - Graciela Barrios, an undocumented immigrant with few resources, has long relied on the county health clinic for the advice, medication and tests that have kept her diabetes under control.
But next month, Barrios and thousands like her will be on their own, and many more people across the nation face the same fate.
Bowing to recession-related budget pressures, Sacramento County recently took the drastic step of cutting non-emergency health services for illegal immigrants. Contra Costa County, on the east side of San Francisco Bay, will vote on a similar measure Tuesday.
Local health systems in other states are facing similar decisions as health officials find themselves trapped between dwindling federal, state and local funding streams and the growing number of newly uninsured who need services.
“The general situation there is being faced by nearly every health department across the country, and if not right now, shortly,” said Robert M. Pestronk, executive director of the National Association of County and City Health Officials, based in Washington.
Difficulty meeting needs
Data on the cost of health care for unauthorized immigrants is hard to come by, because community clinics and hospitals usually do not ask patients for their immigration status. But the Pew Hispanic Center estimates that about 59 percent of the 11.9 million illegal immigrants living in the United States have no health insurance, making up about 15 percent of the nation’s approximately 47 million uninsured.
As the financial crisis takes a toll on local health systems and job losses spike the number of uninsured, health providers are finding it increasingly difficult to meet the needs of the people they serve, said Pestronk.
More than half of local health departments across the country laid off or lost employees in 2008, according to a survey in January by the health officials association. About one-third predicted layoffs in 2009.
In Sacramento County, such cuts initially meant closing three of six clinics. In February, with even less money and more patients lining up, county supervisors and health officials had to decide: close one more clinic, firing up to 40 staffers to save $2.4 million, or cut services to the approximately 4,000 illegal immigrants treated annually.
“It was very difficult ethically for me,” said Keith Andrews, head of primary health services at the Department of Health and Human Service in Sacramento County. “People I’ve been caring for for years will be hurt.”
Hard math
Counties may legally cut services for illegal immigrants. Although hospitals receiving Medicaid funds must provide emergency care for anyone who needs it, there is no law requiring health providers to offer primary care.
Contra Costa County officials are doing the same hard math: If they vote to cut services to the 5,500 illegal immigrants they serve a year, they will save about $6 million.
After letting social workers go, cutting mental health services and seeing a delivery room built to handle 120 births a month accommodate 240, there were few other options, said Contra Costa Health Services Director William Walker.
“We’ve never had this crisis before,” said Walker, who submitted the plan being voted on Tuesday. “We’ve tried to carefully slice what we thought we could without cutting off our ability to respond. Now we’re looking at bad choices among bad choices.”

Federal funding is critical to relieve budget pressure on states – without it they will resort to cuts in eligibility or benefits
National Women’s Law Center ’06 (“The efficiency of Medicaid”, http://www.nwlc.org/pdf/The%20Efficiency%20of%20Medicaid%20-Dec%202006.pdf, December 2006, KH)
   
Many reform proposals involve capping federal funds to the Medicaid program. If federal
contributions to the Medicaid program are capped, the state will be left to shoulder the burden of increasing costs. Given the trend in health care costs, when these costs increase, the state will have to make up any differences without federal assistance, which will be near impossible under current state budget conditions. This will force the state to scale back their program, which often mean eligibility and/or benefit reductions.
Expanding Not Cutting, Medicaid Resources Are the Answer Reducing spending on Medicaid is fiscally unsound and would increase the numbers of uninsured, which costs taxpayers more in the long-run. Instead of searching for ways to cut the program, reform measures should focus on ways to reach even more people and relieve the program’s burden of long term health services and rising health care costs

The counterplan forces trade offs – including rationing
Gunnar, 6 – Associate Professor of Surgery at Loyola University Stritch School of Medicine (William P. Gunnar, M.D., Annals of Health Law, “The Fundamental Law That Shapes the United States Health Care System: Is Universal Health Care Realistic Within the Established Paradigm?” Winter 2006, 15 Ann. Health L. 151, JMP)

Medicaid programs provide funding for health services to over fifty million individuals in the United States and represent the nation's largest health care program. n132 Individual state costs associated with running a Medicaid program and the actual reimbursement rates for the health care services covered by Medicaid impact the availability of these services. n133 In 2002, optional state programs generated 65% of Medicaid spending and  [*167]  83% of the optional spending went to the elderly and disabled populations, the bulk of which was used for long-term care and prescription drug coverage. n134 Overall, children and their parents represent three-quarters of all beneficiaries and 30% of all spending, while the elderly and disabled account for a quarter of beneficiaries and 70% of spending. n135 State budgetary constraints dictate the availability of health services coverage and the number of persons eligible for optional programs. n136 As the demands on Medicaid spending increase, states are forced to restrict Medicaid expenditures, either by decreasing reimbursement to health care providers for health care services rendered or by rationing optional benefits. n137

The counterplan will force states to take a politically costly action and shoulder them with huge financial burden
Knutson, 8 – Articles Editor of the Boston College Third World Law Journal
(Ryan, Boston College Third World Law Journal, “Deprivation of Care: Are Federal Laws Restricting the Provision of Medical Care to Immigrants Working as Planned?” Spring 2008, 28 B.C. Third World L.J. 401, JMP)

C. PRWOA's Lasting Legacy
One of PRWOA's most important changes is its dramatic shift in transferring decisions regarding immigrant eligibility for public benefits from the federal to the state level. n238 Along with this decision-making authority, PRWOA brought about significant cost-shifting from the federal to the local level in the provision of medical care to immigrants. n239 Because PRWOA restricts states' ability to provide non-emergency care to unqualified and undocumented immigrants, hospitals are forbidden from providing the most cost- and medically-effective care. n240 PRWOA's financial strain on U.S. hospitals is illustrated through the steady increase in uncompensated care and underpayment of care, that are, in part, symptoms of a growing immigrant population. n241 Certainly, states are free to pass post-PRWOA affirmative laws that can restore the ability of hospitals and medical centers to provide non-emergency care to immigrants. n242 However, given the current anti-immigrant political climate, it is unlikely that many states will do so. n243 Furthermore, because non-emergency  [*431]  care must be funded without any federal funds, states and local governments will nevertheless carry the burden of providing preventive care should a state decide to pass an affirmative law. n244

Immigrant health care is a hot-button political issue in border states – the counterplan will spur a massive backlash
Dr. Okie, 7 – contributing editor of the New England Journal of Medicine
(Susan Okie, M.D., The New England Journal of Medicine, “Immigrants and Health Care — At the Intersection of Two Broken Systems,” 8/9/2007, Volume 357:525-529, http://content.nejm.org/cgi/content/full/357/6/525, JMP)

Recently, a bipartisan group of U.S. senators, with White House support, introduced an immigration bill that offered the best chance in years of achieving substantial reform of a dysfunctional system. However, the bill met with opposition from both conservatives and liberals and was killed in the Senate this past June, quashing all hope of immigration reform during the current administration. State legislatures this year are considering a record number of anti-immigrant measures, and the Senate bill's demise heightens their chances of passage. "You will see the states and cities scrambling to pass their own laws and regulations, and you're going to get a completely contradictory set of policies," Senator John McCain (R-AZ) predicted in a Washington Post article on July 8. In many areas of the country, one consequence is likely to be reduced access to health care for immigrants.
Noncitizens make up about 20% of the 46 million uninsured people in the United States. Hospitals generally do not collect information on patient immigration status, and there are no reliable national figures on hospital costs for undocumented immigrants. Nevertheless, the soaring cost of uncompensated care (see graph A) has made the problem of providing care for uninsured immigrants a hot political issue, particularly in border states and those (such as the southeastern states) whose immigrant populations have grown rapidly in recent years. Some uninsured immigrants needing emergency treatment (including pregnant women, children, adults with dependent children, and elderly, blind, or disabled patients with incomes below Medicaid thresholds) qualify for emergency Medicaid coverage. In many other cases, hospitals receive no payment for their care, although in 2003 Congress appropriated $250 million per year for 4 years (starting in 2005) to partially compensate hospitals for treating undocumented immigrants.






Welfare Reform Act cancels out state policy
Seam Park, B.B.A., Emory University Georgetown Immigration Law Journal Spring, 2004, Lexis
The Welfare Reform Act prohibits states from providing illegal immigrants with any "state or local benefit," n55 which includes any "health . . . benefit, or any other similar benefit for which payments or assistance are provided to an individual, household, or family eligibility unit by an agency of a State or local government or by appropriate funds of a State of local government." n56 However, the Welfare Reform Act gives states the ability to pass affirmative legislation providing illegal immigrants with state-funded preventive health care at their discretion. n57 States that desire to take advantage of this authority are faced with two problems. First, the Welfare Reform Act has made it difficult and confusing for states to provide illegal immigrants  [*577]  with state-funded preventive care, assuming they desire to exercise this option. The second problem is a subtle, familiar problem caused by Section 434 of the Welfare Reform Act and Section 642 of the Immigration Reform Law. n58 The problem is that illegal immigrants must remain fearful of having their having their undocumented status revealed to the INS, regardless of whether the federal or state government is providing the health care. 

Courts overturn – states can’t regulate immigrants
Adrianne Ortega, 2009 (J.D. Boston U, M.P.H. Boston U School of Public Health. “. . . And Health Care For All: Immigrants in the Shadow of the Promise of Universal Health Care.” 35 Am. J. L. and Med. 185//ZE)
Adjudication has not provided a useful avenue to address health care coverage for undocumented immigrants. States have lost every suit against the federal government which claimed the failure of the federal government to properly manage national security and immigration policy resulted in a disproportionate state burden of caring for undocumented immigrants. n46 Courts have found that the federal government has the sole authority to regulate immigration, and that immigrants are not a suspect class qualifying for heightened scrutiny under the law. n47 The most effective legal solution may lie in legislative action.

states will provide the minimal funding necessary to enact the counterplan—will cut programs and deny services to undocumented immigrants.

Wood 09 (Daniel, Staff Writer of the Christian Science Monitor, http://www.csmonitor.com/2009/0324/p01s01-usec.html)
Jose Cedillo, an illegal immigrant from Mexico, says he has nowhere to turn.  A day laborer since 1986, Mr. Cedillo has received notice from a Los Angeles County hospital that he must start paying out of pocket for the treatment he will need. "I have no choice because I have no insurance and can't work while I'm taking these treatments," he says, sitting in the tiny apartment he shares with his wife, a janitor. The recession – and a big state deficit ­– is leading some California counties to cut back on nonemergency health services to illegal immigrants. In others, cutbacks in services for the uninsured are hitting illegal immigrants especially hard.  The problem is socking California because it is home to the lion's share of US immigrants, both legal and illegal. The latter are often eligible for healthcare provided to the poor. But health departments across the country are facing budget pressures that are leading to slashed services – and that could reignite the debate over providing medical care to illegal immigrants.  "There simply isn't enough revenue to support the network of services which heretofore has been expected," says Robert Pestronk, executive director of National Association of County and City Health Officials (NACCHO). In many states, budget cuts mean reduced funding for the uninsured, many of whom are immigrants and low-income families. In Arizona, a $13 million cut from the state budget eliminated funds partly used to reimburse hospitals for caring for the uninsured. About 64 percent of illegal immigrants nationwide ­– 7.2 million ­– are uninsured, according to the Washington-based, Center for Immigration Studies (CIS).  "The states and local governments tend to bear the brunt of illegal immigration," says Steve Camarota, statistician and demographer for CIS. Now, with revenues falling well short of predictions, services to undocumented immigrants are getting the ax in an effort to preserve other programs, from infrastructure to schools to the environment.  The cutbacks could potentially refire the debate over providing social services such as healthcare for illegal immigrants. In 2007, several state legislatures introduced bills that sought to limit social service benefits including healthcare to illegal immigrants. An LA Times/Bloomberg survey in December 2007 found that one in three Americans wanted to deny social services, including public schooling and emergency-room healthcare, to illegal immigrants.  In California, two counties are pulling back on health services for illegal immigrants. Sacramento County closed two health clinics that serve the poor and ended services with various mental health contractors in early February, saving nearly $6 million in an effort to close a $55 million general fund shortfall.  In Contra Costa County, a proposed plan would screen out illegal immigrants – except for children and pregnant women – from nonemergency healthcare services that are provided to low-income residents who cannot get insurance. The county is looking at cutting services to an estimated 5,500 illegal immigrants they serve annually, to tally a savings of $6 million.  "The pressure is purely economic," says Dorothy Sansoe, senior deputy county administrator for Contra Costa County. Her county has already cut $90 million from its general purpose budget and has to cut another $56 million by July 1.  






___INDIAN HEALTH SERVICES



The states have no authority over Indian nations, and, and attempting to exert authority would result in conflicts and undermines the trust doctrine
American Indian Policy Center, 2002
(American Indian Policy Center [President: John Poupart Masters of Public Policy (MPA), Harvard University, Cambridge, MA, 1980. BA, Criminal Justice, University of Minnesota, 1977. Leadership Seminar, Hubert H. Humphrey Institute, 1983. Paradox of Leadership, 1985]’ “State-tribal relations,” 2002, EM, http://www.airpi.org/projects/statetrb.html, accessed: 7-5-09)EM
The devolution of congressional authority to the states in the last two decades has impinged on the government to government relationship Indian tribes have with the federal government. In the early '80s, Ronald Reagan's policy of New Federalism began the trickle-down of regulatory and taxation authority to the state level. Despite Democratic control of the White House, that trickle has become a torrent. From the state government's frame of reference, it doesn't make sense that the state can't assume regulatory and taxation authority over Indian country, just like every other area. Conflicts over resource management, taxation and regulation erupt because state governments fail to understand or recognize the sovereignty of tribes. The U.S. Supreme Court clearly defined the relationship between Indian tribes and state governments in 1832. In Worchester v. Georgia, Chief Justice Marshall wrote, "The Cherokee Nation, then, is a distinct community, occupying its own territory, with boundaries accurately described, in which the laws of Georgia can have no force, and which the citizens of Georgia have no right to enter, but with the assent of the Cherokees themselves, or in conformity with treaties, and with the acts of congress. The whole intercourse between the United States and this nation, is, by our constitution and laws, vested in the government of the United States." The framework set forth in this case (and two others that comprise the Marshall trilogy) make it clear that states are specifically excluded from relationship between two sovereign nations. These cases echo the constitution which specifically prohibits any state from entering into a treaty with another nations, and, through the commerce clause, gives congress the sole authority to deal with Indian nations. That a state government would try to exert taxation or regulatory authority over an Indian nation makes no more sense than if that same state government tried to tax Canada. It is clear that the governments closest to Indian tribes need the most education. State government jealousy and resentment over casino revenues often cloud a clear point of view. In small group discussion to address tribal-state relations, gaming kept surfacing. According to moderator Roy Taylor, gaming "takes us back to the ignorance displayed by all the players. This ignorance is based on racism, bigotry, power, etc. Because gaming is revenue related, it is the reason for its continued surfacing." The missing element, according to Taylor, is governance in an appropriate manner. It is up to us to inform the general public. Our Congress has to be educated and needs to become even more knowledgeable about Native Americans in order for us to get their help, said Lorraine Rosseau, former tribal chair from South Dakota. Rosseau encouraged the group to go back the their homelands and to do something. There is still a "Hollywood" image of Native Americans left from the '50s and '60s This ignorance and negative view needs to be counteracted, one woman said. Native Americans must out organize and communicate to survive and prosper. With a strategic plan, Native American can become more proactive, another participant said. She added that Native Americans must invite all, like in native tradition. We must offer gifts and talk over dinner with the hope that this will enhance the relationship.

Perm do both - states empirically follow federal regulations on IHS when they work together
Marquez 2001
(Carol A. Associate program director/collaborating investigator in the Department of Nursing, University of Minnesota who has worked with indigenous peoples for 20 years, “The Challenges of Medicaid Managed Care for Native Americans”, Wikazo Sa Review, 16.1:151-159. EKC)
According to Clain, the IHS situation is further complicated because tribes and states may operate under different understandings of the current Medicaid reimbursement practices. Presently, IHS and tribal clinics are allowed the federally qualified health center rate or 100% of the federal medical assistance percentage (FMAP), which is the rate received by the state. The IHS rate is not set in stone and is left to the discretion of each state to negotiate with its tribes (Clain 2000). However, most states with sizable AI/AN populations have reimbursed tribes at the 100% FMAP rate. Very few states have chosen to ignore the IHS rate. For some tribes, though, the rate may not fully cover their expenses so that return to the federally qualified health center negotiated rate may be preferable to tribal health providers.

Greater state authority over tribes in the area of social services undermines tribal sovereignty – state governments will expand their authority and rollback Native protections
Johansen, Professor of Native American Studies, University of Nebraska, 2000
(Bruce E., “The New Terminators: A Guide to the Anti-Sovereignty Movement,” http://www.ratical.org/ratville/NewTerminators.html)
Measures that would impose state taxes on Native businesses are only the tip of the proverbial iceberg of anti-sovereignty efforts in the House and Senate. The American Indian Research and Policy Institute (AIRPI) of Minneapolis-St. Paul issued a detailed report, "Contemporary Threats to Tribal Sovereignty From Congress," describing anti-sovereignty legislation in Congress during the 1990s. The report found that "Much of this legislation is designed to strip tribal authority and to grant states more regulatory power in Indian Country." The report found that legislative attempts to curtail Native sovereignty fell into several areas, including proposed amendments to existing laws affecting the Child Welfare Act (1978); proposed amendments to the Indian Gaming Regulatory Act (1988); proposed taxation of Indian gaming; extension of state sales taxes to non-Indians on trust lands, and proposed amendments to regulatory authority of Indian tribes in the name of environmental protection. The AIRPI noted that "the federal government has historically carried out its trust responsibility to Indians in education, health and welfare via federal social programs. As devolution proceeds and social programs are transferred to states, many Indian programs at the federal level risk being similarly transferred. . . . The intent of this legislation is to move people off welfare and into the job market. The point is lost in Indian Country where most reservations have little economic base and there are few jobs for Indian people." For example, funds for Indian social programs have been defined as discretionary spending, not as an obligation mandated by treaties and the trust obligation. Also during the 105th Congress, Sen. Slade Gorton introduced a provision to the fiscal year 1998 Department of Interior appropriations bill that would have imposed a means test for federal funding. The means test translated into cuts or reduction of federal funds for tribes exceeding a pre-set level of independent tribal income. The funding cuts would have affected tribes with income from gaming, resource extraction and tribe-imposed taxes. This provision was dropped after pressure from reservation governments. Gorton also proposed waiving sovereign immunity for Native nations, but this was defeated in the Senate. Another of Gorton's proposals would require tribal governments to purchase tort liability insurance, and would place jurisdiction over tribal liability suits in federal district courts, bypassing tribal courts. (Keeping Watch) The devolutionists have other ideas as well. One of them, H.R. 325 (1997), would amend the Indian Gaming Regulatory Act (1988) to grant states greater leverage in compact negotiations, as well as the capacity to tax gaming revenue. H.R. 334 (1997), "The Fair Indian Gaming Act," sought to shift the burden of proof from the states to Native nations in gaming-compact negotiations. This bill, another example of devolution at work, would have transferred IGRA oversight from the Interior Department to the governor's office or a given state's legislature. This proposal also called for a two-year moratorium on class III gaming. The bill also contained increased record-keeping requirements for Indian gaming establishments. State attorneys general also are directed to investigate Native gaming -- an extension of state legal jurisdiction.

States will use “means testing” to restrict tribal social services the federal government will not
American Indian Policy Center 2000
(“Contemporary Threats to Tribal Sovereignty From Congress,” http://www.airpi.org/research/st98cont_congress.html)
Also during the 105th Congress, Senator Slade Gordon introduced a provision to the fiscal year 1998 Department of Interior appropriations bill that would impose a means test for federal funding allocated to Indian tribes. Ultimately, this provision was dropped as a result of pressure from tribal governments, however, the bill authorizes a tribal task force to allocate some of the increases in funding. Despite the high levels of unemployment and poverty on many, if not most, reservations, federal funding allocations for social welfare programs are not based on needs. Rather, those resources are part of the trust responsibility of the United States government toward Indian tribes. Means testing for such programs violates the treaty responsibilities and federal trust relationship (National Congress of American Indians, Policy Alert, October, 1997).
Amendments to Key Policies Affecting Indian Tribes
During the 104th Congress, a number of legislative amendments were proposed which could result in weakening the sovereign status of tribes in a variety of ways. States would gain greater leverage in gaming negotiations from a proposal in an appropriations bill waiving tribal sovereign immunity, from amendments to ICWA (1978) that weaken tribal rights to define membership, and from amendments to IGRA (1988). Amendments were also proposed to the Clean Water Act (1977) that would strip tribes of their authority to regulate water policies on reservations.

Federal support is key to Native American Self-determination
Indian Country Today, 2008
(Indian Country Today, “Assessing the past and future of self-determination”, 3-7-08, http://www.indiancountrytoday.com/archive/28409419.html, 6-28-09, KS)
The self-determination policy is a period of major social movement among tribal leaders, communities and activists. It is a period characterized by an increase of Native self-identity, community mobilization, cultural revival, uneven economic development and greater national attention to tribal sovereignty. Since the 1980s, congressional funding, legal support in the courts and administrative policy have not been as favorable as they were in the late 1960s and ;70s. Self-determination policy was generated by tribal actions and is still in formulation. Tribal communities have a central role to play in the future direction of self-determination policy. The expression ''self-determination'' is an outgrowth of the movement to impede termination policy during the 1960s. In some ways, self-termination policy is a way of articulating and reaffirming tribal government powers and community cultures. If left to the policy-makers of the Truman and Eisenhower administrations during the late 1940s and '50s, Indians would have become full citizens of the United States and reservations would now be artifacts of the past.
Indian communities and leaders led the opposition to termination policy and formulated an alternative policy leading eventually to self-determination. At the 1961 American Indian Chicago Conference, Indian leaders and community members met to formulate a statement outlining the conditions of their people. As chair of the steering committee, D'Arcy McNickle, a Cree and Salish-Kootenai adopted member at the Flathead Reservation, authored a new Indian policy titled ''Declaration of Indian Purpose,'' which proposed solutions to many of the problems. McNickle was an anthropologist by profession and worked with John Collier, commissioner of Indian Affairs, during the New Deal era in the 1930s. He brought many unrealized ideas from the New Deal, but now aided with mobilized national Indian organizations and groups looking for an alternative to termination policy. The discussions and reports of the Chicago Conference were presented in 1962 to President John F. Kennedy in the White House by the members of the National Congress of American Indians. Indian activists, community members and program leaders lobbied Congress in the summer of 1964, and gained inclusion of tribal governments as program clients for Community Action Programs and the Office of Economic Opportunity. Their efforts opened the door for tribal governments to direct funding with many federal agencies, bypassing the BIA. In 1968, President Johnson, in consultation with Indian leaders, formulated in a special policy statement to Congress, ''The Forgotten American,'' in which he grafted anti-poverty programs and advocated individual and tribal policy choices. He used the expression ''self-determination,'' but it was not central to his presentation. President Nixon's special policy statement to Congress in 1970 was again formulated from recent tribal experiences in tribal program management and based on extensive consultation with tribal leaders. Nixon suggested that Congress officially end termination policy, and encouraged tribal governments to take greater management of programs and funding. Sen. James Abourezk, D-S.D., having lived on the Pine Ridge reservation, moved many self-determination hearings and reports through Congress. He also worked for passage of The Self-Determination and Education Act of 1975. The self-determination and anti-poverty programs funneled funds to and engendered greater empowerment for tribal governments. In most reservation communities, the tribal governments as we know them today were formed as a result of these policies of the 1960s and '70s. Tribal governments started working directly with many federal agencies, and funds were made available directly to tribal communities.


The federal government must be the only actor when dealing with American Indian services in order to allow for the federal-tribal trust relationship to exist
Mitchell, Attorney for NARF, 02
(Michele, Capital Hill Hearing Testimony“Tribal Federal Recognition”, 9-25-02,  Lexis-Nexis, MEL)
Good morning, I thank the Committee for inviting me here today. My name is Michele Mitchell. I am a staff attorney with the Native American Rights Fund. The Native American Rights Fund (NARF) is a non-profit organization that has been providing legal representation and technical assistance to Indian Tribes, organizations and individuals nationwide since 1970. I am here today to provide testimony on HR 992, a bill that would authorize the Secretary of Interior to provide grants to local governments to assist them in participating in certain decisions related to Indian groups and Indian Tribes NARF strenuously opposes this bill. The principle defect, which pervades every aspect of the bill, is that it ignores more than two centuries of history and law that govern the relationship between the federal government and Indian Tribes. Since the beginning of the Republic the federal government has had a government-to-government, trust relationship with the Indian Tribes. While at once recognizing the Indian Tribes as "distinctive political" entities, or sovereign governments, the United States government has guaranteed to protect the rights, property and existence of Indian Tribes. Indeed, the trust relationship or trust responsibility, has been described as "one of the primary cornerstones of Indian law." Felix S. Cohen, Handbook on Federal Indian Law, 122 (1982 ed.). As stated in the Indian Policy Review Commission Final Report submitted to Congress in 1977: "The Federal trust responsibility emanates from the unique relationship between the United States and Indians in which the Federal government undertook the obligation to insure the survival of Indian Tribes. It has its genesis in International Law, colonial and United States treaties, agreements, federal statutes and federal judicial decisions." This bill directly contravenes that trust relationship. This bill would provide funding to "local governments" in order to finance their opposition to acknowledgment and recognition of Tribes, applications to put land into trust on behalf of Tribes, land claims to recover land lost in violation of federal law, and any other "action or proposed action . . . likely to significantly affect the people represented by that local government." The bill does not appear to include Tribes among the "local governments" to which grants may be provided. If this is the case, it is our interpretation that the purpose and effect of the bill will be nothing more than to provide funding to non- Indian governments to oppose tribal governments. Even if the bill were adjusted to address this inequity, it would still be at odds with the government's trust relationship with Indian Tribes. A trustee simply does not fund opposition to its beneficiary. To make matters even worse, this money would likely come from money that would otherwise go to fund Indian programs. In short, such actions would be at odds with the government's trust relationship with the Indian Tribes and the bill should be rejected on that basis alone. However, NARF has additional concerns with respect to the bill's effects as set forth below. Concerns Regarding Acknowledgment and Recognition Decisions Numerous Indian tribes have survived intact as identifiable Indian Tribes, but are not federally recognized. Lack of federal recognition deprives the Tribes of their rightful government-to- government relationship with the federal government and the benefits and services which accompany that relationship. Federal recognition does not create new Tribes. It acknowledges that Tribes that have always existed as Tribes are entitled to the same government-to-government relationship with the United States as other, similarly-situated Tribes. It is a rigorous process, designed to eliminate political pressures on the process and to eliminate unfounded claims. The process is designed to allow federal recognition decisions to be made by experts based upon objective criteria. To provide funding for the politicization of the process is not in anyone's best interest.

States limit Native American rights
Wilkins, Professor of Native American Studies at the University of Minnesota, Richotte, Professor of Indian Law at the University of North Dakota, 03
(David E., Keith, Oxford Journals, “The Rehnquist Court and Indigenous Rights: The Expedited Diminution of Native Powers of Governance” summer 2003,   http://www.jstor.org/stable/3331165, AD 7-5-09, WPW) As the Court has turned more conservative, as federalism has been redefined to allow the resurrection of a powerful states' rights agenda, and as the Court wrestles with the very nature of tribal sovereignty, which includes a racial-ethnic and a political-governance dimension, indigenous rights, both collectively and individually, have suffered accordingly. In general, and certainly within the last six years, the Supreme Court has made it clear that tribes will rarely win many cases involving non-Indians, tribal-state relations, or federal power vis-a-vis tribal governments. A tribe may sometimes achieve a victory if a clear treaty provision is involved (Mille Lacs), or if the federal government is acting in its trust capacity regarding a tribal resource (Idaho and White Mountain Apache), but even when these conditions are met, tribes cannot rest assured that their sovereignty will be respected by the Supreme Court, unless the tribe or the Indian persons can directly connect the power they are exercising to an express act of Congress. In any event, the conservative majority on the Court appears to be sealing the borders of tribal sovereignty, reducing tribal governments to polities that may only wield a minimal amount of jurisdictional clout over their own enrolled citizens and virtually no one else. 

Interactions between state governments and tribes fail- empirically they end up causing more problems than they resolve
Mason, Associate Professor of Social Sciences at the University of New Mexico Gallup,  ’98
(W. Dale,  “Tribes and States: A New Era in Intergovernmental Affairs,” The Journal of Federalism, 28:1, Winter, Pages 111-112 MAG)
Intergovernmental relations involve relationships of power between and among sovereigns. The study of federalism and intergovernmental relations has traditionally focused on the power relationships between the federal and state governments and between state and local governments. There is, however, another set of power relationships existing in American federalism often overlooked by scholars, if not by practitioners. More than 300 federally recognized American Indian tribes in the lower 48 states exercise government powers that increasingly put them in positions of conflict and cooperation with state governments. Overall, the history of tribal-state relations has tended to be one of conflict rather than partnership. Daniel McCool has noted, "One of the most divisive intergovernmental conflicts in the history of the United States has occurred between state governments and Indian tribes."' Others have written: One of the clearest and most persistent themes involving Indian sovereignty has been the continuous struggle by the states to assert greater control over Indian reservations, either at the expense of the federal or tribal governments. The pace of the struggle, the form that it takes, and the forum in which the struggle occurs have changed over time. Historic issues involving competing claims of states (or territories) and tribes included removal of Indians from their traditional homelands, the admission of new states into the union, the discovery of natural resources on Indian lands, and the "opening" of Indian lands through war and the allotment process. Contemporary issues of controversy between tribes and states have included attempts by states to impose taxes on transactions in Indian Country; the extent of state criminal and civil jurisdiction and law enforcement in Indian Country;  the sovereign immunity of tribal governments against lawsuits; and disputes over treaty rights such as have occurred in Wisconsin and Washington in recent years. Many of these disputes are the result of changing congressional policy and of inconsistent and often contradictory decisions by the U.S. Supreme Court.

The CP devolves control in one area without devolving treaty and trust protections – ensuring that the states can unilaterally terminate the tribes
Wilkins & Lomawaima, Professor of Political Science, University of Minnesota & Associate Professor of Native Studies, University of Arizona, 2002
(David & Tsianina, Uneven Ground: American Indian Sovereignty and Federal Law, p. 177).
Of course, in a few instances Congress has acted to delegate its constitutionally vested authority over Indian affairs to states. We argue that Congress cannot legitimately make such delegation to a state without attaching the existing treaty and trust protections that tribes legally and morally expect from the United States. If the states, the subnational governments, are indeed constitutionally intertwined with the national government, then the treaty and trust commitments of the United States – as a nation – towards tribes cannot be unilaterally terminated simply by delegating those commitments to the states (termination of such commitments would require a mutually agreed upon treaty modification with the tribes’ informed consent).

The states use their sovereignty to mess up the federalism balance and avoid Supreme Court rulings on natives
Gey, Florida State University Law Professor, 02
(Steven G., Florida State Universiy; School of Law, “The Myth of state sovereignty”, Feb 2002, http://law.hofstra.edu/pdf/facwor_gey_paper.pdf , accessed 07-11-09, ET)
It is now apparent that the United States is in the midst of a constitutional revolution. It is a quiet revolution, for the most part. The issues around which the revolution is being fought are so esoteric that anyone not possessing an unnatural strong interest in the structural aspects of constitutional law will have a difficult time staying awake long enough to understand the details of what is happening. In short, during the last ten years a narrow but steadfast fivemember majority of the Supreme Court has used a broad conception of state sovereignty to expand the power of state government (and simultaneously to restrict the power of the federal government) in virtually every area in which the two governments operate. The battle over the new theory of state sovereignty has occurred on four fronts. First, the five states'-rights Justices have asserted the concept of state sovereignty as the rationale for broadening the states' Eleventh Amendment immunity from lawsuits brought by private litigants in federal court to redress state violations of federal law. Second, these Justices have used the concept of state sovereignty to restrict the federal government's ability to require state officials to enforce national social and environmental policies. Third, similar state sovereignty concerns have motivated the majority of the Court to greatly expand the scope of Younger abstention and related doctrines restricting federal court equitable authority to enforce federal law. Finally, the five states'-rights Justices have used the concept of state sovereignty as a primary justification for reversing a fifty-year trend of judicial deference and invalidating several federal statutes enacted under the Commerce Clause. As these examples indicate, the new constitutional limitations on federal power have spread quickly to several different constitutional areas, but these decisions are united by the First, in Seminole Tribe v. Florida, 517 U.S. 44 (1996), the Court closed one window for holding states accountable in federal court for violating federal law by prohibiting Congress from using its Commerce Clause authority to abrogate states' Eleventh Amendment immunity. Thus, Congress cannot by statute subject states to federal court jurisdiction in any legislation that is not passed under the Court's increasingly narrow conception of the Fourteenth Amendment. See Bd. of Trustees of the Univ. of Alabama v. Garrett, 531 U.S. 356 (2001)(rejecting statutory abrogation of states' Eleventh Amendment immunity in federal Americans with Disabilities Act on the grounds that

___ INDIANS -- Rape Prosecution

States can’t solve- only the federal government can alter the jurisdiction of tribal courts- this is the critical internal link to all of our advantages- Gozan 7
(Wende, Amnesty International correspondent, , “U.S. Authorities Fail to Protect Native American and Alaska Native Women From Shocking Rates of Rape, Reports Amnesty International,” Amnesty International, April 24, 2007, http://www.amnestyusa.org/document.php?lang=e&id=ENGUSA20070424001)
In order to achieve justice, survivors of sexual violence frequently have to navigate a maze of tribal, state and federal law. The US federal government has created a complex interrelation between these three jurisdictions that undermines equality before the law and often allows perpetrators to evade justice. In some cases this has created areas of effective lawlessness which encourages violence. Action by US Congress is required to eliminate the possibility that complex jurisdictional rules and legislation in practice may deny survivors of sexual violence access to justice.  Sometimes the confusion and the length of time it takes to decide whether tribal, state or federal authorities have jurisdiction over a particular crime result in inadequate investigations or in a failure to respond at all. Whenever law enforcement officials are required to make on-the-spot decisions about whether a suspect is Indian or non-Indian, public safety on tribal lands is compromised. Amnesty International's research indicates that understaffing and lack of appropriate training in the relevant police forces are also undermining survivors' right to justice.  For different reasons and in different ways none of the three justice systems -- federal, state and tribal -- are responding adequatelywq to Indigenous survivors of sexual violence. The US government has interfered with the ability of tribal justice systems to respond to crimes of sexual violence by under funding tribal justice systems, prohibiting tribal courts from trying non-Indian suspects and limiting the custodial sentences which tribal courts can impose for any one offence. The maximum prison sentence tribal courts can impose for crimes, including rape, is one year. The average prison sentence for rape handed down by state or federal courts is between eight years and eight months and 12 years and 10 months respectively.20  When jurisdiction falls to federal or state authorities and cases are pursued through the federal or state court system, Amnesty International's research found that Native American and Alaska Native women are often denied access to justice. The extent to which cases involving American Indian women are dropped before they even reach a federal court is difficult to quantify as the US Attorney's Office does not compile such statistics. However, the evidence gathered by Amnesty International suggests that in a considerable number of instances the authorities decide not to prosecute reported cases of sexual violence against Native women. When federal prosecutors decline to prosecute cases involving non-Native perpetrators, there is no further recourse for Indigenous survivors under criminal law within the USA.  At all levels, law enforcement and justice systems are failing to inform survivors about the progress of their cases and there is little accountability for failure to investigate or prosecute. For some survivors this can mean months or even years of fear and insecurity.

The counterplan is based on the political calculation of net benefits – means they can’t solve because the response to the Other must be immediate and outside of political calculations- Robbins 2k
Jeffrey, Theology Professor @ St. Bonaventure University, http://web.syr.edu/~jwrobbin/2000AAR.htm
It is my claim that it is Levinas’ recognition of neutrality as a horror that establishes the priority of ethics in his thinking. Thus, his claim that ethics is first philosophy, is his passionate plea for a kind of philosophy that acknowledges its ethical stance—which is different from a thinking that is willing to take a stand, for the latter thinks there is a choice, while Levinas’ claim is that such stands are the very conditions of thinking itself.  The one preserves the centrality of the ego, while the other upsets the balance by reversing the constituting order of exchange—not the self willing responsibility, but an infinite responsibility collapsing the careful divisions between self and other.  To be fair to Heidegger, he too speaks of the self-in-response, but for Levinas, it is the response to what that is decisive.  When naming the originary source of the self’s call to being, Heidegger, so Levinas suggests, resorts to being as a totality.  Levinas, by contrast, speaks of the concrete call of the Other.  From this respect, ethics, from a Levinasian perspective, is much like the Kant of the first and third critiques, in that it is a questioning—a questioning of the conditions and possibilities of thinking itself, a realization that the self has no choice but to be involved, but to speak.  In other words, neither pure objectivity, nor pure subjectivity.  Hardly a neutral, indifferent, or passive endeavor, but instead, a reversal, a transgression, and a commitment.  Ethics asking the question of the ethics of ethics.  And by so doing, the self—the supposed precondition for responsibility—is given over to the Other, by whom and for whom the self is constituted.   What is ethics then?  Certainly not simply a morality, nor more complexly, a hierarchical system of values.  Ethics, instead, is that force of thought that breaks open and through the totality of thought.  Ethics appears as the immediate and urgent call for justice from the voice of the Other.  Ethics is the taking on of the infinite responsibility, which precedes and exceeds the self’s limited and finite capabilities.


Only the federal government has authority over Indian affairs- Suagee 98
Dean B Suagee, lawyer specializing in Native American law and environmental law, May 19, 1998, “Renewable Energy in Indian Country: Options for Tribal Governments”, Renewable Energy in Indian Country, Issue Brief 10, Lexis
In brief, while Congress is said to have "plenary power" over Indian affairs, tribal governments hold inherent sovereignty and also exercise power pursuant to delegations of authority from Congress. Within reservation boundaries, states generally have only limited powers over Indian lands and Indian persons.


Only congressional action accesses our affirmative- only our evidence is in the context of indigenous sexual violence case jurisdiction- Gozan 7
(Wende, Amnesty International correspondent, , “U.S. Authorities Fail to Protect Native American and Alaska Native Women From Shocking Rates of Rape, Reports Amnesty International,” Amnesty International, April 24, 2007, http://www.amnestyusa.org/document.php?lang=e&id=ENGUSA20070424001)
In order to achieve justice, survivors of sexual violence frequently have to navigate a maze of tribal, state and federal law. The US federal government has created a complex interrelation between these three jurisdictions that undermines equality before the law and often allows perpetrators to evade justice. In some cases this has created areas of effective lawlessness which encourages violence. Action by US Congress is required to eliminate the possibility that complex jurisdictional rules and legislation in practice may deny survivors of sexual violence access to justice.



___ LEGAL SERVICES


Program integrity regulations on legal services engender burdensome government control that destroys the viability of public-private partnerships
Lustberg and Hafetz, 5 (Lawrence S., Chairs the Criminal Defense Department and is the Director of the John J. Gibbons Fellowship in Public Interest and Constitutional Law, John, John J. Gibbons Fellow in Public Interest and Constitutional Law at Gibbons, the author of numerous articles in scholarly and popular publications, including the Yale Law Journal, California Western Law Review, and Fordham Journal of International Law, 05-0340(L)-cv, 05-0360(CON)-cv, 05-0787(CON)-cv, 05-0792(CON)-cv, 05-0925(XAP)-cv, United States Court of Appeals for the Second Circuit, 7/6, http://www.independentsector.org/programs/gr/Velazquezbrief.pdf)
C. The Program Integrity Regulation Infringes on the First Amendment Freedoms of Charitable Donors and Non-profit Organizations. In order to realize its full potential, the third sector must retain sufficient freedom to utilize the resources of other sectors of society, particularly the government, while remaining free of unnecessary and onerous restrictions on its activity. The program integrity regulation underscores the harms that result when the government imposes unduly burdensome restrictions on private funds in violation of the First Amendment freedoms of charitable donors and non-profit organizations. 1. The third sector must be able to act in partnership with the government, while remaining free of unnecessary, onerous restrictions like the program integrity regulation. Philanthropies and other private donors have traditionally acted in concert with governmental programs and entities to provide critically needed services to the poor. See Alice Gresham Bullock, Taxes, Social Policy and Philanthropy: The Untapped Potential of Middle- and Low-Income Generosity, 6 Cornell J.L. Pub. Pol’y 325, 332 (1997); Lester M. Salamon, Partners in Public Service: The Scope and Theory of Government-Non-profit Relations, in The Non-profit Sector, supra, at 99. During the Colonial period, local governments provided funds to private charitable educational institutions, hospitals, and social service agencies, enabling those institutions to provide needed services to their communities. Salamon, Partners in Public Service, supra, at 100. Later, public officials relied heavily upon private non-profit agencies to address the social problems accompanying urbanization and industrialization. Id. at 100-01. These public-private partnerships are even more important today. They have grown dramatically in recent years, and this trend is likely to continue in the future given the increasing reliance on market-based solutions to public problems. See, e.g., Martha Minow, Partners, Not Rivals: Privatization and the Public Good 3 (2002). Private involvement in government activity has been particularly pronounced in social services programs as well as in medicine and in education. Id. at 7-8. The government thus increasingly collaborates with charitable funders and non-profits to devise and implement strategies for meeting needs in these and other areas. The government-end of these public-private partnerships takes a “dizzying array” of forms: loans, loan guarantees, grants, contracts, insurance, tax expenditures, vouchers and more. Lester M. Salamon, The New Governance and the Tools of Public Action: An Introduction, 28 Fordham Urb. L.J. 1611, 1612 (2001). See also Partnerships for a Stronger Civil Society, A Report to the President from the Interagency Task Force on Non-profits and Government 6 (Dec. 2000). Government frequently partners with philanthropic entities to fund nonprofit organizations for the delivery of services and for research. See Stanley N. Katz, Philanthropy and Democracy: Which Comes First, Advancing Democracy 3 (1994). For example, a key component of the federal welfare reform legislation enacted in 1996 was block grants, which enable states to allocate federal funds to a host of public, private, and non-profit entities for the delivery of social services, including for the creation of welfare-to-work programs. See, e.g., 42 U.S.C. § 603(a)(5). Private-public partnerships also play an important role in other areas like education and the arts. For example, the No Child Left Behind Act of 2001 provides state block grants for local educational agencies, community-based organizations, and other private or public entities to create opportunities for academic enrichment, youth development activities, art, music and recreation programs, and drug and violence prevention programs. No Child Left Behind Act of 2001, Pub. L. No. 107-110, Title VI, Part B, 115 Stat. 1425 (2002) (codified at - 15 - 20 U.S.C. §§ 6301-6578). As government spending for social welfare and services declines, there is increasing pressure on charitable donors and non-profit organizations to address the unmet needs that invariably result. From their inception, legal services organizations have been a classic and highly effective collaboration between the public, private and charitable sectors. An outgrowth of the charitable Legal Aid movement initiated by lawyers in the nineteenth century, Legal Aid societies were formed by leaders of the private bar to enable immigrants and other poor people to protect their rights. See Martha F. Davis, Brutal Need: Lawyers and the Welfare Rights Movement, 1960-1973, at 15- 17 (1993). Later, private contributors partnered with philanthropic organizations and government agencies to create legal services organizations that provided new and experimental services to the poor. Plaintiff Legal Services of New York City (“LSNY”), for example, received funding from a variety of public and private sources for its innovative confederation of community-based legal services programs. Joint Appendix (“A.”) at 443. Congress, in turn, built upon these models when it created the legal services program in 1974, establishing a partnership between and among the federal, state and local governments, and the third sector. While the federal government provides funds to LSC grantees, the day-today management of each LSC grantee, including ownership and control of the program’s real and personal property, and the hiring and supervising of staff lawyers, is left to the non-profit local grantee. See Velazquez, 531 U.S. at 536 (noting the private/public nature of the legal services partnership). The government, moreover, actively encourages private funding of LSC grantees by assessing an “applicant’s capacity to develop and increase non-Corporation resources” when awarding grants. 45 C.F.R. § 1634.9(a)(7).  Those non-profits, in turn, have been highly successful in raising private funds. [continues]


Public-private partnerships are critical to meaningful cooperation with India
Ayres et al, 9(Alyssa, PhD, McLarty Associates, the Washington-based international strategic advisory firm, Former special assistant to the Under Secretary for Political Affairs, former deputy director of the Center for the Advanced Study of India, “Delivering on the Promise,” Asia Society Taskforce, http://www.asiasociety.org/taskforces/india09/DeliveryOnThePromise_USRelationsWithIndia.pdf).
P resident Bush and Prime Minister Singh saw the potential of involving private voices in official deliberations, and their efforts over the past three years have initiated private-public collaboration. The July 2005 US -India Summit resulted in the creation of numerous governmental dialogues, along with four additional discussion fora that bring private industry and government officials to the same table: the CEO Forum, the Agricultural Knowledge Initiative, the High Technology Cooperation Group, and the Private Sector Advisory Group to the US -India Trade Policy Forum. These discussion venues have been an excellent beginning, but have not begun to tap what we could do together. This Task Force recommends that we should aim for the next phase in our relationship to better channel the excitement and capacity of the private sector to address the kinds of slow-moving, global public goods problems that face us all. Doing so means carving space for the private sector beyond simply an advisory role, and will also require that both governments think very carefully about how best to steer business and NGOs toward outcomes that neither has been able to address adequately. We should expand the range of topics, include a broader roster of participants, and enhance the reach of impact by incentivizing action over talk, through action-oriented summits and the use of government incentives—such as targeted ExIm Bank or Overseas Private Investment Corporation (OPI C) guarantees, to channel private sector participation. We emphasize a much stronger role for public-private partnerships precisely because this is an arena of such great and continually growing strength in the relationship. India’s businesses have gone global, and its NGOs are fully part of (and in some cases, leading) global social movements. India has rapidly growing high-quality health care and educational institutions in the private as well as public sector, and is home to some of the world’s leading thinkers in delivering services as well as goods to the “bottom of the pyramid.” Given this rich knowledge base and expertise, we should be able to put our people together to think about tough issues. In this process, our governments should serve to catalyze innovation, through dialogues and seed funding for collaborative ventures. Whether focused on energy, trade, climate change, or global health and human security, expanding the range of discussions will help Americans and Indians to identify where our cooperation can change the world. And we should dream big, establishing visionary goals, like assisting with a second green revolution in agriculture in India. Such goals would help focus our relationship with India on subjects we both care about deeply, and would offer ways to demonstrate the transformative power resulting from our combined forces. We provide four ambitious examples here to illustrate how a public-private approach to cooperation with India could address some of the toughest issues facing the world today.

States will impose their own restrictions on funding
Brennan Center for Justice, 3 (at NYU School of Law, STRUGGLING TO MEET THE NEED:
COMMUNITIES CONFRONT GAPS IN FEDERAL LEGAL AID, March, http://brennan.3cdn.net/7689d2f385e9f3d753_bvm6y9ucy.pdf)
A simple lack of money is not the only reason that non-federal revenues for legal aid fail to fill the gap left by decreases in and restrictions on federal legal aid funding. Another reason is that much of the newly found revenues are either earmarked for certain populations or purposes or encumbered by restrictions barring their use for certain populations or purposes. For example, Colorado, Georgia, Illinois, Montana and West Virginia all authorize general appropriations or filing fees for legal aid, but all also earmark these funds exclusively for victims of domestic violence. Although this funding undoubtedly saves the lives of many battered women, it does nothing for the many people encountering other kinds of legal problems, such as evictions, difficulty obtaining Medicare or veterans’ benefits, and so on. Taking a slightly different approach, in 1997 Indiana allocated $500,000 in general appropriations for civil legal aid, with the proviso that the money cannot be used to bring class actions; to represent prisoners; to influence legislation, regulations, or general policies of federal, state or local governments; or in connection with the reapportioning of legislative or judicial districts. Likewise, since 1995 recipients of state funds in Montana and Tennessee have been prohibited from using those funds to bring class action lawsuits on behalf of clients. Restrictions like these often stem from government officials or others who simply want to ensure that lowincome people do not have the ability to challenge them, regardless of whether those persons’ claims are just. In Texas, for example, a Voting Rights Act suit filed by Texas Rural Legal Aid aroused the ire of some elected Texan officials. When the state legislature considered establishing a court filing fee surcharge to benefit legal aid, President George W. Bush — then the Governor of Texas — indicated he would oppose it unless legal aid programs were restricted in how they could use the money generated. As a result, the $3 million now provided by Texas for legal aid is burdened by restrictions that are in some ways even more severe than those that restrict LSC money. For example, the Texas funds cannot be used to sue any government official, except in cases seeking governmental benefits such as public assistance, Medicaid, or subsidized housing. Even LSC funds can still be used to enable poor people who are victimized by government to sue government officials, unless the case involves a challenge to a welfare law. The Texas money also comes with restrictions identical to many of the LSC restrictions. For example, recipients cannot use the Texas money to file class-action suits or abortion-related litigation. In 2001, Virginia followed Texas’ example. In Virginia, agribusiness interests wanted to make sure that their employees could not enforce minimum wage, overtime and health and safety laws. So this industry focused its lobbying efforts on the Virginia state legislature, which has been providing approximately $3.4 million in funding for civil legal aid for lowincome residents each year. These funds consist of $1.8 million generated by surcharges on court fees and fines, and a direct appropriation of $1.6 million from the state’s general budget. The money has been important to Virginia’s poor. Homeless people and elderly homeowners caught in finance company scams in Virginia, like many other poor people, have been able to turn to programs such as the Central Virginia Legal Aid Society for help. Just as importantly, Virginia’s state funding had enabled undocumented migrant workers, who cannot receive LSC-funded legal representation because of Congress’s restrictions, to obtain legal assistance from the Virginia Justice Center for Migrant and Immigrant Workers in cases involving troublesome workplace conditions, claims for back pay, and more. Pressure from agribusiness groups led Virginia legislators to threaten the imposition of a modified version of the federal restrictions on all state appropriations, filing fees and IOLTA funds. These socalled copy cat restrictions included prohibitions against abortion-related litigation, representation of undocumented immigrants, challenges to welfare reform, and class action suits. In a last ditch effort to avert these restrictions, the Legal Services Corporation of Virginia was forced to agree to no longer fund legal representation for migrant workers in employment matters in exchange for withdrawal of restrictions legislation. The practical effect of this agreement may be to leave thousands of undocumented workers without any legal representation. Virginia employers are now able to hire these workers, many of whom are working legally in the U.S. on special visas sought by their employers, while refusing to pay them a legal wage, with very little fear of being held accountable for their wage and hour and worker safety violations.

Removing restrictions is vital --- it prevents legal services from taking state money for blacklisted services
Solomon-Fears, 5/23/7 (Carmen, Specialist in Social Legislation, Domestic Social Policy Division, Congressional Research Service, http://assets.opencrs.com/rpts/RL34016_20070523.pdf)
Since its inception, the legal services program has been controversial, and Congress has imposed restrictions on activities of local attorneys. The authorizing statute contains restrictions against lobbying, political activities, class actions except under certain conditions, and cases involving abortion, school desegregation, and draft registration or desertion from the military. Additional restrictions have been included in appropriations laws each year. Under the current appropriations law, LSC grantees may not ! engage in partisan litigation related to redistricting; ! attempt to influence regulatory, legislative or adjudicative action at the federal, state, or local level; ! attempt to influence oversight proceedings of the LSC; ! initiate or participate in any class action suit; ! represent certain categories of aliens, except that both LSC and non-LSC funds may be used to represent aliens who have been victims of domestic violence or child abuse; ! conduct advocacy training on a public policy issue or encourage political activities, strikes, or demonstrations; ! claim or collect attorneys’ fees; ! engage in litigation related to abortion; ! represent clients in eviction proceedings if the eviction was based on drug-related activities; ! represent federal, state, or local prisoners; ! participate in efforts to reform a federal or state welfare system; ! engage in activities related to assisted suicide, euthanasia, or mercy killing; or ! solicit clients. LSC grantees must establish priorities, and staff must agree in writing not to engage in activities outside these priorities. Moreover, federal law prohibits the LSC from receiving nonfederal funds, and grantees are prohibited from receiving non-LSC funds, unless the source of funds is told in writing that these funds may not be used for any activities prohibited by the LSC Act or the appropriations law.


LSC is vital to intra-state and inter-state coordination --- ensures most effective assistance
Solomon-Fears, 5/23/7 (Carmen, Specialist in Social Legislation, Domestic Social Policy Division, Congressional Research Service, http://assets.opencrs.com/rpts/RL34016_20070523.pdf)
Before the implementation of the 1998 State Planning Initiative, LSC grantees often were unaware of other LSC grantees in the state. Work and training collaborations and other cooperative endeavors were rare among LSC grantees in the same state, and practically nonexistent among LSC grantees in other states. Further, most legal services programs only had superficial relationships and minimal contact with law firms and local judges. In anticipation of reduced federal funding, the LSC first encouraged and later directed grantees to form partnerships with the judiciary, private bar associations, and with each other. The 1998 State Planning Initiative was the means by which the LSC sought to ensure that LSC funds were efficiently and effectively used to provide legal services to poor persons in all areas of the states and jurisdictions. Pursuant to the 1998 Initiative, the LSC made participation in statewide civil legal services delivery systems a condition of receipt of LSC funding.4 It is generally agreed that poor persons in need of legal assistance have benefitted from the LSC’s statewide delivery system approach. The LSC has done this by requiring federally funded legal services providers to coordinate their work with other persons and organizations within a state, including groups historically considered funding “competitors” (other nonprofit organizations and non-LSC legal services programs) or “unlikely partners” (judges, legislators, bar leaders).5


Federal LSC funding is key to uphold its role in maintaining the justice system and establish funding baselines
Barnett, 5 (Helaine M., President of the Legal Services Corporation, “Documenting the Justice Gap in America, The Current Unmet Civil Legal Needs of Low-Income Americans” Legal Services Corporation, September 2005, Page 18 http://www.lsc.gov/press/documents/LSC%20Justice%20Gap_FINAL_1001.pdf)
The research and analysis in this report reveal a very serious shortage of civil legal assistance—an urgent justice gap—in the United States. Under its authorizing statute, the Legal Services Corporation has a responsibility to communicate to Congress what is required to ensure that economical and effective legal assistance is provided across the nation: necessary access to civil legal assistance. To secure necessary access there must be a partnership of federal and state governments, the private bar, and concerned private parties. Government unquestionably must bear the laboring oar in this effort, consistent with its role in maintaining the formal civil justice system and providing an orderly forum for the resolution of disputes and an avenue to equal justice for all. LSC serves as the primary conduit for the federal government’s share. It establishes the federal funding baseline, supporting and ensuring a backbone of civil legal assistance throughout the country. In light of the compelling evidence in this report, LSC must move forward firmly and expeditiously to close this justice gap. A key first step is to indicate the overall level of funding and support required for necessary access, as well as the requisite federal share of that amount. The federal contribution, as noted earlier, has lagged badly over the past two decades. Compared to its high water mark of $321,300,000 in FY 1981—$687,063,000 adjusted for inflation—the FY 2005 appropriation of $330,803,705 represents only 49 percent of the earlier amount. By contrast, the contributions from state government, the private bar and other partners to LSC-funded programs have increased approximately three and half times over the same period.22 Notwithstanding this strong support in a significant number of states, the real dollar decline in the federal contribution means that in large portions of the country the justice gap is wider than it was twenty-five years ago.

No Funding --- State legal aid money is tied to interest rates which collapsed --- state budget deficits mean they can’t fund the plan
Brennan Center for Justice, 2/1/09 (http://www.brennancenter.org/content/resource/the_economy_and_civil_legal_services/)
Interest on Lawyer Trust Account (IOLTA) programs have become the second single largest source of revenue for civil legal aid programs across the country.  In 2007, IOLTA income amounted to $370 million nationally and accounted for almost 12 percent of the income of the nonprofit civil legal aid programs that also receive funding from the federal Legal Services Corporation (LSC).[1]  For non-LSC funded organizations, IOLTA revenue typically is even more critical.  The decline in real estate transactions, the largest contributors to IOLTA accounts, and interest rates has meant that IOLTA revenue has plummeted.  This critical income source is expected to fall by as much as 50 percent in 2009.[2]   Funding shortfalls resulting in layoffs, salary reductions, and office closures are being reported across the country.  California.  IOLTA revenue could be as low as $3 million in 2009 - less than half of the $7 million that has been the record low since the California IOLTA program was started in 1984 - and making layoffs at legal services organization a possibility.[3] Connecticut.  IOLTA revenue, the largest sources of revenue for legal aid in Connecticut, has dropped from $21 million in 2007 to an estimated $4 million in 2009.  The state, which also funds legal services, faces a $3 billion budget deficit next fiscal year.  The three biggest providers of legal services for the poor are considering letting go of up to one-third of their 150 staff members if they cannot find other funding by midsummer.  Staff at Connecticut Legal Services is taking a 20 percent pay cut for 2009 to try to save jobs; managers are taking cuts of up to 35 percent.[4] Kentucky.  The state typically provides $1.5 million in funding for the four legal aid organizations in Kentucky.  This fiscal year, that amount was cut to $500,000 to divide between the groups, and Governor Beshear has proposed cutting legal aid funding to $250,000.[5]  Legal Aid of the Bluegrass already has cut payroll by $400,000 and has eliminated five or six positions in the last six months alone.[6] Massachusetts.  The Massachusetts Legal Assistance Corporation (MLAC), the largest funding source for civil legal aid in the state, is being forced to reduce its general support grants for legal aid programs by almost 40 percent in the next fiscal year due to the 54 percent drop in IOLTA revenue.  This will mean a drop in client services of at least 18 percent statewide and will leave approximately 20,000 low-income individuals and families without the legal help they need.[7] Greater Boston Legal Services is expecting a 13.5 percent reduction in funding, meaning they will likely serve 2,000 fewer people than they do currently.  Neighborhood Legal Services is expecting a 29 percent drop in funding.[8]  South Middlesex Legal Services will lose $260,000 of its $1.7 million total budget.[9] New Jersey.  IOLTA funds typically account for  almost 60 percent of the revenue for the state's legal aid programs.  However, this year, Legal Services of New Jersey, the statewide umbrella organization for legal services, expects only $25 million in IOLTA funds this year, down from $40 million last year.  This means that LSC-funded South Jersey Legal Services, which covers seven counties, will have to cut its staff by five attorneys and shut down two offices beginning in January.  The organization will have to cut services by an expected 25 percent this year, leaving 3,000 more people without legal help.[10]  Even with a state emergency grant for legal services, legal services will still be operating at a likely $14 million deficit in the next fiscal year.[11] New York.  State appropriations for civil legal services for the poor fell from $15.3 million in 2007-8 to a projected $7.3 million in 2008-9.[12]  Governor Paterson has cut all funding for civil legal services in his 2009-2010 budget.  Ohio.  The state's 2008 IOLTA revenue was expected to be 50 percent, or $11 million, lower than the 2007 total of $22 million.  Estimates for 2009 put Ohio's IOLTA income at only $4 million.[13]  The Legal Aid Society of Columbus lost $1 million in funding in the past year, out of a total annual budget of $4.5 million; seven attorneys recently lost their jobs.[14] Oregon.  In 2007, IOLTA received $3.6 million, which dropped to $2.3 million in 2008, and is projected to fall to $1.2 million in 2009.[15] Texas.  Residents' legal needs are higher than average, given hurricane recovery-related issues, but IOLTA revenue is plummeting.[16]  The Texas Access to Justice Foundation's 2008 IOLTA revenue was projected to be $28 million, but given recent interest rate cuts, it is now projected to be $12.5 million.  Revenue for 2009 is projected to drop to $7.5 million.[17] Washington. The IOLTA revenue available for state grants is expected to fall by one third in 2009, from $9 million to $6 million. [18]  While the Northwest Immigrant Rights Project has seen an upswing in requests for representation, the project will lose 17 percent of its IOLTA funding in 2009, about 10 percent of the Project's total revenue.[19] Wisconsin.  LSC-funded Legal Action of Wisconsin, which serves 39 counties, has been notified that its funding from the Wisconsin Trust Account Foundation will be cut by more than 92 percent in 2009, from $897,000 to $67,000.  This could mean a staff reduction of 30 percent.[20] Wisconsin Judicare Inc., serving 33 counties, will see a reduction in IOLTA funding from its current $100,000 to $18,595.[21]

Restrictions force legal centers to jump hoops to accept state funding --- precludes using non-federal funding
Tady, 7 (Megan, National Political Reporter for InTheseTimes, Oct. 25, http://www.commondreams.org/archive/2007/10/25/4796)
When the U.S. Supreme Court refused on October 1 to hear Legal Services for New York City v. Legal Services Corporation, a case challenging restrictions on access to lawyers for the poor, it sent a clear message: Courts shouldn't be bothered with the problems of poor people.  Funny, I thought "justice for all" meant justice for every person. It now appears an asterisk is missing from the last line of our nation's pledge. For clarity, perhaps it should read so like this:  "...And justice for all.*  * (The validity of this clause is subject to class and race restrictions and can be ruled null and void upon persons' failure to comply. The government reserves the right to alter the meaning of eligible applicants for justice at any time. The wealthy may disregard this disclaimer.)"  The loopholes for equality are pervasive in this country. This time, the government wiggled out of protecting poor peoples' legal rights when Congress passed a law in 1996 that limits the work of independent civil legal aid programs that receive federal funding. The government's Legal Services Corporation provides grants to independent programs that offer free legal service to low-income people across the nation.  The rule prevents legal aid centers from using either federal or non-federal funds to file class action lawsuits, claim court-ordered attorneys' fee awards, or represent certain categories of immigrants. There's one exception: Centers can do this work if they establish a separate office with non-federal dollars.  In other words, legal aid centers around the country that take government funding are only allowed to use private money-funds from the state and individual and philanthropy donations-to represent a huge group of people in a class action suit, go to bat for exploited immigrants, or use attorneys' fee awards as a tactic, if they set up a physically separate facility with a different staff. It's as rational as mandating that someone trying to spend their last two dollars on milk at the local grocery store can only buy it at a store that's a bus-fare away. No money when you get there? No luck.  Laura Abel, deputy director of the Justice Program at the Brennan Center for Justice, explains why the "physical separation requirement" has a "devastating effect" on the 138 centers that receive government grants.  "Civil legal aid programs are notoriously underfunded and they never have even the fraction of the funds they need, so they don't have any extra money at all," Abel says. "So they may think, 'Could we open up a separate office across the street?' But they would have to turn away hundreds of clients a year."  The Brennan Center is currently representing three legal aid centers that are challenging the constitutionality of the separation requirement, saying it violates the First Amendment. The Center first filed the lawsuit in 2001. But the Supreme Court's refusal to hear the case will send the long-languishing case back to a district court.  The implication of the restriction is as stark as the Supreme Court's indifference. Abel says one "glaring example" of how the rule hurts low-income people is the current predbatory loan crisis. Had legal aid centers been able to represent entire communities suffering at the hands of predatory lenders, the bottom may not have dropped.  "Unfortunately [legal aid centers] haven't been able to bring class action lawsuits; all they can do is represent one person at a time," Abel says. "As a result...the lenders continue their practices."  If it seems like legal aid centers have their hands tied, their mouths are gagged as well. Federally funded centers are also not allowed to use private funds to tell people about their legal rights and then offer to represent them, and they can't lobby on behalf of their clients-unless of course they lease and staff another office.  Lewis Papenfuse, executive director of the Farmworker Legal Services of New York, a plaintiff in the case, says he was "extremely disappointed" that the Supreme Court had turned up its nose.  In 1996, rather than accept the restrictions, Papenfuse says Farmworker Legal Services rejected any federal funding. Papenfuse and his staff had to take a severe pay cut, and have been building up their center ever since.  "There's so many people with so many issues-so many people not getting paid what they're supposed to," Papenfuse says. "Access to justice is even less for people who are invisible in society or have no access to even getting the information."  Not every program can be as resilient. According to the Legal Service Corporation, the agency on average endows half the budgets of the programs it funds.  Papenfuse and other advocates have been urging the courts and Congress to toss out the restriction for years. In 2005, 130 non-profit organizations and philanthropies filed an amicus brief on behalf of the plaintiffs, and the National Council of Churches and 30 faith groups appealed to legislators in a letter, noting, "The law closes the doors of justice for many low-income individuals and families who simply cannot afford to hire a private lawyer to help them in civil matters."  Congress, it appears, doesn't sympathize. A 2005 editorial in The New York Times chastised the government: "The fact that Washington provides money for legal representation does not give it unlimited authority to control what lawyers say or do, or to restrict the use of private money so severely."  The Legal Services Corporation, on the other hand, feigns compassion on its website, writing, "...our nation falls far short of meeting the need for civil legal aid." So why has the agency repeatedly fought and appealed the current court case?  To go to such lengths to keep certain groups of people from obtaining legal aid speaks volumes about the government's fear of the informed and represented masses. Abuse and mistreatment becomes trickier when the adage "I'll see you in court" actually has weight.  Of course, what's particularly troubling about this rule is that low-income people, communities of color, and immigrants are those groups most at risk of being exploited and violated, from employers withholding a worker's wages to corporations dumping toxins in entire neighborhoods.  It should be easy, not almost impossible, for the country's most vulnerable to seek redress. By standing firmly with this rule, we are merely offering a cruel taunt when pledging our allegiance to "justice for all." 

Perm do both
 Solves best --- federal and state cooperation is critical to eliminating the justice gap
Barnett, 5 (Helaine M., President of the Legal Services Corporation, “Documenting the Justice Gap in America, The Current Unmet Civil Legal Needs of Low-Income Americans” Legal Services Corporation, September 2005, Page 4 http://www.lsc.gov/press/documents/LSC%20Justice%20Gap_FINAL_1001.pdf)
The enormity of the justice gap documented in this report means that eliminating the gap will require a sustained, long-term effort involving a partnership of federal and state governments, the private bar, and concerned public and private parties. A key first step is to quantify what it would take to provide necessary access to civil legal assistance. This report concludes that doing so will require increasing our nation’s capacity to provide civil legal assistance to five times the current capacity. While the Legal Services Corporation cannot accomplish this alone, it is incumbent on LSC to lead the way by drawing attention to the justice gap, identifying the goal of eliminating it, and beginning to move toward it in firm, measured strides.


The counterplan forces cutbacks in legal services in order to create physically separate services and be eligible for state funding
Edie, 2 (John A., senior vice president and general counsel of the Council on Foundations, June, http://www.foundationnews.org/CME/article.cfm?ID=1993)
Not surprisingly, shortly after 1996 supporters of legal services challenged the extension of these many restrictions on the use of nonfederal money as a violation of free speech. To counter this constitutional challenge, the LSC made changes in their rules to permit private funds to be used for the restricted activities, but only if the local legal services program creates a separate legal services office, housed in physically separate facilities. These separate facility regulations are modeled on a similar set of rules that had been upheld by the U.S. Supreme Court in Rust v. Sullivan (1991), a case involving federal funding of family planning clinics where discussion of abortion as an option was prohibited (private funds could be used to discuss the abortion option, but only if provided in a physically separate facility). As a practical matter, local legal services programs have found the "physically separate facility" option unworkable. When legal services funding is already scarce, renting separate office space, paying separate personnel, paying separate executive directors, operating separate computer networks, operating separate telephones and maintaining separate files and furniture is wasteful and would require significant cutbacks in other areas



___ MARRIAGE INCENTIVES

Federal role is key – the federal government has empirically had a unique post Civil war responsibility to maintain a national standard of equality
Weil, 06 – President of the Food Research and Action Center (James, Clearinghouse REVIEW Journal of Poverty Law and Policy, May–June 2006, “The Federal Government—the Indispensable Player in Redressing Poverty,” http://www.frac.org/pdf/Weil06.pdf

If economic insecurity and poverty were trivial matters, the federal government would not need to become heavily involved. But they are not trivial matters. The damage that poverty, unequal opportunity, and material deprivation inflict on people is deeply injurious to our democracy as well as our economy—one key reason that they must be a matter of fundamental concern to the society as a whole and compel a national response. As Aristotle wrote: It is therefore the greatest of blessings for a state that its members should possess a moderate and adequate property. Where some have great possessions, and others have nothing at all, the result is either an extreme democracy or an unmixed oligarchy; or it may even be … a tyranny.… … Where democracies have no middle class, and the poor are greatly superior in number, trouble ensues, and they are speedily ruined.23 Similarly Pres. Franklin D. Roosevelt said that “true individual freedom cannot exist without economic security and independence.… People who are hungry and out of a job are the stuff of which dictatorships are made.”24 Poverty quashes the spirit and saps the energy of America’s workers and parents, and this weakens the economy and dulls the political vibrancy of the nation. Denial of opportunity corrodes the American social compact. Parental and child poverty reduces infant birth weight; harms health and mental health; leads to higher rates of disabilities, impairments, and injury; causes school absenteeism, lower achievement scores, and higher special education and dropout rates; and leads to higher rates of delinquency and other self-destructive and antisocial behavior during adolescence.25 America’s high rate of child poverty costs the nation an estimated $130 billion per year (in 1996 dollars).26 Those issues that America cares about and is serious about tackling receive a national response. Having federal atten- tion is not just a matter of marshaling resources; it is also an ongoing statement about the centrality of the issue and the needs of those affected in our national value system. It raises the ranking of an issue in the hierarchy of the nation’s concerns and makes it a matter of sustained and extensive concern. Symbolically as well as programmatically and organizationally, when something matters to our society, the federal government is assigned important tasks. Thus a preeminent federal role is a national political and moral statement about poverty and economic security. One part of that statement has to reflect a societal commitment to some national minimum standard of well-being. All people who live in this country, wherever they live, should have access to certain essentials in life. Too much inequality from state to state subverts the post–Civil War concept of the nation and subverts our political and economic roles in the world. The low-income people of Alabama and Mississippi should not lack access to primary health care if everyone else has it. The people of New Mexico and Oklahoma should not go hungry, the people of Massachusetts should not freeze in winter, the seniors of Minnesota should not have to live in shelters, children in Texas should not have to go without support from their fathers, and young children in North Carolina should not have to work in cotton mills because we have no national standard of minimal decency and their states have chosen to deny them the basics.27 The other dimension of fundamental national morality is race, and the ongoing need to redress the nation’s history of racial injustice. The post–Civil War amendments to the U.S. Constitution redefined the concept of national citizenship and gave the national government the primary responsibility to ensure equal rights and opportunity for all Americans. Nearly a century and a half later, this responsibility is undiminished, as is the need for the nation, through its national institutions, to fulfill the responsibility. The historian John Hope Franklin concluded his autobiography with an impassioned plea to meet the particular needs of young African- American males. After
describing the history of violence, racism, and economic deprivation that they have faced, Franklin writes: [O]ur society as a whole and the fate of the least among us are inextricably woven together. And our entire social system bears the special responsibility for the plight of these young people who, in a very real way, may be regarded as a metaphor for the ills of our society and the problems we face.… [T]hey must be reached, through legis- lation, goodwill, understanding, and compassion. The test of an advanced society is not in how many millionaires it can produce, but in how many lawabiding, hardworking, highly respected, and self-respecting loyal citizens it can produce. The success of such a venture is a measure of the success of our national enterprise.28 Our moral and political success depends on the quality of our national enterprise, but so, as discussed below, d Federal Management of the Economy Is Essential in the Fight for Opportunity and Against Poverty When political debate turns to the national role of fostering opportunity and reducing poverty, the default assumption is that the speaker is talking about spending—especially spending on social insurance and means-tested welfare, health, child care, nutrition, and similar programs—and the comparative advantage that the federal government has in raising revenue, creating such programs, and spending adequate sums on those programs. In much of this article I focus as well on the spending issues. But the federal government does much more to combat domestic poverty and to improve economic security and opportunity in its other roles of manager of the national economy and regulator of labor, business, and international affairs. A full discussion of these roles is beyond the scope of this article, but consider the impact on poverty, opportunity, and economic security of just the examples on the following list: ■ The balance struck by the Federal Reserve Bank, in managing interest rates and the money supply, between keeping the inflation rate low versus pushing toward full employment and keeping the economy growing rapidly and real wages increasing. The highest poverty rates in the last forty years were in the early 1980s when unemployment skyrocketed as “the Fed” drove up interest rates to control inflation.29 ■ The role of federal fiscal as well as monetary policy in stabilizing the economy and limiting the depth of recessions and the growth of unemployment. ■ The federal government support for or hostility to labor organizing. ■ The level of the federal minimum wage. ■ The federal rules regarding bankruptcy and the extent to which destitute individuals and families can get a fresh start or are enmeshed in endless debt. ■ The regulation of private pensions and the extent to which the government strengthens that system or allows pension underfunding and corporate bankruptcy laws to undercut security for workers when they retire.30 ■ The extent to which the government does or does not tax the earnings of low-income people and thereby deepen or alleviate their poverty. ■ Whether the government protects workers against job and earnings loss when family circumstances, such as the birth of a child or a spouse’s or child’s illness, interrupt the ability to work. ■ How the federal government defines overtime eligibility and overtime pay. ■ The ways in which tax policy subsidizes housing, health care, child care, and other basics and work supports, and the degree of subsidy at different income levels. ■ Federal immigration policy and labor and public benefits policy for immigrants. ■ The scope, strength, and level of enforcement of civil rights laws, including laws requiring equal pay and fair credit. ■ The definition of which political, civil, and economic rights receive special protection under the Constitution. ■ The way in which the federal government defines poverty and counts the number of poor people—this going far toward shaping public attitudes as to how widespread poverty is and how deep the deprivation involved is. In all of these areas the federal government has the predominant role. In some areas it has an exclusive role according to the Constitution. In others its exclusive authority is not constitutionally mandated, but, when it acts, it preempts state action. In yet other areas it may not be preemptive, but it still became a dominant or important presence in the twentieth century as the national ideal evolved and the economy changed. Many of these areas of federal action, of course, are seen as being “about” the economy, not “about” opportunity or economic security or poverty. But often they also have a more profound impact, for good or ill, on poverty and opportunity and security than most spending decisions. By definition, then, the federal government is taking a leading role on these matters. The key question is whether increasing economic security and opportunity and reducing poverty—reducing suffering and deprivation among the American people— is an important consideration in the development of these policies. When it is, the poor will be better off, and spending policy will complement that. When it is not, the poor will suffer, and spending policy will not be able to redress that. In no area of American life are these interactions as serious, and so contentious, as when race discrimination is involved. As President Bush said in his speech in New Orleans two weeks after Hurricane Katrina hit: [T]here’s also some deep, persistent poverty in this region, as well. That poverty has roots in a history of racial discrimination, which cut off generations from the opportunity of America. We have a duty to confront this poverty with bold action.… [W]e’re tied together in this life, in this nation….31 The two periods of greatest leaps in empowering and creating opportunity for African Americans in our nation—the Reconstruction period after the Civil War and the period of the civil rights movement in the 1960s and 1970s—were periods of political and economic progress complemented by federal spending policy. In both instances the economic change created through access to property, to jobs, to political power, to the courts, and to education dwarfed that created by new federal spending initiatives. But, in both periods, spending initiatives were an important secondary source of
change.32 And both produced a fierce reaction stemming from the defense of the economic and political power of whites and of economic elites. Both times the challenge to poverty, economic injustice, and racial discrimination slowed or reversed. In other words, political cycles tend to drive federal economic management and federal spending policy to move in tandem: both are likely to be inadequate for the poor when political weakness means that the national government can ignore their needs. For example, in the last few years Congress passed damaging bank- ruptcy law changes and the Bush administration sought damaging changes in overtime and civil rights policy, while Congress cut Medicaid, child support, child care, and other spending for the poor. But when spending and economic policy are positive and complement each other, great strides can be made in increasing opportunity and reducing poverty. The mid- and late 1990s, while far from ideal, saw economic policy (e.g., low unemployment and a higher minimum wage) complementing some spending policy (e.g., an increase in the earned income tax credit) to a degree that poverty (particularly African American poverty and poverty in families headed by single women) dropped significantly, even in the face of the aftershocks of the 1996 welfare law.33  

5.    only the federal government has the appropriate resources to respond to poverty.  They can’t fiat this away – state funding capacity has empirically been a fundamental problem.
Weil, 06 – President of the Food Research and Action Center (James, Clearinghouse REVIEW Journal of Poverty Law and Policy, May–June 2006, “The Federal Government—the Indispensable Player in Redressing Poverty,” http://www.frac.org/pdf/Weil06.pdf

In addressing poverty and economic security through social insurance, means-tested benefits, and other antipoverty efforts, the federal fiscal advantage is decisive. Personal poverty is the result of individuals and families lacking income and resources, and one central answer to that poverty is helping increase their income and resources. Some states and localities are far less able to respond to this need than others. Moreover, places with the most poor people generally are the places with the greatest shortage of resources. Community poverty and personal poverty are entwined. If jobs are scarce and wages are low, then per-capita income is low and so are local or state tax revenues. The locality or state cannot mount an adequate or robust response to the poverty.34 Because of disparate resource bases, the states’ responses to poverty become widely disparate.35 While disentangling political from fiscal factors is difficult (and the political factors themselves have economic causes), clearly state and local funding capacity is a fundamental problem. In 1935, before Congress passed the Aid to Dependent Children program (later renamed the Aid to Families with Dependent Children program) as part of the Social Security Act, the Committee on Economic Security, in its recommendations that led to the Act, reported:36 Less than one-half of the local units [of government] authorized to grant mothers’ aid are actually doing so. Many others are granting amounts insufficient to defend the children involved. Part of this situation is due to indifference, but in part it is due to the poverty of many local government units….37 Today we still see vast disparities in payment levels in TANF, the successor to mothers’ aid and Aid to Families with Dependent Children, as well as in eligi- bility levels for Medicaid benefits among parents, in state child care and preschool policies, and in other areas left to state and local control—and resources.38 The disparities,
moreover, are enduring. Localities, states, and regions are beset by long-term poverty and economic distress. In 1970 the per-capita income of the wealthiest state (Connecticut) was 194 percent that of the poorest state (Mississippi).39 In 2004, nearly two generations later, Connecticut still had percapita income 187 percent that of Mississippi.40 Similarly in 2004 the five states with the highest incidence of poverty (Mississippi, 21.6 percent; Louisiana, 19.4 percent; New Mexico, 19.3 percent; District of Columbia, 18.9 percent; West Virginia, 17.9 percent; Arkansas, 17.9 percent) and the District of Columbia had rates more than twice as high as the six with the lowest incidence (Maryland, 8.8 percent; New Jersey, 8.5 percent; Minnesota, 8.3 percent; Alaska, 8.2 percent; New Hampshire, 7.6 percent; Connecticut, 7.6 percent).41 While some differences in the costs of living between many wealthy and many poor states are real, those differences narrow in effect but hardly eliminate the poverty rate and resource disparities. States such as Mississippi, Alabama, Arkansas, and Louisiana (as seen vividly after Hurricane Katrina) suffer from longterm deprivation that robs them of the public resources they need to combat poverty and maximize opportunity. The federal government response to these human needs and these state resource disparities is a set of social welfare and antipoverty programs that often are completely or overwhelmingly federally funded (e.g., social security, Supplemental Security Income, school lunches, Medicare, food stamps, refundable earned income tax credit, and child tax credit) or in which poorer states receive a higher level of federal matching funds (e.g., Medicaid). These financing mechanisms— and these and other programs to improve economic security, cover health care insurance, and reduce poverty—have proven to be both effective and durable. Some have suggested that most or all antipoverty programs should be designed as well as operated completely at the state or local level even if the federal government is needed for robust funding. Federally funded block grants generally are an example of this. Certainly the relative amount of federal power over the design of a program should differ markedly depending on the type of program it is. Income support for retired seniors based on a fixed formula or for families with children through the tax code has imperatives different from those of community development spending where a national bureaucracy likely would be too rigid and distant to make first-rate allocation decisions. Most programs, even when overwhelmingly federally funded, do operate with shared federal and state or local responsibility for program design; and most have primary state or local responsibility for the day-to-day administration of benefits. But generally programs in which the federal government provides money but has no meaningful programmatic role tend to be unsuccessful or short-lived. Over time Congress and the Executive Branch lose interest when they are not engaged in program design, much less control, and so funding erodes, often dramatically. Title XX of the Social Security Act, which funds social services, the revenue- sharing program that Pres. Richard Nixon started, and many of the block grants that Congress created at Pres. Ronald Reagan’s behest in 1981–82 are examples. By contrast, when the federal government provides both funds and direction, the outcome usually is better. Some of these programs are so successful that we no longer remember how deep (how “intractable”—to use a phrase often applied to the problems of the poor) the problems that they tried to solve supposedly were. Social security, Supplemental Security Income, Job Corps, Medicare, Medicaid, Head Start, school lunch and school breakfast, food stamps, child support enforcement, immunizations, and the Special Supplemental Nutrition Program for Women, Infants, and Children (commonly known as the WIC program) are among the many programs that fit this model. All of this focus on the federal role is not to denigrate the importance of state action, innovation, experimentation, flexibility, and leadership.42 They all play a key role. But too often such actions are small-scale or vulnerable to quick political shifts or (no matter how successful) do not spread into very many other states unless the federal government takes the lead. The states and localities are not the only entities that do not have adequate resources for the job. As helpful as are private charities, they simply do not have sufficient resources to substitute for the federal government either. The Red Cross that ran out of food vouchers in England, Arkansas, in 1931 raised considerable funds after Hurricane Katrina and did not run out of money, but that was in significant part because its resources were dwarfed by the federal response. One difference between 1931 and 2005, for example, was that the federal Disaster Food Stamp Program quickly issued hundreds of millions of dollars worth of food vouchers in Louisiana, Alabama, and Mississippi.43 When President Bush spoke in September 2005 in New Orleans, two weeks after Hurricane Katrina hit, the charity for Katrina relief that his father and Pres. Bill Clinton had begun had gathered $100 million in pledges, while Congress had appropriated $60 billion for the effort.44 One sector besides the national government
does, in theory, have adequate resources for a job as big as redressing poverty: the private, for-profit sector. That sector plays the central role in generating the productivity and growth that make economic security possible for most people. But experience makes clear that growth alone will not foster adequate opportunity and security for workers at the bottom, much less for those who cannot work. As Christopher Jencks has written: [A] market economy is not designed to ensure that workers get paid what other people think they deserve. The logic of a market economy is that we should all be paid the smallest amount that will ensure that our work gets done, and that is what low-wage workers generally receive.45 The work of ensuring equal opportunity, adequate economic opportunity, and the redress of poverty is left, then, to the public sector. 

5.    Recessions make federal action key – only the federal government can run a deficit; states can’t.
Weil, 06 – President of the Food Research and Action Center (James, Clearinghouse REVIEW Journal of Poverty Law and Policy, May–June 2006, “The Federal Government—the Indispensable Player in Redressing Poverty,” http://www.frac.org/pdf/Weil06.pdf

Not only is there a long-term disparity in state resources (and state poverty rates) that calls for a national response, but also there are short-term spikes in need and troughs in resources that exacerbate long-term disparities or that themselves create a more urgent need for federal investment. Some of these are caused by natural or man-made disasters—a September 11 attack or a Hurricane Katrina. Most have economic causes. Although to some significant degree state economic trends move “in sync” with the nation’s economy, sometimes a local, state, or regional economy diverges from the direction of the nation as a whole. An industry or economic sector such as defense or the Internet or agriculture or oil and gas is hit hard by its own climatic, economic, or political cycle or by worldwide supply and demand forces. In such circumstances, a state faces a “double whammy.” First, its people have greater need for help: unemployment rises; wages, private health insurance coverage, and other benefits decline; poverty grows. Second, state tax resources decline. The state has declining capacity to cope with rising need, even if other states and the nation as a whole do not face similar problems. In these circumstances the national government, with its ability to distribute resources across state lines, can be particularly effective in responding, meeting the growing need, and priming the local economic pump with countercyclical spending. The Federal Fiscal Advantage Is Even More Pronounced During a Nationwide Economic Problem When the nation as a whole faces particularly rough times—that is, during a widespread recession—the federal government is the one that has the resources to respond. The recession means that need increases in many geographic areas for job creation, unemployment insurance, public assistance, and other spending to keep families from suffering greater deprivation as their earnings decline or disappear. The private market cannot respond: businesses are the ones laying people off and reducing wages. Charities and state and local governments face declining resources themselves as their contributions and tax revenues shrink. In these circumstances, although the federal government suffers shrinking tax revenues also, the federal government has the ability to run a deficit—to increase essential social spending even in the face of declining revenues. States generally cannot. They may have tied their own hands with balanced-budget provisions in their constitutions, so their inability to respond has political as well as fiscal origins, but their inability to respond is indisputable. The federal government’s ability to borrow not only gives it the resources to act, and act decisively, but also makes it the unique countercyclical actor—it can spend in a way that softens the impact of the recession and should stabilize
the economy and restart growth. Individual states do not have comparable capacity or the same interest in taking large fiscal risks to prime the national economy, especially because other states may not be sharing the burden and doing the same.


States can’t decrease marriage incentives – states over ruling federal law violates the Constitution
Gary Imhoff, Washington writer and vice president of DC Watch,11-26-06, DC Watch
The reason that DC has to obey an “old federal law” is because of an even older US Constitution, which made the national government preeminent over state governments. I think that Bill and Larry misunderstand what was at stake in this case. The Johnson Act, the major federal law regulating gambling devices, is a national law that applies nationally. The section of the law that applies specifically to the District of Columbia also applies to almost all areas that are not states or are otherwise directly under federal control, such as US territories and possessions, Army bases, and so on. The sponsors of the slots casino initiative and the DC Board of Elections and Ethics held that the DC city council, and thus an initiative passed by DC voters, could overturn, repeal, or amend the Johnson Act. They held, in fact, that DC could overturn any federal law passed by the US Congress and codified in the US code, if that law applies only to the District of Columbia. Larry and Bill agree. They argue that DC citizens’ rights are harmed if the DC city council isn’t given priority over the US Congress, if it doesn’t have the power to overturn federal laws that apply to the District of Columbia. But no state has the power to overturn federal laws, and DC isn’t shortchanged in any way by not being given that power. Bill’s and Larry’s position goes much further than home rule or self government, by a long stretch. Before the Civil War, an extreme version of states rights theory held what Larry and Bill say, that a state should be able to nullify a federal law and overturn a federal law within that state. However, the theory of nullification held only that a state could overturn a federal law that it believed to be unconstitutional. Larry and Bill, the slots proponents, and the Board of Elections promote what would have been an extreme form even of nullification — that DC should be able to overturn any federal law applying to DC, whether or not the city council believed it was unconstitutional. The Civil War settled permanently any doubt about whether the federal government or the states were preeminent, and whether state law could trump federal law. Since then nullification theory has been unquestionably invalid. No state can overturn federal law, and DC’s power isn’t greater than that of the states. Judge Judith Retchin in the Superior Court got that question wrong, and the decision of the Court of Appeals simply affirmed that. It didn’t curtail DC’s powers in any way; it just affirmed that in this respect DC citizens have the same rights as all other citizens, no less but also no greater. If we want to change national law, we have to change it at a national level; we can’t do it in the city council or by a local initiative. If Larry and Bill want DC’s lawmakers to be more powerful than Congress, then statehood won’t satisfy their ambitions — DC will have to become an independent nation.

The Federal Government is key to marriage incentives programs – they have the biggest responsibility to decrease them
(Robert Rector, Domestic Policy Studies Senior Researcher in the Heritage Foundation, 02 10 05, “Welfare Reform and the Healthy Marriage Incentive,” http://www.heritage.org/research/welfare/tst021005a.cfm)

First, the government is already massively involved when marriages either fail to form or break apart. Each year, the government spends over $150 billion in subsidies to single parents. Much of this expenditure would have been avoided if the mothers were married to the fathers of their children. This cost represents government efforts to pick up the pieces and contain the damage when marriage fails. To insist that the government has an obligation to support single parents—and to control the damage that results from the erosion of marriage—but should do nothing to strengthen marriage itself is myopic. It is like arguing that the government should pay to sustain polio victims in iron lung machines but should not pay for the vaccine to prevent polio in the first place.  Second, the government is already heavily (and counterproductively) involved in individual marriage decisions, given that government welfare policies discourage marriage, by penalizing low-income couples who do marry and by rewarding those who do not. The President’s Healthy Marriage Initiative would take the first steps to reduce these anti-marriage penalties.  Third, under the President’s initiative, the government would not “intrude” into private matters concerning marriage, since all participation in the marriage promotion program would be voluntary. Nearly all Americans believe in the institution of marriage and hope for happy and long-lasting marriages for themselves and their children. Very few wish for a life marked by a series of acrimonious and broken relationships. The President’s program would offer services to couples seeking to improve the quality of their relationships. It would provide couples seeking healthy and enduring marriages with skills and training to help them to achieve that goal. To refuse services and training to low-income couples who are actively seeking to improve their relationships because “marriage is none of the government’s business” is both cruel and shortsighted.  Finally, the government has a long-established interest in improving the well-being of children. For instance, the government funds Head Start because the program will ostensibly increase the ability of disadvantaged children to
grow up to become happy and productive members of society. It is clear that healthy marriage has substantial, long-term, positive effects on children’s development: Conversely, the absence of a father or the presence of strife within a home both have harmful effects on children. If government has a legitimate role in seeking to improve child wellbeing through programs such as Head Start, it has a far more significant role in assisting children by fostering healthy marriage within society.




___ MARRIAGE PROMOTION

Developing services for marriage and removing current disincentives within welfare will solve. Federal action is key and so is the rest of our plan text.
Robert E. Rector in 2009 (Robert Rector is Senior Research Fellow in the Domestic Policy Studies Department at The Heritage Foundation. January 13, Reducing Poverty by Revitalizing Marriage in Low-Income Communities: A Memo to President-elect Obama, Special Report #45
In The Audacity of Hope, you wrote: [R]esearch shows that marriage education workshops can make a real difference in helping married couples stay together and in encouraging unmarried couples who are living together to form a more lasting bond.  Expanding access to such services to low-income couples, perhaps in concert with job training and placement, medical coverage, and other services already available, should be something everybody can agree on.[6] You were exactly right. By and large, young low-income men and women aspire to have strong, healthy marriages. They also seek upward social and economic mobility. Marriage education can help at-risk individuals appreciate the role that healthy marriage can have in meeting long-term life goals and can enable them to make decisions about childbearing that best match their life aspirations. These programs can also provide training in life partner selection and in skills that help to build healthy enduring relationships. Such programs should not be regarded as imposing alien middle-class values on the poor, but rather as providing vital tools to help individuals fulfill their real life goals. You have also written, "most people agree that neither federal welfare programs nor the tax code should penalize married couples."[7] Again, you are right. Given the private and social benefits of marriage, it is absurd for the welfare industry to penalize marriage. Yet that is exactly what welfare does. Specifically, welfare programs create disincentives to marriage because benefits are reduced as a family's income rises. A mother will receive far more from welfare if she is single than if she has an employed husband in the home. For many low-income couples, marriage means a reduction in government assistance and an overall decline in the couple's joint income. Marriage penalties occur in many means-tested programs such as food stamps, public housing, Medicaid, day care, and Temporary Assistance to Needy Families. The welfare system should be overhauled to reduce such counterproductive incentives. Now is the time for action. You and your Administration, by launching the following specific initiatives, can help to revitalize marriage in America.     * Recognize that the key to arresting the decline of marriage in the U.S. is moral leadership. Use the White House bully pulpit to reaffirm the value and importance of marriage. You are uniquely suited to this task. Your strong personal affirmation of values will prove critical in transforming anti-marriage norms and in promoting a long-overdue renewal of marriage in low-income communities.    * Use the bully pulpit to emphasize the historical importance of marriage within the black community. Remind the nation that even at the height of Jim Crow segregation prior to World War II, nine out of ten black children were born to married couples. Warn the nation that the same decline in marriage that afflicted black communities a generation ago is now battering low- and moderate-income white communities.    * Encourage public advertising campaigns on the importance of marriage that are targeted to low-income communities.    * Provide marriage education programs in high schools with a high proportion of at-risk youth. Most low-income girls strongly desire to have children. They also wish and intend to be good mothers. These young women will be very receptive to information that shows the positive effects of marriage on long-term child outcomes. Such education could be funded under the current "healthy marriage initiative" program at the U.S. Department of Health and Human Services (HHS).   * Make voluntary marriage education widely available to interested couples in low-income communities. This could be done by expanding the small "healthy marriage initiative" currently operating in HHS. These programs may also provide job training to participants, but that should not be their primary emphasis.     * Provide marriage education referrals in Title X birth control clinics. Government- funded Title X clinics operate in nearly every county in the U.S., providing free or subsidized birth control to over 4 million low-income adult women each year. Many clients of these clinics go on to have children out of wedlock within a short period. With 38 percent of children born outside of marriage, it is obvious that a policy of merely promoting birth control is highly ineffective in stemming the rise of non-marital births. In addition to providing birth control, Title X clinics should be required to offer referrals to education in relationships, marriage, and life-planning skills to clients who are interested.     * Reduce the anti-marriage penalties in welfare. The simplest way to accomplish this would be to increase the value of the earned income tax credit (EITC) for married couples with children; this could offset the anti-marriage penalties existing in other programs such as food stamps, public housing, and Medicaid.
 

Having states implement the plan cannot help, they have no money.
(Sherry Leiwant, senior staff attorney, 2k4. “Why Now Legal Defense Opposes Federal Marriage Promotion in TANF Reauthorization” http://www.legalmomentum.org/assets/pdfs/marriagebackgrounder.pdf, retrieved 6/23/09)

Opposition to federal marriage promotion mandates within TANF should be a core issue. With many States facing deficits that will reach into the billions and the unemployment rate rising, not receding, Requiring states to spend money on marriage promotion cannot help but result in less resources to directly address the problems of those who are poor and out of work, in desperate need of subsistence benefits, job training and child care.

3. Federal Action is Key – Block grants for marriage promotion are given competitively. Only the plan encourages innovation and best practices.
Department of Health and Human Services 05 (Agency: Department of Health and Human Services Office: Administration For Children And Families https://www.cfda.gov/index?s=program&mode=form&tab=s tep1&id=6600b590be0b832ef82f08efa983e8b7&cck=1&au=&ck).

Authorization (040):  Social Security Act, Title IV, Part A, Section 403(a)(2) as included in the Deficit Reduction Act of 2005 (DRA), Public Law 109-171.  Objectives (050):  Included four objectives: (1) To fund Healthy Marriage Promotion activities that will help couples, who have chosen marriage for themselves, gain greater access to marriage education services on a voluntary basis. These services will help couples acquire the skills and knowledge necessary to form and sustain a healthy marriage; (2) To fund Responsible Fatherhood promotion activities specifically designed to promote responsible fatherhood to reverse the rise in father absence and its subsequent impact on our nation's children. ACF will award these funds on a competitive basis to States, territories, Indian tribes and tribal organizations, and public and nonprofit community entities, including faith-based organizations; (3) To award competitive based demonstration projects designed to test the effectiveness of tribal governments or tribal consortia in coordinating the provision to tribal families at risk of child abuse or neglect of child welfare services and services under tribal programs funded under this part; and, (4) To provide technical assistance by the Federal government to States, Indian tribes and tribal organizations, receiving a grant for any program funded under this part.  Types of Assistance (060):  Project Grants; Dissemination of Technical Information.  Uses and Use Restrictions (070):  The Secretary may not award funds on a noncompetitive basis, and may not provide any such funds to an entity for the purpose of carrying out healthy marriage promotion activities or for the purpose of carrying out activities promoting responsible fatherhood unless the entity has submitted to the Secretary an application which describes how the programs or activities proposed in the application will address, as appropriate, issues of domestic violence; and what the applicant will do, to the extent relevant, to ensure that participation in the programs or activities is voluntary, and to inform potential participants that their participation is voluntary; and contains a commitment by the entity to not use the funds for any other purpose; and to consult with experts in domestic violence or relevant community domestic violence coalitions in developing the programs and activities.  Eligibility Requirements (080)  Applicant Eligibility (081):  The Healthy Marriage and Responsible Fatherhood grants were awarded one time for a five-year (5) project period. The awards were made final in September 2006 and will run for five consecutive years up through September 2011. There are no subsequent competitive awards for this program. Eligible organizations for Healthy Marriage Grants in general were public and private entities. This included, but was not limited to: States; County governments; City or township governments; Special district governments; State controlled institutions of higher education; Native American tribes and tribal organizations; Nonprofit organizations; Private organizations of higher education; For-profit organizations; and faith-based and community organizations. Application Eligibility for Responsible Fatherhood Grants included: States; territories; Indian tribes and tribal organizations; and public and non-profit community entities, including Faith-based organizations. Application Eligibility for Tribal TANF Child Welfare TA Grants includes Native American Tribal governments.

Perm solves. Plans will always fail without assistance from the feds because without federal regulation they will continue to amplify the damage by continuing the misguided federal wellfare
Patrick Fagan, 2001 former Deputy Assistant Health and Human Services Secretary, 3/26/01, http://www.heritage.org/Research/family/BG1421.cfm accessed 6/23/09

Though cultural attitudes, social science findings, and social policies have begun to recognize the importance of supporting marriage and decreasing the incidence of divorce, the policies and activities of state governments are still biased against marriage. This bias amplifies the damage caused by decades of misguided federal welfare policy that has virtually eliminated marriage among the poor and federal tax policy that is penalizing marriage. Regardless of whether additional welfare reform is passed at the federal level, states can alter the way they spend their revenue, administer their programs, collect data and conduct research, select high school curricula, enact laws, and even talk about marriage.

Current welfare programs disincentivize marriage ensuring depedence and failure.
(McKinley L. Blackburn, Department of Economics, the Darla Moore School of Business, University of South Carolina, July 27th, 2000. “The Effects of the Welfare System on Marital Dissolution.” http://www.jstor.org/stable/pdfplus/20007868.pdf.   Retrieved 6/23/09. Ajay)
A major component of the welfare system in the United States is a program that primarily provides income support to unmarried women with children. For years, this program operated under the name Aid to Families with Dependent Children (AFDC), a federally-directed but state-administered program.1 The categorical nature of the eligibility for the program - any unmarried woman with children and sufficiently low income was entitled to benefits - led many to speculate that it served as a contributing factor to the formation and continuation of family situations without a male adult. The economic logic behind this supposition was simple: provide an income benefit that is primarily obtainable only if a woman is the sole head of a family, and you provide an incentive for women to engage in activities that lead to her becoming a female head. Thus, it was often suggested that the AFDC program led to increased childbearing out of wedlock, lower rates of marriage or remarriage for unmarried women with child, and a greater tendency for women to end marital unions.



__ MEDICAID

The feds are key – costs are shared between the federal and state governments, expanded coverage requires the federal government.
Kaiser Family Foundation 9 (“Medicaid as a platform for broader health reform: Supporting high need and low-income populations”, The Kaiser Commission on Medicaid and the Uninsured, http://www.kff.org/medicaid/upload/7898.pdf, May, AD: 6/29/9) LS
Provide additional federal support to expand coverage. Medicaid financing is shared across the state and federal governments.  On average, the federal government pays for 57 percent of Medicaid costs, but this varies across states ranging from a floor of 50 percent to 76 percent.  Federal financing for Medicaid is guaranteed with no set limits.  Federal Medicaid financing has been critical in helping to support state efforts to fund health services for low- income individuals and to expand health coverage more broadly (like in Massachusetts).  Given state balanced budget requirements and limited fiscal resources, expanding coverage to additional low-income populations will require that the federal government assume a greater share of the financing or shift some current Medicaid costs to the federal government.    Under current law, Medicaid pays for a variety of Medicare related expenses (Figure 19).  Medicaid pays for premiums and cost sharing for low-income Medicare beneficiaries; provides coverage during the 29-month waiting period for low- income individuals with disabilities under age 65 to receive Medicare, and finances a portion of Medicare coverage for prescription drugs for individuals who are dually eligible for Medicare and Medicaid through a payment to the federal government referred to as the “clawback”.  Shifting these costs to the federal government could reduce current barriers that make it difficult for Medicare and Medicaid to develop effective care coordination models for this expensive population.

2. Expanding eligibility can only happen at the federal level because states are limited in who they can provide care for.
Kaiser Commission, 9 (“Expanding Health Coverage for Low-Income Adults: Filling the Gaps in Medicaid Eligibility” May 12 2009. http://www.kff.org/medicaid/7900.cfm AD 7/3/09) JM
Medicaid helps protect some low-income adults from being uninsured, but many remain  ineligible for the program.  Reflecting the program’s historic ties to welfare, states can only  cover certain groups of people through Medicaid, including children, pregnant women, elderly  and disabled individuals, and parents.  States must cover these groups to federal minimum levels  and have the option to expand eligibility to higher incomes. The federal minimum for parents is et by reference to a state’s 1996  welfare eligibility levels, which is  below poverty in every state and below  50% of poverty in many states.  While  some states have expanded eligibility  above these levels, overall, parent  eligibility levels remain low,  particularly when compared to  children.  As of January 2009, 34 states  limited parent eligibility to less than  100% of poverty, with 14 limiting  eligibility to less than 50% of poverty  or about $9,000 for a family of three  (Figure 6 and Appendix Table 2).  In  contrast, 44 states covered children to  at least 200% of poverty or roughly  $35,000 for a family of three. Further, childless adults are not included in the categories of people states can cover through  Medicaid under current federal rules, regardless of their income.  States can only cover these  adults through Medicaid if they obtain a waiver of federal rules, known as a Section 1115  waiver, or they must create a fully state-funded program.  Because waivers do not provide states  with any additional federal funds and state-funded programs do not benefit from federal  matching funds, states have limited ability to expand coverage to childless adults through these  vehicles.  Reflecting these financing constraints, waiver or state-funded coverage for adults is  often limited by enrollment caps and/or provides more limited coverage than available through  Medicaid (see Appendix Table 2).   

Medicaid increases at the state level detract from higher education funding – especially during a recession. Federal funding is the only way to avoid the trade-off from getting worse.
Orszag and Kane 3 (Peter and Thomas, 37th Director of the Office of Budget Management and Harvard Professor of Economics, “Higher Education Spending: The Role of Medicaid and the Business Cycle”, The Brookings Institute, http://www.brookings.edu/papers/2003/09useconomics_kane.aspx, A.D.: 6/29/09) JH
Statistical analysis also underscores the importance of the business cycle, and the interaction between the business cycle and Medicaid spending. Although the stringency varies somewhat, all states except Vermont have some sort of balanced budget requirement. These requirements force state governments to undertake countercyclical fiscal policies, reducing expenditures or raising taxes during an economic downturn. Typically, states cut back programs during the downturn and then expand them during the subsequent recovery. Higher education has historically tended to be among the most cyclical of state budget categories. As the economy entered a recession in the early 1980s, for example, appropriations declined in real terms. Then during the recovery of the mid-1980s, appropriations recovered and ultimately exceeded their pre-recession peak. (The cyclical pattern of appropriations is less apparent in figure 1 since the denominator is also declining during a recession and increasing during a recovery.) However, something was dramatically different during the economic cycle of the 1990s. As the economy entered a recession in the early 1990s, real appropriations per capita again declined. But during the boom of the 1990s, appropriations for higher education recovered slowly and only reached pre-recession levels by 1999. Over this same time period, expenditures per student were rising, particularly at private institutions. This pattern also manifests itself on a cross-state basis. States with larger increases in unemployment between 1979 and 1982 reduced their appropriations for higher education more than states with smaller increases in unemployment. During the subsequent 1980s recovery, states that had larger reductions in unemployment then boosted their higher education appropriations by more than states with smaller reductions in unemployment. Something dramatically different occurred in the 1990s, however. As the national economy went into a recession, states with larger increases in unemployment rates once again reduced their higher education appropriations by more than states with smaller increases in unemployment rates. During the recovery of the mid-1990s, however, larger declines in unemployment rates across states were not statistically associated with larger increases in higher education appropriations. During the 1990s, state higher education appropriations did not respond to the reduction in unemployment as one would have expected based on earlier relationships. Econometric analysis of the interactions among the business cycle, higher education, and Medicaid spending suggest that the expansion in Medicaid coverage cited above played an important role. States with higher average Medicaid expenditures per capita between 1980 and 1998 reduced higher education expenditures during the 1990-1991 economic downturn by more than other states. In addition, in states with higher Medicaid spending, state appropriations for higher education became more sensitive to increases in unemployment going into the 1990-91 recession and less sensitive to declines in unemployment coming out of the 1990-91 recession, relative to other states. The bottom line is that there is a strong negative linkage between higher education appropriations and Medicaid spending. The substantial increases in Medicaid spending during the 1980s and early 1990s appear to have played an important role in the failure of higher education appropriations to rise significantly during the 1990s boom. The projected increases in Medicaid costs over the next several decades thus raise serious questions about the future path of state appropriations for public higher education.

Expanded federal match rates are critical to solvency – states can’t access.
Kaiser Family Foundation 9 (“Medicaid as a platform for broader health reform: Supporting high need and low-income populations”, The Kaiser Commission on Medicaid and the Uninsured, http://www.kff.org/medicaid/upload/7898.pdf, May, AD: 6/29/9) LS
Provide for an automatic adjustment to the Medicaid match rate during an economic downturns.  During economic downturns, Medicaid enrollment and spending rise as state revenues fall (Figure 21).  In 2003 and again in 2009, Congress enacted legislation to help states by having the federal government pay a larger share of Medicaid costs to help meet rising demand and shrinking resources during an economic downturn.  In exchange for the enhanced federal support, states were required to maintain eligibility levels.  Fiscal relief helped states to address budget shortfalls, avoid making deeper reductions in their Medicaid programs and preserve eligibility in 2003-2004.  Legislation could be crafted to provide an automatic adjustment to the federal matching rate (FMAP) triggered by economic conditions.  Additional federal resource could help states when they face fiscal stress during an economic downturn.  Such an adjustment was included in Senator Baucus’ “A Call to Action:  Health Reform 2009” based on the number of states experiencing an increase in unemployment and the magnitude of that increase.


__MENTAL HEALTH/COMMUNITY MENTAL HEALTH

states can’t coordinate to create an effective system
SUTNICK, Articles Editor, New York University Law Review, 1993
(Gary, “‘Reasonable Efforts’ Revisited,’”  NYU LR,  April)
Although many agree that the current mental health system must be reformed to focus on the provision of family preservation services, they disagree as to whether reform should occur primarily on the state or the federal level. Several commentators already have proposed state-level statutory reforms.   n141 However, there are two reasons for pursuing changes in federal statutory law instead. First, as the analysis above demonstrates, the states have made only limited progress toward development of family preservation services despite years of efforts by reformers.   n142 While the federal government has not done much better so far,   n143  [*165]  change at the federal level seems more practicable than fighting fifty separate state-level battles for statutory reform. Existing state service systems vary substantially in their organizational structures and approaches,   n144 making it quite daunting, if not impossible, to develop a single, highly-detailed, state-level model that could be implemented nationwide. Second, the federal government has the resources and supervisory power to induce the states to take immediate action to reform the delivery of children's mental health services. By combining adequate funding with appropriate incentives for provision of the needed types of services,   n145 the federal government can act as the agent of change.

States will race to the bottom
Cashin 99 (Shreyll, Prof Law @ Georgetown. 99 Colum. L. Rev. 552)
The insights of this Article complement another predominant argu ment for national-level primacy over redistributive policy choices: that devolution of welfare responsibility induces a "race to the bottom" be cause of an inverse inter-state competition to avoid becoming welfare magnets.   n12 Paul Peterson and others argue that the fierce inter-state and inter-city competition for high tax-paying firms and people constrain state and local governments from pursuing redistributive policies.   n13 Ex plicit in this literature is a recognition that, if left to their own devices, lower level governments cannot be trusted to pursue redistributive aims with vigor. To do so would be economically irrational. But while Peter son's theoretical justification for the primacy of the federal government over redistributive policy is premised in large part on economic competi tion and avoidance of a "race-to-the-bottom," this Article focuses on the empirical evidence of political process failures and public choice problems at the state level.   n14 Together, the two arguments provide a  [*558]  much fuller explanation for why fundamental policy choices about redis tribution are best made at the national level. In addition, by enriching the discussion with an empirical examination of political processes, this Article adds to the small body of literature concerning how federalism actually works in practice.   n15 In particular, few federalism scholars have attempted to test theories of federalism by examining the influence of politics on state policy choices. For, as one author put it, "any theory [of federalism] that fails adequately to take actual political experience into account isn't likely to be worth much."   n16

State HC budgets are stretched thin now- the CP forces tradeoffs causing patient deaths- impact is the aff
VIZENA 2009 – http://www.record-eagle.com/opinion/local_story_161070603.html?keyword=secondarystory

The current economic crisis has already led to a dramatic increase in the need for mental health services. Community mental health boards across the state are reporting 15 to 20 percent increases in requests for already limited services.
Access to behavioral health care is essential in times of extraordinary stress for Michigan residents. As we struggle in the midst of the current economic downtown, it is not time to dramatically reduce important mental health and substance abuse disorder treatment services that are offered.
Michigan Mental Health Code Act 258 of 1974 requires community mental health organizations to serve individuals with a severe mental illness or disability regardless of their ability to pay.
Many individuals have nowhere to seek help before turning to a community mental health organization and now these consumers will have to be turned away due to lack of funding. While waiting for services, many individuals may drastically deteriorate, requiring more intensive treatments and, sadly, some consumers may die while waiting for services.
The proposed disinvestment in services will have a profound impact among the mental health community in Michigan while also impacting other state systems such as corrections and human services. Community mental health boards will have to do less with less and the impact will be detrimental to the mental health of Michigan's residents for years to come.

Local interest groups will rollback the CP or slash HC funding to the poor and mentally ill.
Calvert ’97 (Winter, Cornell Journal of Law and Public Policy)
 Eule, in contrast, advises that courts take a "hard look" at direct ballot issues, especially popular referendums, because:  [*417] 
In several ways the popular referendum has the potential to be the most dangerous of direct democratic devices. Like the mandatory referendum [where state constitutions or statutory law require a public vote, e.g., school bond issues], it affords the opportunity for inflamed majorities to take away the gains that minority groups have struggled to achieve through the representative system [initiatives and referendums to repeal gay rights ordinances come to mind].... [A] court willing to review these electoral vetoes would have to rely on a thesis never accepted by a Supreme Court decision - that "mere repeal" of a single piece of legislation unaccompanied by a boarder restructuring of the political decision-making process can itself violate the Constitution. For the present, however, the threat of popular referenda is purely speculative. Because the time period for gathering the requisite signatures tends to be short - typically no more than ninety days after adjournment of the legislative session that produced the law - the device has seldom been used.   n206
 But in Montana, the deadline for obtaining signatures to suspend a contested law and forcing a public vote is a relatively permissive six months after enactment.   n207 Further, Referendum 112, because it is accompanied by suspension gained by winning the signatures of a small minority of voters (as few as six percent of the registered voters), represents a clear negation of the majority rule principle in that the majority, or even an equivalent minority of voters, have no procedural recourse with which to stop suspension.   n208
 Further, the success of the Natelson effort in Montana invites the use of the suspension-referendum process in other places and for other issues in addition to taxes. The opportunity for mischief is great given that the topics excepted from the suspension by the minority are few in all states that permit it. In addition to chilling legislative attempts to impose new taxes or increase old ones, curtailed revenue possibilities may compel state legislatures to cut existing programs and services. Furthermore, the things most likely to be cut affect the interests of the least powerful and most despised constituencies, e.g. the poor, racial minorities, and homosexuals. Indeed, the use of fiscal means to implicitly reduce governmental obligations to certain relatively powerless groups  [*418]  avoids troublesome constitutional guarantees safeguarded under the Equal Protection Clause.


Only national national leadership addresses this
Cashin 99 (Shreyll, Prof Law @ Georgetown. 99 Colum. L. Rev. 552)
 The preceding arguments flowing from the empirical evidence on the political economy of state decisionmaking beg the question whether interest group dynamics surrounding redistributive policy choices are any different at the national level. There are several reasons why fundamental redistributive policy choices - such as whether to have an income sup port program and who should be eligible for it - are likely to result in greater redistribution if made at the national level: (1) historically, voters have shown more willingness to accept redistributive spending at the national level, and voter tendency toward self-interest appears less pronounced at this level; (2) low-income interest groups are likely to be more effective at the national level, inter alia, because of the improved potential for voter acceptance and the benefits of economies of scale; and (3) the national legislature possesses several institutional advantages over state legislatures, including a captured tax base and its facility for logrolling arrangements that tend to equalize power between representatives of affluent and poor districts.
1. The Historical Context. - Admittedly, passage of new redistributive legislation is a rare occurrence in American politics.   n173 If the nation were starting from scratch today, without the context of the Great Depression and the New Deal, perhaps a majority of voters would not support federal efforts to provide a minimum social safety net.   n174 Historically, however, the national government has been far more interventionist than have state governments on behalf of both the poor and racial minorities,   n175  [*595]  and this history is consistent with empirical evidence suggesting that voters are more receptive to such interventions when they are made at the national level.   n176 While voters generally are not enamored of social welfare spending, our capacity for shared sacrifice and protection of the most vulnerable in our society has been highest at the national level. By contrast, the state level is the situs of government that has been most associated with the subordination of racial, if not political, minorities in America, and state governments generally have been less willing to sup port public assistance programs.   n177 Arguably, citizens show more capacity for self-interested behavior and less capacity for charity toward persons perceived as "other" the closer the issue at hand is to them.   n178 For it has only been with pressure from higher levels of government that self-interested or discriminatory behavior at more localized levels has been over come.   n179 And African-Americans have fared better under nationally - rather than locally - determined welfare policies.   n180 History suggests, therefore, that the national arena provides a better political context for deciding fundamental redistributive questions than do state-level political fora.
 [*596] 
2. Strategic Advantages of National-Level Advocacy. - The national arena also offers low-income and anti-poverty interest groups the strategic advantage of being able to focus energies on one political forum, with attendant economies of scale. At the national level, research, public education, and advocacy on poverty issues may be undertaken much more cheaply than if such activities are undertaken repeatedly in multiple fora.   n181 Moreover, to the extent that the self-interested tendencies of voters are more pronounced at state and local levels, anti-poverty interest groups must work harder at those levels to overcome these political barriers. The transaction costs involved in organizing in multiple fora, there fore, are much greater than the transaction costs involved in forming a few central associations at the national level. Finally, the possibilities for interest-group formation and coalition building improve exponentially when committed individuals and potential alliances can emerge from a single national pool.   n182

Voter confusion and institutional political power proves the counterplan will be rolled back – advocates for the mentally ill will be overwhelmed by institutional care support and stigma
Gardner 99 (Prof Law @ Western New England College School of Law. 40 S. TEX. L. REV. 759)
These observations are borne out by studies of initiatives in states that permit them. Intended originally as a way for the people to  [*780]  bypass state legislatures perceived as beholden to powerful special interests by acting directly to achieve the common good, initiatives and referenda have fallen well short of their proponents' ambitious goals. Ballot propositions are often lengthy and complex, and use technical or legal jargon unfamiliar to voters.   n82 According to one study, comprehension of ballot propositions typically requires a college or graduate education, an educational level attained by less than twenty percent of the populace.   n83 The result is that voters are frequently confused about the meaning of the ballot measures on which they are asked to vote,   n84 sometimes to the point of voting against the very positions they wish to take.   n85
Widespread voter confusion not only undermines the ability of initiatives and referenda to respond to the popular will by obscuring it, but also makes these instrumentalities of direct democracy particularly susceptible to exploitation by well-financed special interests.   n86 Today, the typical initiative campaign pits "a poorly funded grass roots coalition" against "a corporate-backed organization with significant financial resources."   n87 In Oregon, for example, the energy, tobacco and trucking industries have funnelled millions into blocking proposed limitations on nuclear power, smoking in public places and unsafe trucking practices.   n88 Furthermore, the complexity of ballot issues and the efforts voters must undertake to inform themselves skew voter turnout on ballot propositions in favor of better educated, more affluent and older voters,   n89 a group far from  [*781]  representative of the general population.   n90 In light of these developments, it seems impossible to claim that mechanisms of direct democracy provide a vehicle by which popular majorities may circumvent state legislatures dominated by narrow factions. If anything, direct democratic control seems only to supply another route by which narrow factions may use governmental institutions to advance their own self-interest at the expense of the common good.

Unique federal government infrastructure and national coordination is essential to combating stigma and effective provision of services
Dr. Chavez July 27 1995 (FNS, Nelba, Adminstrator for SAMHSA before Senate Committee on Labor and Human Resources)
Discrimination and stigma associated with substance abuse and mental disorders continue to impede service development and delivery.SAMHSA's Role SAMHSA was created in 1992 in recognition of                     the need for leadership and a Federal focus for mental health and substance abuse treatment and prevention. We face tremendous challenges in providing this legislatively mandated leadership at a time of deficit reduction; government streamlining; devolution of responsibilities from the Federal Government to States and local governments; and rapid change in mental health and substance abuse service systems. We consider this to be an environment that demands the creative application of Federal resources.
We have opened and sustained pertinent dialogue with all interested parties over the past year, culminating in meetings in seven cities across the country this spring. We convened providers, family members, consumers, and State and local officials, all of whom raised those issues that they considered most important. What we heard, over and over, regardless of geographic location, was that national perspective and coordination have never been more important than they are in today's climate.
Our customers expect much of SAMHSA and the programs administered by our Centers, the Center for Mental Health Services, the Center for Substance Abuse Prevention, and the Center for Substance Abuse Treatment. SAMHSA must provide the primary Federal mechanism for coordination, communication, and sharing of knowledge. Our customers believe that SAMHSA must meet the needs of all involved in serving people with substance abuse and mental illnesses, and the communities in which they live, by:
Keeping the public and policymakers informed of trends that warrant attention. Setting national goals to help ensure progress in reducing the costs and other consequences of substance abuse and mental illness
Conducting demonstrations and making knowledge available to give States and communities the tools to implement practical prevention strategies, treatment, and other services
Empowering consumers, families and communities by educating them about these illnesses, the prospects for successful outcomes, and getting needed treatment


__ TRANSPORTATION

Only federal funding solves the aff – a policy allowing for cars to be owned by those receiving a certain level of wellfare would spir job creation – states simply cant afford this and don’t have the right method of spuring commitment
Waller , Director of The Mobility Agenda, former Fellow at the Brookings Institution Senior Advisor on domestic policy in the Clinton-Gore , 12-‘5 (Margy ,  Brookings , “High Cost or High Opportunity Cost? Transportation and Family Economic Success” , http://www.brookings.edu/~/media/Files/rc/papers/2005/12poverty_waller/pb35.pdf)
Many scholars have found strong relationships between access to a car and employment rates, hours worked, and earnings. A number of these researchers have called for investment in car ownership assistance. The federal government recognizes the investment value of an education and subsidizes post-secondary training with Pell Grants, student loans, tax incentives, and more. Federal policy acknowledges the need for child care and health coverage for low-income workers and increased funding for both after welfare law changed. While these investments fail to meet current needs, they signal federal interest in supporting lowincome workers with proven and promising services. However, the federal government has taken only small steps toward implementing policy in response to academic research on transportation, car ownership, and employment. In 1997, as part of transportation reauthorization legislation, Congress and the Clinton administration created the Job Access and Reverse Commute (JARC) fund for innovative solutions to transportation problems faced by poor workers. JARC requires local officials to develop locally responsive transportation plans, for example, improving fixed-route transit service in dense urban areas and implementing demand-responsive options in less- dense places. Unfortunately, federal and local agency practice makes it difficult to use the funding for solutions that involve car purchase. In early 2000, President Bill Clinton proposed a package of initiatives to address transportation barriers. His administration increased the appropriation for JARC grants and adopted rules making it easier for states to ensure that having a car did not prevent eligible families from receiving food stamps. Clinton also proposed making federal funding available to match savings of low-income working families who need a car. Congress did not take up the savings proposal until after the Clinton administration ended and has not yet passed bills containing the provision. In his first term, President George W. Bush proposed to eliminate the vehicle asset test in the food stamp program to ensure that owning a car was not a barrier to eligibility. However, Congress did not pass that proposal and the administration has not renewed it. Left to manage the transportation dilemma with limited federal support, many state and local governments have supported creation of car ownership programs. There are now at least 160 programs supporting car ownership for low-income households. Some programs use donated cars repaired by welfare recipients newly trained as mechanics; others purchase cars at auction or assist welfare recipients with purchase decisions while subsidizing auto loans. These are all small programs, generally requiring a financial contribution from participating families. Local entrepreneurs who create these programs are a long way from meeting existing need for automobiles. State and local budget decisions threaten funding for car programs. In recent years, programs in Arizona, Georgia, and New York lost all or most of their funding in budget cutbacks. Perhaps because these programs are relatively new and small, to date there is no experimental research using control groups and random assignment to assess the impact of car ownership programs. However, in a recent evaluation of a subsidized car ownership program in Vermont, Marilyn Lucas and Charles F. Nicholson used models to control for other factors and found that the Vermont program led to statistically significant increases in both employment and income. Earned income increased by about $220 per month, approximately two-and-a-half times higher than earnings prior to receipt of the car. Even after controlling for other effects, the researchers determined the impact of car ownership was between $124 and $127 per month, while individuals were 19 percent more likely to have earned income after getting a car. The researchers found that the cost of the car to the program is made up within a few months, as earnings replace welfare cash assistance. Other researchers, such as Paul M. Ong, have controlled for the fact that the relationship between car ownership and positive employment outcomes could result from another factor; after implementing these controls, these researchers find that the relationship persists. More formal evaluations would provide valuable information about effectiveness of the public investment in car-ownership assistance on employment and measures of family well-being, in addition to assessing the effectiveness of particular approaches. New public investment would highlight transportation barriers and evaluate programmatic responses. A bipartisan Senate proposal would allow Congress to appropriate up to $25 million for each of the next five years to fund a national competition for grants to run programs that “improve access to dependable automobiles” for low- income families. A similar stand-alone bill in the House of Representatives would authorize up to $50 million per year and expand options for state and local providers to match Individual Development Account savings for car purchases. Both bills require an evaluation of funded programs. Congress should pass these bills to provide state and local governments and providers with resources for experimentation and evaluation. Still, many lowincome workers will remain transit dependent. Policymakers should support investment and policy that is equitable for low-income transit riders by encouraging use of distance fares and improved service in dense urban areas. Finally, increased funding for JARC should be made available so that other local transportation strategies to increase opportunities for low-income workers can be developed and tested.

____PRISONS

States can no longer manage prisons and have begun to close them

New York Times “To Trim Costs, States Relax Hard Line on Prisons” March 25, 2009. Lexis

For nearly three decades, most states have dealt with lawbreakers in two ways: lock more of them up for longer periods, and build more prisons to hold them. Now many governments, out of money and buried under mounting prison costs, are reversing those policies and practices.  Some states, like Colorado and Kansas, are closing prisons. Others, like New Jersey, have replaced jail time with community programs or other sanctions for people who violate parole. Kentucky lawmakers passed a bill this month that enhances the credits some inmates can earn toward release.  Michigan is doing a little of all of this, in addition to freeing some offenders who have yet to serve their maximum sentence. And last Wednesday, Gov. Bill Richardson of New Mexico, a Democrat, signed legislation to repeal the state's death penalty, which aside from ethical concerns was seen as costly.  Being tough on crime and sentencing has long been the clear path toward job retention for state lawmakers -- Republicans and Democrats alike. But the economic crisis is forcing them to take a more pragmatic approach as prisoners are increasingly seen less as indistinct wrongdoers and more as expenses that must be reined in.  ''When state budgets are flush,'' said Barry Krisberg, president of the National Council on Crime and Delinquency, ''prisons are something that governors and legislators all support, and they don't want to touch sentencing reform. But when dollars are as tight as they are now, you have to make really tough choices. And so now things are in play.''  Recessions tend to prompt changes to corrections policies. After the recession at the start of this decade, numerous states enacted laws eliminating some long mandatory minimum sentences; several began to offer early release and treatment options to some drug offenders. Those changes, though, were far less reaching than what is happening now and did little to curb exploding corrections budgets.  In the past 20 years, correction department budgets have quadrupled and are outpacing every major spending area outside health care, according to a recent report by the Pew Center on the States. With 7.3 million Americans in prison, on parole or under probation, states spent $47 billion in 2008, the study said.  Faced with such costs, even states known for being particularly tough on crime are revisiting their policies and laws.



The courts have ruled that state prison health care has failed and is turning over control to the federal government

Los Angeles Times “CALIFORNIA; State loses bid on healthcare plan for inmates; A judge refuses to drop court oversight despite improvements, saying he has 'no confidence' progress will continue.”   March 25, 2009 

A federal judge Tuesday rejected a bid by Gov. Arnold Schwarzenegger  and state Atty. Gen. Jerry Brown to end court oversight of healthcare in state prisons and to drop construction plans for inmate medical facilities estimated to cost up to $8 billion.  U.S. District Judge Thelton Henderson, who seized control of the prison health system in 2006, wrote in a 24-page decision that the state had not proved it would, on its own, bring the quality of care up to standards consistent with inmates' constitutional rights.  His ruling escalated the showdown between state officials and the federal courts over conditions in California prisons. Brown and Schwarzenegger's aides said they would seek to have the decision overturned by the U.S. 9th Circuit Court of Appeals.

California’s prisons are massively inefficient and unable of dealing with any simple task

Contra Costa Times, May 4th, 2009 

REGARDLESS OF how the May 19 special election turns out, California's government is going to have to cut back spending far more than lawmakers have been willing to do. That is true even if more tax increases are heaped upon a state with the third highest unemployment rate in the nation. A good place to look for additional savings is in the area where California is a top spender — its massive, inefficient prison system. Prison guards are paid far more than the national average, boosting prison costs per inmate to one of the highest in the nation. But the overspending doesn't stop there. A lack of fiscal responsibility has worsened the situation. For example, a state audit found that multiple delays and inefficient staff conduct at the departments of Correction and Rehabilitation and General Services led to a waste of $580,000 in taxpayer money on unused office space. State Auditor Elaine Howle blamed Corrections for most of the problem, saying it failed to give General Services an accurate description of its space needs. As a result, office space in San Diego went unused for more than four years at $13,800 a month. We wonder how expensive offices can remain empty for so long without anyone doing anything about it. Corrections has admitted its fault and has sent its staff for training on property-leasing tasks. Perhaps it will learn that it is not a good idea to pay rent month after month for space that is unused. Another example of taxpayer abuse comes from the California Correctional Peace Officers Association, the prison guards' union. It owes the state about $1.3 million to repay the costs of three representatives performing union-related activities from May 2003 through December 2008.
The representatives were three prison guards who were excused from their prison jobs to work full time on union activities. Fair enough, but the union should have paid for the use of taxpayer-financed guards. Even worse, why hasn't the state demanded and collected the money in the four years since the state auditor first investigated the situation in 2005? One has to ponder just how many other cases of mismanagement and waste there are in Sacramento. No wonder taxpayers are so upset with their state government that they are likely to kill all the key propositions on the May 19 ballot and are strongly opposed to any more tax increases. The relatively easy job of getting rid of obvious waste is too much for state leaders, just how successful will they be in tackling the tough chore of making painful but necessary cuts to state services?
 
 
Michigan’s state prisons are jeopardizing the state economy. They need less spending, not more

The Detroit Free Press, September 9th 2007, page 1
Michigan's super-sized prison system has put the state on financial lockdown. The Department of Corrections is largely responsible for the state's ongoing budget crisis and the nearly $2-billion shortfall it faces for the next fiscal year. Michigan taxpayers spend $1.9 billion a year -- $5 million a day -- to lock up more than 50,000 prisoners. That's more than it spends on higher education. Today, one of three state civil service employees works for Corrections; in 1980, one in 20 did. Most troubling, Michigan incarcerates at an average rate of 40% higher than the seven other Great Lakes states, which also report lower crime rates. Michigan's higher incarceration rates take an extra $500 million a year from the state's depleted general fund. It's money that could be better used for education, health care, roads or even a tax cut. Michigan, with some of the nation's toughest sentencing and parole policies, has become a national leader in incarceration. It must reform those policies if it hopes to get its fiscal house in order. That won't happen as long as Republican leaders continue to oppose reasonable ideas to control Michigan's prison population, while asserting, without factual support, that the department can save $200 million by essentially becoming leaner and more efficient. To be sure, Corrections, like any other department, can operate more efficiently. The state ought to move ahead, as Republicans have recommended, with a performance review from the auditor general to recommend ways to eliminate waste. In truth, however, the department is already pretty lean, having cut hundreds of millions of dollars in recent years, partly by eliminating dozens of management positions, consolidating administrative offices, and closing several prisons. Without question, greater efficiency ought to be encouraged, but such efforts won't yield anywhere near the $100 million, or more, in savings that are needed -- or the $200 million that Senate Republicans seek. Republicans have also proposed outsourcing, or privatizing, some Corrections services, such as transportation and food preparation. Again, outsourcing should be considered in any performance audit of the department, but there's no evidence that such a change would save significant sums. The department's food service operation, for example, is highly efficient, with costs of less than $1 a meal. In fact, some efforts to privatize have been a disaster. Correctional Medical Services Inc., which provides primary medical care in state prisons, has brought national shame to Michigan with negligent care that has resulted in unnecessary suffering and deaths. The company has failed to contain costs or deliver health care that meets the barest constitutional standards. The recently closed youth prison in Baldwin, run by a private, for-profit company, was one of the most inefficient and costly prisons in Michigan. Outsourcing can work and save money, but it is certainly no panacea.

California lawmakers’ neglect of prison reform has laid huge bills on the budget

Los Angeles Times, April 17th 2008

California's leaders are faced with the job of under-funding the state's already struggling schools and cutting services to the poor because of a chronic budget shortfall, exacerbated by the weak economy. But on the bright side, we stand to get a whole bunch of gleaming new prison buildings. The federal receiver in charge of the state's prison healthcare system has requested $7 billion to pay for seven new facilities for chronically sick or mentally ill inmates.
The Legislature will have little choice but to go along because the receiver, J. Clark Kelso, is backed by the power of the federal bench, which can order the state to spend the money. This comes at a time when the shortfall has been projected at up to $16.5 billion, though it has since been reduced through borrowing and budget cuts. Lawmakers are crying foul about the added burden on the budget, even though they have no one but themselves to blame. A prison crisis that combines overcrowding, a negligent healthcare program and a crumbling juvenile justice system has been worsening for three decades, during which time dozens of studies have chronicled the problems and pointed the way to solving them. The reports are now gathering dust on a shelf somewhere, ignored by lawmakers. Indeed, legislators and the electorate have decisively made matters worse by approving get-tough-on-crime initiatives that further cram prisons and do nothing to address conditions inside. One of the latest studies, released in January 2007 by the independent state oversight agency known as the Little Hoover Commission, is a model of the form. It practically shrieked at lawmakers to implement the needed reforms, which include creating an independent sentencing commission that could lengthen terms for the most dangerous criminals while creating community-based options for nonviolent offenders, reinventing the state's disastrously inefficient parole system and expanding prison-based drug rehabilitation and job-training programs. A year later, the Legislature has acted on none of those recommendations. Its sole accomplishment on corrections was to approve $7.9 billion in new prison and jail construction. Kelso's order demonstrates the inadequacy of this strategy: His call for $7 billion in bonds comes on top of what the Legislature has approved, and all this construction still may not satisfy a separate three-judge panel that is considering the overcrowding crisis and could order further spending. We simply cannot build our way out of this problem, especially because all these new facilities will add crushing operational expenses to future state budgets. The only solution is to cut the prison population by implementing reforms such as those suggested by the Little Hoover Commission. And lawmakers might want to get on with it before they get hit with another whopping bill from the federal justice system. Delay and inaction have gotten us to this point; only the courage to act on these proposals will get us out.


31 states have announced problems with prisons and have began to close them

USA TODAY “To save money on prisons, states take a softer stance; Critics see threat to public safety” March 18, 2009. Lexis

As 31 states report budget gaps that the National Governors Association says totaled nearly $30 billion last year, criminal justice officials and lawmakers are proposing and enacting cost-cutting changes across the public safety spectrum, with uncertain ramifications for the public.  There is no dispute that the fiscal crisis is driving the changes, but the potential risks of pursuing such policies is the subject of growing debate. While some analysts believe the philosophical shift is long overdue, others fear it could undermine public safety.  Ryan King of The Sentencing Project, a group that advocates for alternatives to incarceration, says the financial crisis has created enough "political cover" to fuel a new look at the realities of incarcerating more than 2 million people and supervising 5 million others on probation and parole.  "It's clear that locking up hundreds of thousands of people does not guarantee public safety," he says.  Joshua Marquis, a past vice president of the National District Attorneys Association, agrees the economy is prompting an overhaul of justice policy but reaches a very different conclusion about its impact on public safety.  "State after state after state appears to be waiting for the opportunity to wind back some of the most intelligent sentencing policy we have," Marquis says. "If we do this, we will pay a price. No question."  Among recent state actions:  *Kansas officials closed two detention facilities last month to save about $3.5 million. A third will be shuttered by April 1, says Roger Werholtz, chief of the state prison system. Inmates housed in the closed units will be moved to other facilities in the state.  *A California panel of federal judges recommended last month that the cash-strapped state release up to 57,000 non-violent inmates from the overcrowded system to help save $800 million.  *Kentucky officials last year allowed for the early release of non-violent offenders up to six months before their sentences end to serve the balance of their time at home.  *New Mexico and Colorado are among seven states where some lawmakers are calling for an end to the death penalty, arguing capital cases have become too costly to prosecute, reports the Death Penalty Information Center, which tracks death penalty law and supports abolition of the death penalty.  "State governments operated on the principle that if you built it, they would come," King says of prison construction during the economic boom. Since 1990, corrections spending has increased by an average of 7.5% annually, reports the National Association of State Budget Officers.  "As soon as they built those prisons, they filled them," King says. "They were never able to keep up with it. There is certainly a different atmosphere now."

Several states are incapable of funding prisons in the status quo.
Sears 2k7
(Senator Richard Sears, July, 2007 “Vermont can't afford to keep locking up nonviolent offenders”)

In 10 years, Vermont's incarceration rate has increased 73 percent, compared with 19 percent nationwide. In those same 10 years, Vermont's violent crime rate has increased by 2 percent and property crime has decreased by 31 percent. A recent study, released in February by the Pew Charitable Trust, estimates that, "By 2011, without changes in sentencing or release policies, Alaska, Arizona, Idaho, Montana and Vermont can expect to see one new prisoner for every three currently in the system." Over the past 10 years, Vermont has seen an increase of about 100 beds per year. On June 6, 2006, Vermont's in-state prison population was 1,591, and there were 562 out of state, for a total of 2,153. In fact, state spending on corrections has risen faster than any other area of state government; double-digit increases have been the norm for several years. Between 2006 and 2008 the budget rose by 16.4 percent, from $110 million in 2006 to nearly $129 million for fiscal year 2008, and if nothing changes, that trend can be expected for the foreseeable future. To put it another way, a family of four will pay an average of $800 in state taxes just to support corrections. It may be little consolation, but we are not alone: In 1982 American taxpayers spent $9 billion for corrections; by 2002 that number had mushroomed to $60 billion. The Pew Charitable Trust study found that "one in every 32 U.S. adults is currently under some form of correctional supervision" and that "by 2011 … one in every 182 U.S. residents will live in prison." I doubt many would argue the need for prison space for violent offenders, but in Vermont between 40 percent and 45 percent of the males who are incarcerated are in prison for offenses that the Corrections Department classifies as nonviolent. With females, roughly 70 percent are incarcerated for nonviolent offenses. That means that on any given day, from 900 to 1,000 offenders are incarcerated for nonviolent offenses.


States Cannot fund prisons now.
Ryan,  2k7
(Beth Gorczyca Ryan, December 6th, 2007, Counties Re-Examine How to Fund Regional Jails)

During the past several years, counties around the state have struggled to come up with a way to pay the state Regional Jail and Correctional Facilities Authority for inmates the county sends to local regional jails. Counties, particularly Cabell County, say they don't have enough money to pay the bills, which can exceed millions of dollars each year. The Regional Jail Authority, however, says state law requires counties to pay their share, and if they don't it puts the entire regional jail system in jeopardy.
The dispute reached to the state Supreme Court of Appeals, which recently issued a writ of mandamus saying the Regional Jail Authority is right -- Cabell County and other counties are required by law to pay their jail bill.
"Given this Court's duty to uphold the laws of this state, which includes the enactments of our Legislature, we are ... constrained to recognize the mandatory language directing that the counties 'shall pay' for the 'costs of operating the regional jail facilities of this state to maintain each inmate' as well as statutory language that imposes responsibility on the counties for 'costs incurred by the Authority for housing and maintaining inmates in its facilities,'" Justice Joseph P. Albright wrote in the majority's opinion.
Justice Larry Starcher concurred with the rest of the Court but reserved the right to file his own opinion.
As a result of the high court's ruling, Cabell County must pay the estimated $1.8 million it owes the regional jail system.

Lack of state prison funding results in trade off.
The Guardian 2k9

(The Guardian, February 2009, “US states cut prison spending in attempt to balance budget”)


Legislators in some states are slashing prisoner rehabilitation programmes, releasing inmates early or packing them more tightly into crowded facilities to save money.
Others are using technology, such as satellite tracking, to monitor sex offenders, drunken drivers and other criminals instead of keeping them behind bars. To avoid building new prisons, many states ship inmates to private facilities that often are thousands of miles away.
Other states are exploring long-term strategies aimed at preventing recidivism, a leading factor behind overcrowded prisons and jails - and rising costs. At any given time, more than 2.3 million people are locked up in federal, state and local facilities in the US, and more than half of those released from prison are back behind bars within three years, according to the federal Bureau of Justice Statistics.
"We're at a crossroads. I think there is an acknowledgment that if we continue the status quo, we're going to continue to have a prison population that increases to untenable levels," said Ryan S King, a policy analyst with The Sentencing Project, which lobbies for changes in sentencing laws as a way to reduce incarceration rates.
For the first time, one in every 100 adults in the US is behind bars, according to a February 2008 report by the Public Safety Performance Project (which, like Stateline.org, is part of the Pew Centre on the States).
The booming prison population cost states nearly $50bn in 2007, but the high incarceration rate has had no discernible effect "either on recidivism or overall crime", the report said.
Nationally, corrections trails only healthcare, education and transportation in consuming state dollars. Prison spending increased 127% from 1987 to 2007, and at least five states - Connecticut, Delaware, Michigan, Oregon and Vermont - now spend as much or more on corrections as they do on higher education, according to the National Association of State Budget Officers and the Public Safety Performance Project.
The statistics are alarming state legislators in all regions of the US and, increasingly, on both sides of the political aisle. Criminal justice reform - for years a controversial issue for legislators wary of being labelled "soft on crime" - is finding new proponents as public officials seek ways to save money. But a single strategy to tackle incarceration costs has yet to emerge, and some critics say state policymakers are dragging their feet and avoiding comprehensive changes that have become necessary.

Federal prisons provide the best way to target disease spread because the period of stay is longer

Drs. Peter M Ford and Wendy L Wobeser are with the Department of Medicine, Queen’s University, Kingston, Ont 2000 http://www.cmaj.ca/cgi/reprint/162/5/664.pdf

Screening for disease and provision of adequate treatment programs in short-term detention facilities (i.e., provincial jails), which have high turnover rates, is difficult although possible, if these programs are integrated with community services. Because periods of stay are longer in federal penitentiaries, these institutions should be able to do better. Unfortunately, the same problems exist at the federal level.
Continues…
Failure to provide adequate screening and failure to provide timely treatment may increase the burden of ill health later on and may also increase the costs to the health care system. Transmissible diseases that spread in prisons and that are left undetected or untreated will ultimately spread to the community.

The aff will be modeled by the states

New York Times [staff writer Tom Wicker] “the wrong model” July 27, 1972

If the Federal Government wants to set up a model, it ought to be doing better things than building prisons, particularly when the trend in many states is toward closing them .... Mr. Carlson undoubtedly is correct that there will always be some offenders who have to be imprisoned for public safety; but these are the few rather than the many, and they scarcely justify the federal government embarking now on a vast program of prison construction. That seems exactly the wrong model to provide, at a time when federal leadership and assistance might go far toward eliminating an American penal system that encourages rather than prevents crime.

____ SEX TRAFFICKING

States can’t solve—access to federal social services and a TVisa is a prerequisite to citizenship and sufficient benefits
Free the Slaves and Human Rights Center, ‘5 [Free the Slaves and Human Rights Center of the University of California Berkeley, “Hidden Slaves: Forced Labor in the United States,” Berkeley Journal of International Law, 23 Berkeley J. Int'l L. 47 2005]
Ironically, as awareness about trafficking and forced labor has increased at the level of local law enforcement, new tensions have arisen between state and federal agencies. Victims who cooperate with local authorities are technically eligible for a T visa but run into problems because the Trafficking Act favors documentation of cooperation from federal law enforcement over an endorsement from state officials. The new amendments to the Trafficking Act attempt to make state endorsements equivalent to federal ones, but the new law has not yet been implemented. n114 Advocates are watching the certification process carefully. Without access to federal immigration and welfare benefits, victims in state prosecutions are unable to regularize their status and must fall back on state benefits - if available - or private support. The NGO advocate recounted that victims "are surviving on the good will of local citizens to take care of them, and they have no legal status."

Federal law must deal with trafficking—
Chacon, ‘6 [Jennifer M. Chacon, Assistant Professor, University of California, Davis, School of Law, MISERY AND MYOPIA: UNDERSTANDING THE FAILURES OF U.S. EFFORTS TO STOP HUMAN TRAFFICKING, 74 Fordham L. Rev. 2977, May, 2006, lexis]
Much of the literature diagnosing the domestic shortcomings of the TVPA focuses upon the legal barriers to relief that are encountered by trafficking victims in the United States. The proposed solutions focus on improving the identification and assistance of trafficking victims in the United States. But the United States is not a passive recipient of trafficked human beings. Efforts to deal more effectively and humanely with the domestic manifestations of global human trafficking must take account of the role that the United States plays in generating a viable market for trafficking. This requires express recognition that specific elements of U.S. law and policy actually facilitate the trafficking of human beings into and within the United States. When the issue is framed in this way, it quickly becomes evident that the shortcomings of the Trafficking Act are neither new nor unique failures; n6 they are simply the most recent examples of the wider failure of U.S. law to successfully assess and grapple with the global and domestic forces that drive migration.


Perm is best-- Federal involvement is key to local solvency—state and local alone don’t solve
Dalrymple, ‘5 [JOYCE KOO DALRYMPLE, Staff Writer, BOSTON COLLEGE THIRD WORLD LAW JOURNAL (2003-2004). “BOOK REVIEW: HUMAN TRAFFICKING: PROTECTING HUMAN RIGHTS IN THE TRAFFICKING VICTIMS PROTECTION ACT: HUMAN TRAFFIC: SEX, SLAVES & IMMIGRATION. By Craig McGill.” 25 B.C. Third World L.J. 451, Spring, 2005, lexis]
For smooth and comprehensive delivery of protections, a multi-disciplinary coordinated response is necessary to address the trafficked person's variety of needs. n130 Lawyers, nonprofit service providers, and federal and local law enforcement must work in tandem to combat trafficking in their community. n131 Working groups should be established in cities nationwide, tailoring their services to the specific  [*471]  needs of their given community. n132 Community responses should focus on, among other things: victim identification and management, victim assistance for safety and medical and rehabilitative services, crime scene investigations, and coordination among different levels of law enforcement. n133 Working groups should also strive to increase public awareness, since the effectiveness of these protections depends on the wider community's knowledge of the laws. n134 First, federal officials should train local law enforcement entities that may not be aware of the federal law. n135 Professional schools in the fields of nursing, social work, law, medicine, business, and mental health should also integrate awareness of human trafficking into their curricula. n136 To educate the public, working groups should develop media campaigns modeled after successful public health initiatives, such as anti-smoking, HIV/AIDS, domestic  [*472]  violence, and drunk driving awareness efforts. n137 To be effective, education and public awareness campaigns about trafficking should utilize the media in immigrant communities, such as newspapers or newsletters circulated in other languages.

(   ) Perm solves best—ensures cooperation between feds and states
Free the Slaves and Human Rights Center, ‘5 [Free the Slaves and Human Rights Center of the University of California Berkeley, “Hidden Slaves: Forced Labor in the United States,” Berkeley Journal of International Law, 23 Berkeley J. Int'l L. 47 2005]
Three years after the passage of the Trafficking Act, U.S. law enforcement personnel, policymakers, and labor rights advocates are still wrestling with the legal mandates established under the new law. Our research suggests that effective implementation and enforcement of the Trafficking Act will depend on several factors, including training law enforcement officers, particularly at the local level, to identify victims and forced labor operations; improving cooperation and information sharing between federal and state agencies charged with combating forced labor; revising procedures for the handling of survivors; and finding more effective measures for providing survivors with protection, benefits, and compensation.

Any solvency deficit means you vote aff
Hyde, 01 [Hyde, Representative in Congress from the State of Illinois, and Chairman, Committee on International Relations. Internet Speech. “HEARING BEFORE THE COMMITTEE ON INTERNATIONAL RELATIONS HOUSE OF REPRESENTATIVES ONE HUNDRED SEVENTH CONGRESS FIRST SESSION IMPLEMENTATION OF THE TRAFFICKING VICTIMS PROTECTION ACT”. 2001 http://commdocs.house.gov/committees/intlrel/hfa76351.000/hfa76351_0.htm}
In particular, we have asked our witnesses to discuss the extent to which various agencies of the United States Government have discharged the responsibilities imposed upon them by the act, and whether they have effectively wielded the tools provided by the act to punish and prevent these atrocious crimes and to protect their victims. A law without vigorous and effective implementation is worse than no law at all, because it lulls us into the false sense that we have done something to solve the problem. So it is vitally important not only that the Trafficking Victims Protection Act be implemented, but also that its implementation be guided by the fundamental policy choices that Congress made in enacting it.


Trafficking disproportionately effects CA, FL, NY, TX—state action will bankrupt these states
Free the Slaves and Human Rights Center, ‘5 [Free the Slaves and Human Rights Center of the University of California Berkeley, “Hidden Slaves: Forced Labor in the United States,” Berkeley Journal of International Law, 23 Berkeley J. Int'l L. 47 2005]
Our data also suggest that forced labor operations are concentrated in the states of California, Florida, New York, and Texas - all of which are transit routes for international travelers. Cities where reported forced labor occurred also tended to be in states with large populations and sizable immigrant communities. Our data is consistent with findings of the U.S. government. The U.S. Department of Justice reports that in 2003, the largest concentrations of survivors of trafficking who received federal assistance resided in California,  [*59]  Oklahoma, Texas, and New York. n13 In 2002, the DOJ reports that survivors of trafficking who received federal assistance resided in Texas (31%), Florida (19%), and California (14%). n14



___TRANSPORTATION

Only federal funding solves the aff – a policy allowing for cars to be owned by those receiving a certain level of wellfare would spir job creation – states simply cant afford this and don’t have the right method of spuring commitment
Waller , Director of The Mobility Agenda, former Fellow at the Brookings Institution Senior Advisor on domestic policy in the Clinton-Gore , 12-‘5 (Margy ,  Brookings , “High Cost or High Opportunity Cost? Transportation and Family Economic Success” , http://www.brookings.edu/~/media/Files/rc/papers/2005/12poverty_waller/pb35.pdf)
Many scholars have found strong relationships between access to a car and employment rates, hours worked, and earnings. A number of these researchers have called for investment in car ownership assistance. The federal government recognizes the investment value of an education and subsidizes post-secondary training with Pell Grants, student loans, tax incentives, and more. Federal policy acknowledges the need for child care and health coverage for low-income workers and increased funding for both after welfare law changed. While these investments fail to meet current needs, they signal federal interest in supporting lowincome workers with proven and promising services. However, the federal government has taken only small steps toward implementing policy in response to academic research on transportation, car ownership, and employment. In 1997, as part of transportation reauthorization legislation, Congress and the Clinton administration created the Job Access and Reverse Commute (JARC) fund for innovative solutions to transportation problems faced by poor workers. JARC requires local officials to develop locally responsive transportation plans, for example, improving fixed-route transit service in dense urban areas and implementing demand-responsive options in less- dense places. Unfortunately, federal and local agency practice makes it difficult to use the funding for solutions that involve car purchase. In early 2000, President Bill Clinton proposed a package of initiatives to address transportation barriers. His administration increased the appropriation for JARC grants and adopted rules making it easier for states to ensure that having a car did not prevent eligible families from receiving food stamps. Clinton also proposed making federal funding available to match savings of low-income working families who need a car. Congress did not take up the savings proposal until after the Clinton administration ended and has not yet passed bills containing the provision. In his first term, President George W. Bush proposed to eliminate the vehicle asset test in the food stamp program to ensure that owning a car was not a barrier to eligibility. However, Congress did not pass that proposal and the administration has not renewed it. Left to manage the transportation dilemma with limited federal support, many state and local governments have supported creation of car ownership programs. There are now at least 160 programs supporting car ownership for low-income households. Some programs use donated cars repaired by welfare recipients newly trained as mechanics; others purchase cars at auction or assist welfare recipients with purchase decisions while subsidizing auto loans. These are all small programs, generally requiring a financial contribution from participating families. Local entrepreneurs who create these programs are a long way from meeting existing need for automobiles. State and local budget decisions threaten funding for car programs. In recent years, programs in Arizona, Georgia, and New York lost all or most of their funding in budget cutbacks. Perhaps because these programs are relatively new and small, to date there is no experimental research using control groups and random assignment to assess the impact of car ownership programs. However, in a recent evaluation of a subsidized car ownership program in Vermont, Marilyn Lucas and Charles F. Nicholson used models to control for other factors and found that the Vermont program led to statistically significant increases in both employment and income. Earned income increased by about $220 per month, approximately two-and-a-half times higher than earnings prior to receipt of the car. Even after controlling for other effects, the researchers determined the impact of car ownership was between $124 and $127 per month, while individuals were 19 percent more likely to have earned income after getting a car. The researchers found that the cost of the car to the program is made up within a few months, as earnings replace welfare cash assistance. Other researchers, such as Paul M. Ong, have controlled for the fact that the relationship between car ownership and positive employment outcomes could result from another factor; after implementing these controls, these researchers find that the relationship persists. More formal evaluations would provide valuable information about effectiveness of the public investment in car-ownership assistance on employment and measures of family well-being, in addition to assessing the effectiveness of particular approaches. New public investment would highlight transportation barriers and evaluate programmatic responses. A bipartisan Senate proposal would allow Congress to appropriate up to $25 million for each of the next five years to fund a national competition for grants to run programs that “improve access to dependable automobiles” for low- income families. A similar stand-alone bill in the House of Representatives would authorize up to $50 million per year and expand options for state and local providers to match Individual Development Account savings for car purchases. Both bills require an evaluation of funded programs. Congress should pass these bills to provide state and local governments and providers with resources for experimentation and evaluation. Still, many lowincome workers will remain transit dependent. Policymakers should support investment and policy that is equitable for low-income transit riders by encouraging use of distance fares and improved service in dense urban areas. Finally, increased funding for JARC should be made available so that other local transportation strategies to increase opportunities for low-income workers can be developed and tested.

– Frazer says without a federal policy the CP would make people ineligable to food stamps – meaning either they don’t solve case or they rid food stamps





VETERANS

Not all of the information is available at the state level
Iowa Veterans Benefit Study ‘8 (“Veterans Final report and Recommendations” https://www.iowava.org/images/Veterans_Final_Report_2008.pdf AD: 5-26-09) NS
The challenge with communication is that the state does not have comprehensive information about veterans living in Iowa. Because of the federal role in providing benefits, IDVA and the county veterans affairs offices do not have complete lists of their constituencies. This is not just an Iowa issue as many states are working on means to identify their veterans for purposes of communication. During focus groups, veterans themselves were surprised that information on all veterans was not available at the state level. These veterans expressed a desire to receive active communication regarding benefits and services.

The federal government is key, states only fill in the gaps
Iowa Veterans Benefit Study ‘8 (“Veterans Final report and Recommendations” https://www.iowava.org/images/Veterans_Final_Report_2008.pdf AD: 5-26-09) NS
While the federal government ultimately bears responsibility for veterans affairs, state and local governments are playing an increased role in addressing the needs of veterans by offering new or enhanced benefits and filling gaps in available federal benefits. The greatest role states are playing is by establishing an infrastructure, both state and local, of trained service officers who can assist veterans in filing claims for benefits. More than $680 million in federal benefits is distributed annually to Iowa veterans and their family members. These benefits are critical to ensure quality of life for our veterans and free up millions of dollars in county and state government budgets to be utilized for other essential services. Given the positive impacts on individual veterans and at the state level, Iowa must do all that is possible to increase the number of Iowa veterans receiving federal benefits, ensuring the health and well being of those who have served our country.

Only the Federal Government ensures good quality   
Iowa Veterans Benefit Study ‘8 (“Veterans Final report and Recommendations” https://www.iowava.org/images/Veterans_Final_Report_2008.pdf AD: 5-26-09) NS
Many changes such as eligibility, level of services provided, and others are frequently made to the federal veterans benefits system. Complicating the issue, local budgets for county veterans service offices and the level of training of state and county veterans service officers vary greatly across the state. As a result, the operating hours of county service offices and the quality of services provided at the local and state levels vastly differ. A federal veterans benefit quality assurance and training team will ensure a high standard of federal veterans benefits claims filing services are provided at the local and state level. Counties and the state will be able to maximize federal benefits claims for Iowa veterans, lessening the financial burden on local and state governments.
 
VA most experienced and accomplished in diagnosing hidden PTSD symptoms
Litz and Orsillo 7 (Brett and Susan, Ph.D, The Returning Veteran of the Iraq War:
Background Issues and Assessment Guidelines, http://www.ncptsd.va.gov/ncmain/ncdocs/manuals/iraq_clinician_guide_ch_3.pdf, 2/26/07, AD: 6/26/09) JC
A variety of factors including personal and cultural characteristics, orientation toward coping with stressors and painful emotions, pre-deployment training, military-related experiences, and postdeployment environment will shape responses to the Iraq War. Further, psychological responses to deployment experiences can be expected to change over time. While mental health professionals within the VA are among the most experienced and accomplished in assessing and treating chronic combat-related PTSD, veterans of the Iraq war can be expected to present unique clinical challenges. The absence of immediate symptoms following exposure to a traumatic event is not necessarily predictive of a long-term positive adjustment. Depending on a variety of factors, veterans may appear to be functioning at a reasonable level immediately upon their return home particularly given their relief at having survived the war-zone and returned to family and friends. However, as life circumstances change, symptoms of distress may increase to a level worthy of clinical intervention.
VA is the best actor – it has specialized PTSD programs and far-reaching patient network that cooperates with the DoD to diagnose and treat PTSD veterans.
Bascetta 4 [Cynthia A. “VA and Defense Healthcare.” GAO Reports. Sept. 20 Ln AD 06/10/09] JL

VA has specialized PTSD programs that are staffed by clinicians who have concentrated their clinical work in the area of PTSD treatment. VA specialized PTSD programs are located in 97 VA medical facilities and provide services on an inpatient and outpatient basis. VA PTSD services include individual counseling, support groups, and drug therapy and can be provided in non- specialized clinics, such as general mental health clinics. Veterans who served in any conflict after November 11, 1998 are eligible for VA health care services for any illness, including PTSD services, for 2 years from the date of separation from military service, even if the condition is not determined to be attributable to military service. This 2-year eligibility includes those Reserve and National Guard members who have left active duty and returned to their units. After 2 years, these veterans will be subject to the same eligibility rules as other veterans, who generally have to prove that a medical problem is connected to their military service or have relatively low incomes. In July 2004, VA reported that so far 32,684 or 15 percent of veterans who have returned from service in Iraq or Afghanistan, including Reserve and National Guard members, have accessed VA for various health care needs. DOD and VA have formed a Seamless Transition Task Force with the goal of meeting the needs of servicemembers returning from Iraq and Afghanistan who will eventually become veterans and may seek health care from VA. To achieve this goal, DOD and VA plan to improve the sharing of information, including individual health information, between the two departments in order to enhance VA`s outreach efforts to identify and serve returning servicemembers, including Reserve and National Guard members, in need of VA health care services. Since April 2003, VA requires that every returning servicemember from the Iraq and Afghanistan conflicts who needs health care services receive priority consideration for VA health care appointments.8 DOD uses two approaches to identify servicemembers who may be at risk of developing PTSD: the combat stress control program and the post-deployment health assessment questionnaire. DOD`s combat stress control program identifies servicemembers at risk for PTSD by training all servicemembers to identify the early onset of combat stress, which if left untreated, could lead to PTSD. DOD uses the post-deployment health assessment questionnaire to screen servicemembers for physical ailments and mental health issues commonly associated with deployments, including PTSD. The questionnaire contains four screening questions that were developed jointly by DOD and VA mental health experts to identify servicemembers at risk for PTSD.

The Federal Government has a moral obligation to provide Veterans employment services 
US Office of Personnel Management 4 (“OPM Hosts Veterans’ Preference and Employment Symposium for Key Human Capital Managers”, May 27, http://www.opm.gov/news/opm-hosts-veterans-preference-and-employment symposium-for-key-human-capital-managers,327.aspx, AD:6-29-09)
Washington, D.C. - U.S. Office of Personnel Management (OPM) Director Kay Coles James today hosted a special symposium for agency human capital leaders, human resources specialists, and program managers on veterans' preference and recruitment. The all-day event focused on advancing existing policies and strategies to recruit veterans into the federal work force, and to reiterate that veterans' preference is the law and not a courtesy.
"Recognizing the sacrifices of those who wear our country's uniform, the federal government embraces a moral obligation to ensure that veterans have appropriate and proper access to federal jobs when they separate from military service," James told the crowd of over 250 attendees. "That obligation is spelled out in plain legislative language extending back sixty years - we refer to it as veterans' preference."
The event was held at the Ronald Reagan Building and International Trade Center, and brought together key federal human capital officials to focus on an issue President George W. Bush has entrusted to James.
The symposium included a presentation by Terrance P. O'Mahoney, chairman of the President's National Hire Veterans Initiative; a presentation on the current status of veterans' employment in the federal work force; breakout presentations focusing on special hiring authorities, veterans' preference, and national transition assistance programs; and remarks by both OPM Deputy Director Dan Blair and Major General Bobby G. Hollingsworth, Ret., executive director of the National Committee for Employer Support of the Guard and Reserve.
"OPM has done an excellent job in coordinating and addressing veterans' issues," stated O'Mahoney. "From reminding agency heads of their obligations to veterans and urging them to hire more -- to ensuring that veterans get their preferences to which they are entitled -- OPM is doing a great job."
James also discussed efforts OPM has made recently to increase veteran hiring, including regular meetings with veterans' service organizations; designing a special section of the OPM USAJOBS website, www.usajobs.gov, for veterans seeking federal employment; and the Veteran Invitational Program, an initiative that provides veterans in transition from military service to civilian life with timely, accurate, and useful information regarding civilian employment opportunities with the federal government.  
"Today's veteran brings the same level of dedication to the job as previous generations of veterans, but in addition they bring many of the high-tech skills needed in the current federal work force," stated James. "The federal government has a responsibility to help these men and women as they transition back to civilian life, and veterans represent a ‘good-catch' in filling critical work force vacancies, particularly as we begin seeing retirements of older workers. As members of the best trained and volunteer military in the world, veterans have demonstrated an appreciation and competence for excellence and teamwork, and I cannot think of a better source of talent for the federal government than those who have completed their service in uniform."  
Since President Bush took office, more than 133,000 veterans have been hired. Currently, approximately 450,000 veterans are employed in the federal civil service - 25 percent of the total work force.

Equal mental health care for women is critical to solving the high rates of PTSD in women
Ilem 7 (Joy J, Assistant National Legislative Director of Disabled American Veterans, “Addressing the Needs of Women Veterans Who Served in Operations Enduring and Iraqi Freedom,” Statement before Committee on Veterans’ Affairs Subcommittee on Health and Subcommittee on Disability Assistance and Memorial Affairs for United States House of Representatives, http://www.dav.org/voters/documents/statements/Ilem20070712.pdf, July 12, 2007, AD: 6/26/09) JC   
According to the VA Women Veterans Health Program Office, as of August 31, 2006,  approximately 70,000 women have served and separated from military service in OEF/OIF.   Among this group nearly 37.2 percent, or 25,960, have sought and received health care from VA  since separation from military service (up from 32.9 percent, or 15,903, in the previous year).   According to VA the prevalence of potential PTSD among new OEF/OIF women veterans  treated at VA from fiscal year 2002-2006 has grown dramatically from approximately one  percent in 2002 to nearly 19 percent in 2006.  The challenge of addressing the health care needs of the growing number of women  veterans exposed to combat with and without obvious injury is daunting.  In the future, the needs  will likely be significantly greater with more women seeking access to care, increased health  care utilization, and a more diverse range of medical conditions.  It is unlikely the past  experience of women veterans in the VA will serve as an accurate guide because of the unique  experiences of women who have served in OEF/OIF.     Equal access to quality mental health services is critical for women veterans, especially  women veterans who have readjustment problems associated with serving in a combat theater or  those who have suffered sexual or other trauma during military service.  The VA Women’s  Health Project, a study designed to assess the health status of women veterans who use VA  ambulatory services, found that active duty military personnel reported rates of sexual assault  higher than comparable civilian samples, and there is a high prevalence of sexual assault and  harassment reported among women veterans accessing VA services.  The study noted and we  agree, that it is “essential that VA staff recognizes the importance of the environment in which  care is delivered to women veterans, and that VA clinicians possess the knowledge, skill, and  sensitivity that allows them to assess the spectrum of physical and mental conditions that can be  seen even years after assault.”      According to VA, approximately 19 percent of the women screened between fiscal years  2002 and 2006 responded “yes” to experiencing MST, compared to one percent of men screened.   In response to these reports, VA established a committee to explore ways to address the mental  health needs of women veterans and to improve mental health services to women who have  experienced MST.  In 2006, VA developed an MST support team under its mental health service  to specifically work with MST coordinators in the field to better monitor tracking, screening,  treatment, and training programs for MST.  VA is yet to implement earlier recommendations  made by the Mental Health Strategic Health Care Group Subcommittee on Women’s Mental  Health, including development of an MST provider certification program, providing separate  sub-units for inpatient psychiatry and other residential services, and improved coordination with  DoD on transition of women veterans.  We encourage VA revisit these recommendations.     Given the increasing role of women in combat deployments and with more than 70,000  women now having served in OEF/OIF combat theaters, we are pleased that VA’s Women’s  Health Science Division of VA’s National Center for PTSD is evaluating the health impact of  combat service on women veterans, including the dual burden of exposure to traumatic events in  the war zone and MST.  According to the center, although there is no current empirical data to  verify MST is occurring in Iraq there have been numerous reports in the popular press citing  cases of sexual misconduct.  In the center’s Women’s Stress Disorder Treatment Team, of 49  returning female veterans, 20 (41 percent) reported MST.     The Center notes that anecdotal reports from  OEF/OIF veterans suggest a number of  unique concerns that have a more direct impact on women than their male counterparts returning  from combat theaters, including lack of privacy in living, sleeping, and shower areas; lack of  gynecological health care; healthcare impact of women choosing to stop their menstrual cycle;  health consequences of dehydration and chronic urinary tract infection.  There are also reported  findings that suggest distinct differences in homecoming, including that women may be less  likely to have their military service recognized or appreciated; possible differential access to  treatment services; and possible increased parenting and financial stress.  Additionally, women  may be more likely to seek help for psychological difficulties.      We are pleased the Center is looking at gender differences in mental health, MST in the  war zone, and gender differences in other stressors associated with OEF/OIF service and  homecoming.  We understand a number of research initiatives/projects are focused on treatment  of PTSD in women, enhancing sensitivity toward and knowledge of women veterans and their  healthcare needs among VA staff, and MST among Reserve components of the armed forces.       Some women will suffer from severe PTSD which will require more intensive evidence  based treatment.  VA has conducted ground breaking research on evidence based treatment for  PTSD, including a recent study that established the efficacy for women.  The most effective  approaches often require intensive outpatient or residential care.  Lack of adequate child care is a  significant problem for women requiring such care, as is transportation to treatments which  require frequent, even daily attendance.  Furthermore, while the establishment of the efficacy of  these approaches is an important first step, they will only have an impact on the thousands of  women veteran affected when they are fully deployed throughout the VA system and easily  accessible to patients.  This is not currently the case, as acknowledged by the National Center  representative in recent testimony before the President's Wounded Warriors Commission.      We recognize that VA is attempting to address the needs of women veterans returning from  combat theaters in a variety of ways and has provided guidance for medical facilities to evaluate  the adequacy of programs and services for returning OEF/OIF women veterans in anticipation of  gender-specific health issues.  We understand that the Women Veterans Health Program Office  and the local women veterans’ program managers (WVPMs) have partnered with the VA  Seamless Transition Office to provide information during National Guard, Reserves, and family  member demobilization briefings on VA services and programs for women veterans. VA should  continue to strengthen its partnership with the DoD to ensure a seamless transition for women  from military service to veteran status.  An improvement in sharing data and health information  between the Departments is essential to understanding and best addressing the health concerns of  women veterans. Unlike female veterans from previous conflicts, this new cohort of female  veterans has been routinely exposed to combat in Iraq.  It is imperative to acknowledge that we  do not fully understand the barriers that may prevent OEF/OIF women from accessing VA care.   We do know from recent studies of OEF/OIF active duty and reserve component personnel that  stigma is a major in accessing mental health services; with over 40% reporting that stigma would  impact their access.  Furthermore, we must acknowledge that we will never adequately  understand the barriers to seeking VA care by only studying the minority of female veterans who  actually receive care, as is the case with VA patient satisfaction surveys.      Therefore, DAV makes the following recommendations to better serve women veterans returning from combat theaters VA and DoD should collaborate to conduct surveys of recently discharged active dutywomen and recently demobilized female reserve component members that fully assess the barriers that they perceive or have experienced to seeking health care through VA.  These surveys should include assessments of the effect of sigma, driving distance, absence of child care, understanding of VA eligibility and services, user friendliness of VA services for those who have attempted to access care, cultural sensitivities that differentially affect women, and other key potential barriers.VA should quickly disseminate and deploy resources to make evidence based PTSD treatment easy accessible for women veterans across the country, and explore options for providing child care for those needing it to attend treatment V DoD should fund a prospective  population‐based health study of women who served in OEF/OIF.An epidemiologic study with at least a tn year follow‐up is needed.  This study should be carried out by DoD, VA and University researchers collaboratively.                                   
VA and the DOD must coordinate to provide equal healthcare and treat sexual crimes against women
Ilem 7 (Joy J, Assistant National Legislative Director of Disabled American Veterans, “Addressing the Needs of Women Veterans Who Served in Operations Enduring and Iraqi Freedom,” Statement before Committee on Veterans’ Affairs Subcommittee on Health and Subcommittee on Disability Assistance and Memorial Affairs for United States House of Representatives, http://www.dav.org/voters/documents/statements/Ilem20070712.pdf, July 12, 2007, AD: 6/26/09) JC   
In closing, VA needs to ensure priority is given to women veterans’ programs so quality health care and specialized services are available equally for women and men. VA must continue to work to provide an appropriate clinical environment for treatment, even where there is a disparity in numbers. Given the changing roles of women in the military, VA must also be prepared to anticipate the specialized needs of women veterans who were sexually assaulted in military service or catastrophically wounded in combat theaters, suffering amputations, blindness, spinal cord injury, or traumatic brain injury. Although it is anticipated that many of the medical problems of male and female veterans returning from combat operations will be the same, VA facilities must address the health issues that pose special challenges for women. DAV has recommended that VA focus its women’s health research on finding the health care delivery 9 model that demonstrates the best clinical outcomes for women veterans. Likewise, VA should develop a strategic plan along with DoD to collect critical information about the health status and care needs of women veterans with a focus on evidence-based practices to identify other strategic priorities for women’s health research agenda.  



WELFARE REFORM

Absent a minimum federal assistance level, states will restrict eligibility and eliminate procedural safeguards.  The counterplan results in slashed benefit levels, new forms of behavioral modification, and deeper poverty.

Roberts, Kirkland & Ellis Professor, Northwestern University Law School
Professor, Department of African-American Studies and Sociology, 1997
(Dorothy, Killing the Black body, p. 208-209, AS) 

The new federal law threatens to roll back the meager gains won by the l960s welfare rights movement, once again placing poor Black mothers and their children at the mercy of state legislatures and local bureaucrats. Under the Social Security Act of 1936, the federal government reimbursed states for part of the AFDC benefits they disbursed as long as the state plans comported with federal requirements. Among the most critical federal standards were criteria for eligibility, ensuring that all applicants who met a standard of need were entitled to benefits. Federal entitlements also represented a national commitment to providing a safety net for poor families. Although states remained free to determine a maximum assistance payment, even one that left families below the poverty level, they nevertheless could not exclude eligible applicants. The demise of federal eligibility standards began several years ago as states secured federal waivers allowing them to implement experimental welfare programs. Even before the federal law went into effect in 1996, more than half of the nation’s welfare recipients were covered by state rules that, without the waivers, would have violated federal law.  Without a federally enforceable right to benefits, most states are likely to cut back eligibility standards and procedural safeguards. Not only will behavior modification rules proliferate, but fiscal pressures will drive reductions in benefit levels, job training, child care, and other service programs. The new law represents a disastrous turn in the way we think about welfare. Numerous critics have noted that American welfare policy, by differentiating between welfare and social insurance programs , has long branded AFDC recipients as immoral freeloaders who are responsible for their own fate.24 Mainstream politicians never fully acknowledged that recipients’ poverty resulted from economic and social forces that prevented them from finding work. The welfare system never included a serious effort at aggressive job-creation or eradication of social barriers to employment. Yet until recently welfare policy minimally sought to reduce poverty and improve the living conditions of recipients. Welfare was stingy and humiliating, but at least it responded to the needs of poor children. In the new era of welfare, government assistance has become a tool of social control, a means of improving the behavior of poor families. Under the new scheme, even the neediest children are cast deeper into poverty if their mothers do not conform.


Devolution is the means used by social conservatives to invisibly gut anti-poverty programs dating back to the New Deal.

Brown, University of California at Santa Cruz Politics Professor, 03
(Michael, Sandford Schram et al., Bryn Mawr College Graduate School of Social Work and Social Research social theory and policy instructor; Joe Soss, American University School of Public Affairs Government Associate Professor; Richard Fording, University of Kentucky Political Science Associate Professor, Race and the Politics of Welfare Reform, P. 53, JD)

What are the origins of this perverse policy? It was no accident. As Republicans clearly understand, a block grant with fixed funding is a Form of budgetary control. According to one congressional aide involved in creating the program, block grants “are one of the best ways to cut the budget. The cuts are so ethereal. You don’t have to specify what will really happen to people and programs.  You just give the states less money and let them decide” (Conlan ‘998, 237). Republicans initially introduced legislation converting federal programs into eight block grants, and tried to eliminate the federal entitlement for welfare, Medicaid, and food stamps. They were hardly interested in improving governmental efficiency Republican affection for block grants goes back to the 196os and their efforts to derail the Great Society. In fact, there is a consistent theory of devolution and budget cutting that runs from Nixon to Newt Gingrich. TANF’s paradoxical discrepancy between fiscal incentives and racialized poverty should be understood as the result of a partisan political struggle over financing of federal social Policy that dates to the New Deal and the racial conflict defining the history of AFDC and the anti-poverty programs of the Great Society.

Fiscal federalism perpetuates racist inequalities and undermines national welfare

Brown, University of California at Santa Cruz Politics Professor, 03
(Michael, Sandford Schram et al., Bryn Mawr College Graduate School of Social Work and Social Research social theory and policy instructor; Joe Soss, American University School of Public Affairs Government Associate Professor; Richard Fording, University of Kentucky Political Science Associate Professor, Race and the Politics of Welfare Reform, P. 55-56, JD)

Fiscal federalism is usually justified on grounds of efficiency minimizing externalities in the provision of public goods and enhancing responsiveness to citizens’ preference for different bundles of basic services, taxes, and regulation It is usually assumed as well that decentralization of public services promotes democracy and protects individuals from overweening central authorities. Doubtless, federalism has promoted diverse responses to public problems and it might even be seen a bulwark against federal intrusion Yet these conventional justifications for federalism evade its role in perpetuating inequalities. Decentralizations to small units ignores; as Grant McConnell observed long go, “questions of power within the unit of organization” (1966), McConnell’s point, of course, was that some individuals or groups gain by decentralization while others may lose.

Devolution of federal programs to the states increases racism

Risa Kaufman, Acting Assistant Professor, New York University School of Law, Lawyering Program, 2005, Hastings Race & Poverty Law Journal, “Bridging the federalism gap: procedural due process and race discrimination in a devolved welfare system,” p. 2-3
 
This impact is compounded by devolution. As the Court limits the ability of individuals to bring states (and, in some cases, local governments) into federal court, Congress is devolving significant power to states and localities to create and implement poverty-related programs. Through block grants, Congress is deregulating a significant portion of the safety net and giving states and localities more flexibility and discretion over social welfare programs. This discretion and authority, when further devolved to local workers and administrators, can be tainted with racial bias, raising the risk of and resulting in a disparate impact on people of color. As a result, individuals may face a greater risk of race discrimination within the welfare system, with fewer statutory protections available to challenge such discrimination. With limited federal constitutional protections against class and race discrimination,  poor and low-income people, especially poor and low-income people of color, thus may become caught in the federalism gap.

Devolution has increased the concentration of power in the hands of welfare administrators, increasing racial bias

Risa Kaufman, Acting Assistant Professor, New York University School of Law, Lawyering Program, 2005, Hastings Race & Poverty Law Journal, “Bridging the federalism gap: procedural due process and race discrimination in a devolved welfare system,” p. 8-9

Finally, devolution allows states to delegate significant discretion to individual caseworkers and local welfare administrators, resulting in what Professor Matthew Diller describes as "the concentration of power in the hands of ground-level administrators." Thus, not only do state and county welfare programs exercise their own discretion to set certain standards and requirements, such as time limits and work participation, they also call on front-line welfare caseworkers to make a number of critical judgments, such as whether an applicant is excused from work, what type of work he or she is capable of, whether the individual has access to suitable child care, and whether the applicant has a good excuse for missing an assignment or appointment. In many cases, front line workers decide what types of programs and services applicants and recipients are eligible and suitable for, and whether they should be referred to a particular training or educational program. Given the already overwhelming nature of  their work, welfare workers often do not have the time to fully explain the options available to claimants or to assist them in making the best choices for their individual circumstances.  Thus, welfare reform and devolution mean little uniformity, with welfare workers playing a significant role in their clients' lives. And, as will be discussed more fully in Section III B, infra, there is growing evidence that this increased discretion given to ground level workers introduces a significant risk of racial bias and discrimination influencing their individual determinations, particularly with regard to sanctioning and access to support services. With fewer federal guidelines to standardize these decisions and fewer avenues for legal redress, however, poor people have fewer ways to challenge such discrimination.

Personal & institutional race bias means that individuals will be discriminated against in the implementation of devolved programs

Risa Kaufman, Acting Assistant Professor, New York University School of Law, Lawyering Program, 2005, Hastings Race & Poverty Law Journal, “Bridging the federalism gap: procedural due process and race discrimination in a devolved welfare system,” p. 11
 
 As described previously, poor and low-income people of color may fall into the gap where devolution intersects with diminished protection against discrimination. Poor people come into frequent contact with the government, relying on government workers and offices to provide critical benefits, as well as coming under greater scrutiny for alleged infractions. Indeed, as Judge Patricia Wald states, "the neediest of our citizens are most conspicuously dependent on government largesse for the satisfaction of their most basic needs." Devolution means that welfare workers play an even greater role in the lives of their clients. They connect recipients with support services, which are critical for recipients to transition successfully from welfare into the workforce, and help recipients identify appropriate training and education programs, job placement programs and other services that help them to move off of welfare. Yet, recent studies, discussed in greater detail below, suggest that devolution puts recipients at greater risk of being discriminated against because of personal and institutional race bias. To cite one example, a study of Wisconsin's welfare system found "a consistent pattern of racial and ethnic disparities in the use of sanctions" against participants in the state's welfare program.

The administration of devolved benefits has a disparate impact on African Americans & Latinos in welfare programs

Risa Kaufman, Acting Assistant Professor, New York University School of Law, Lawyering Program, 2005, Hastings Race & Poverty Law Journal, “Bridging the federalism gap: procedural due process and race discrimination in a devolved welfare system,” p. 24
 
 Second, where standardless decision making has a disparate adverse impact on poor people of color, potential plaintiffs can show that the lack of the necessary procedural safeguards raises a substantial risk of erroneous deprivation of benefits and services. In particular, potential plaintiffs can show that caseworkers, exercising discretion with little oversight or check on inherent biases or prejudices, make decisions which disproportionately harm people of color, curtailing access to benefits and services that would enable them to leave welfare for self-supporting work. This disparate impact indicates that people of color runa substantial risk of being erroneously deprived of welfare and supporting benefits Indeed, there is growing evidence that devolution has a disparate discriminatory impact on African American and Latino welfare recipients. In 2001, the United States Civil Rights Commission reported on the experiences of minorities within the U.S. welfare system, noting that: Welfare reform has done little to eliminate historical discrimination in public assistance. People of color encounter insults and disrespect as they attempt to navigate the welfare system. Women are subjected to sexual inquisitions at welfare offices and sexual harassment at job activities. Individuals with limited English proficiency encounter language barriers. Immigrants are often turned away because of misconceptions  about their eligibility status. A study by the Institute for Wisconsin's Future examined whether the change in the racial and ethnic composition of the caseload of Wisconsin's welfare program, Wisconsin Works, or W-2, was attributable to differential treatment of blacks and Latinos through the state's sanctioning policy. Under the W-2 program, participants incur sanctions in the form of loss of benefits when they do not attend all of the activities required in their "employability plan." The study found "a consistent pattern of racial and ethnic disparities in the use of sanctions against W-2 participants." Specifically, the research revealed that African Americans and Latinos were 75% and almost 50% more likely, respectively, to be sanctioned than their white counterparts. The study cited subjective program rules as a possible cause for the disparity, noting that individual welfare agencies and case-managers are granted vast discretion to determine when and whether a participant is sanctioned and what constitutes a realistic employability plan in the first instance. Caseworkers have the discretion to determine what supports and services a family may receive and what they are required to do in return, including whether a family loses benefits due to absence from an assigned work activity. The researchers concluded that the disparity in sanctioning rates "reveals a potential lack of fairness within W-2 because of racial or ethnic bias."  A study of Virginia welfare recipients found similar racial disparities. The study looked at two rural counties in northern Virginia and the interactions between the welfare recipients and their caseworkers to determine whether black and white welfare clients received similar or different support from their caseworkers. It found that black welfare recipients reported significantly less discretionary transportation assistance and less  support from caseworkers in accessing education than white recipients. Moreover, the study found that fewer black recipients received notification of potential jobs from their caseworkers and were less likely to think that caseworkers treat similarly situated black and white recipients fairly. For example, the study found that 41% of white recipients, but none of the black recipients, were encouraged by their caseworkers to pursue or complete their education. And 47% of white recipients and no black recipients reported receiving transportation assistance other than gas vouchers. The report concluded that "taken together, white welfare recipients benefit considerably from the discretionary actions of their caseworkers."  Another study, surveying individuals who had come into contact with the welfare system in thirteen states, found that as a result of welfare reform and devolution to the state and local entities, individuals suffered differential treatment due to the arbitrary nature of the systems, and widespread discrimination based on race, gender, language, and national origin. Moreover, the study found that significantly more people of color than whites were required to perform a work activity in order to receive benefits, and blacks and Native Americans were more likely to have been sanctioned than members of other racial groups. Evidence of disparate racial impact can strongly suggest a real risk of an "erroneous deprivation" of benefits, resulting from caseworkers making arbitrary decisions and exercising unregulated discretion in sanctioning, access to support services, and a host of other determinations regarding eligibility and benefits. Similar to the way in which it raises the inference of discrimination in the employment context, evidence of disparate impact in the welfare context suggests that decision makers are making prohibited, thus erroneous, determinations that deprive individuals of critical benefits and services. Accordingly, plaintiffs able to show evidence of such a disparate, adverse racial impact can argue that standardless and discretionary decision making raises the risk of an erroneous deprivation of benefits sufficient to satisfy the second  prong of the Mathews v. Eldridge analysis.

Devolution has resulted in the privatization of welfare services

Risa Kaufman, Acting Assistant Professor, New York University School of Law, Lawyering Program, 2005, Hastings Race & Poverty Law Journal, “Bridging the federalism gap: procedural due process and race discrimination in a devolved welfare system,” p. 8-9

Devolution under the PRWORA also allows for considerable privatization of the welfare system. The 1996 welfare law contains a provision allowing states to operate their welfare programs "through contract with charitable, religious or private organizations." Many states have since turned to large national and sometimes multinational private corporations to conduct case management, employment services, support services, and other specialized services, including mental health and substance abuse treatment, for their welfare applicants and recipients. Nearly all of  the states and the District of Columbia have contracted with a nongovernmental entity for the provision of some welfare-related function at the state and/or local level. Privatization of the welfare system raises a number of concerns, including the ability of recipients to hold corporate entities accountable for their actions, and the ability of recipients to enforce their rights in a privatized, as opposed to state-administered, system.

Existence of federal welfare matching grants critical to prevent a race to the bottom

Steven Schwinn, law professor, Lewis & Clark Law Review, Summer, 2005, “Toward a More Expansive Welfare Devolution Debate,” p.

First, it is widely assumed that AFDC is a Federal entitlement that the Federal Government can restrain without relinquishing. It is not. There is no Federal entitlement to welfare for individuals. Each State devises its own program. The Federal Government provides a matching grant. Abolish the matching grant and you can reasonably expect a race to the bottom.
 
Only the federal government can ensure equality among benefits throughout all the states

Steven Schwinn, law professor, Lewis & Clark Law Review, Summer, 2005, “Toward a More Expansive Welfare Devolution Debate,”  p. 344-5
 
Consider alternatively a state that overfunds its welfare program or relaxes its requirements relative to programs in other states. Presumably, a relatively generous state behaves thus for a reason - community values, historical norms, or economic or political considerations unique to that state - and these considerations outweigh the financial benefit to the state in providing less generous programs. Given this calculation, the relatively generous state is unlikely to reduce benefits out of equality concerns for recipients in other states. And less generous states have no incentive to increase their own benefits to promote equality with the generous state. No state can directly impact the behavior of any other state to promote equality; again, only the federal government can provide incentives to promote equality between states.

States can’t and won’t deficit spend – fiscal discipline is the order of the day
Eley, 6-27-2009
Tom, Worldwide Socialist Web, “US states’ budget crisis sets stage for new attack on the working class”, http://www.wsws.org/articles/2009/jun2009/cris-j27.shtml

Moreover, it is unlikely, in most cases, that states will be able to meet their obligations through significant deficit spending. Many states are constitutionally required to balance their budgets through reactionary “pay-as-you-go” rules. And the Obama administration, using California as an example, has made clear that it will not step in to meet the needs of the states' underfunded social spending requirements. By downgrading California’s credit rating, thus making its interests rates more expensive, ratings agencies and the finance industry have served notice to states and local governments that “fiscal discipline” shall be the order to the day.

If you give complete power to the states, it will be unpopular in congress: the unpopularity of Regan’s New Federalism Proposal proves

Pierson ’96
Paul Pierson, Associate Professor of Government at Harvard University, author of “Dismantling the Welfare State? Reagan, Thatcher and the Politics of Retrenchment (1994),” and coeditor of “European Social Policy: Between Fragmentation and Integration (1995).”  World Politics. 48.2; 143-179. Project Muse. 1996. http://muse.jhu.edu/journals/world_politics/v048/48.2pierson.html#top

This first-year record has shaped many appraisals of the Reagan revolution. 51 As in other countries, however, popular support for retrenchment dissipated rapidly. The Reagan assault petered out in 1982, when further budget cuts were overwhelmingly rejected. Reagan's single major reform initiative, the New Federalism proposal, would have transferred responsibility for AFDC and food stamps to the states (in return for the federal government's assumption of complete control over [End Page 164] Medicaid). The proposal was so unpopular, however, that it could not find even a single congressional sponsor and died without ever being introduced. 52 By Reagan's second term incremental expansions of various social programs for the poor were back on the agenda, and Congress passed modest increases in food stamps and Medicaid and a dramatic expansion of the earned income tax credit for poor working families. 53

The decision to defederalize control welfare was the historical basis for the racial stratification of the welfare state, which continues to this day.

Neubeck, Professor Emeritus of Sociology at the University of Connecticut, Cazenave, Associate Professor of Sociology at the University of Connecticut, 2001
(Kenneth, Noel, Welfare Racism: Playing the Race Card Against America’s Poor, p 20-21, IS)

Robert C. Lieberman, in Shifting the Color Line, 14 is likewise interested in the U.S. welfare state. His focus, however, is on the ways in which the U.S. welfare state has been institutionally structured. Racism, he notes, played a significant role in the politics surrounding the origins of the welfare state during the New Deal, influencing both the policies that were deemed politically possible by state actors and the kinds of institutions that they created to carry these policies out. Aid to Families with Dependent Children, a program that would eventually come to serve many impoverished African-American women and children, was from the very start institutionally structured in ways that made it politically vulnerable. It was, for example, administered at the individual state and local levels of government, where parochial and race-based political interests could most readily hold sway. In contrast, Old Age Insurance, another program created during the New Deal, from the start served an overwhelmingly white clientele. The program was structured so as to be centrally administered at the federal level, and it was set up in a way that insulated it from outside political meddling. In line with the state-centered perspective, Lieberman’s emphasis is on state institutions and the importance of the nature of their originating structures. Yet his work provides useful insights into ways in which the administration of welfare policy may both reflect and help to perpetuate racial inequalities over time.   Another variant of the state-centered perspective is provided by Michael Brown in Race, Money, and the American Welfare State. 15 Brown argues that “ques- tions of fiscal capacity—the ability of policy makers to raise revenues necessary to finance new policies—lie at the center of the development of the American welfare state.” 16 In his view, the state actors who strove to initiate the New Deal had to first contend with minimizing the resistance of the people who would have to pay for its programs, namely investors and taxpayers. One way to minimize this resistance was to adopt a position of fiscal conservatism to hold down both taxing and spending, and to decentralize control over those welfare state programs likely to be most politically contested. Taxing and spending for Old Age Insurance were minimally controversial, so state actors made the decision to centrally administer it at the federal level. With regard to AFDC, a decision was made by federal state actors to give individual state and local governments broad discretion in the setting of benefit levels and administration, and thus control its costs. As this occurred in the mid-1930s, at a time when white racism was normative and segregation widespread at the individual state and local levels of government, Brown argues that such decisions set the stage for the racial stratification of the U.S. welfare state that continues to this day.

State and local control of welfare policy is a license to practice welfare racism with no federal constraints or oversight. 

Neubeck, Professor Emeritus of Sociology at the University of Connecticut, Cazenave, Associate Professor of Sociology at the University of Connecticut, 2001
(Kenneth, Noel, Welfare Racism: Playing the Race Card Against America’s Poor, p 179, AS)

Recent “welfare reform” by the federal racial state has returned enormous discretion to the individual states. It began this devolution of authority by granting many states waivers to the Social Security Act to experiment with their own welfare programs in the late 1980s and early 1990s. The federal racial state then institutionalized the individual states’ authority to form and implement their own welfare programs by passing the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. In doing so, the federal racial state effectively shifted back to the welfare policy approach of the pre-1960s states’ rights era. For decades, local and state governments adapted their welfare policies and practices to prevailing patterns of white racial hegemony. Particularly, but not exclusively, in the South, this concession to states’ rights frequently led to the exclusion of African-American and other families of color from public assistance. Until the civil rights and welfare rights movements successfully challenged welfare racism in the streets, legislative bodies, and the courts in the 1960s, public assistance did not become an “entitlement” in real terms for many families of color. 1 As in the states’ rights era, the current policy approach allows states and localities license to express welfare racism—often thinly camouflaged as “race-blind” policies and practices—with relatively little federal oversight or effective constraints.n Recent evidence indicates that the so-called race-blind welfare reform policies and practices initiated in the 1990s have a disproportionately adverse effect on members of racially oppressed groups. In many instances these ostensibly race-blind policies and practices have in fact functioned to impede, deny, or reduce the welfare eligibility and benefits of impoverished women and children of color. In some instances, racial discrimination against applicants or recipients has been quite open and direct. The bulk of this chapter is dedicated to showing that welfare racism is thriving in rural and urban settings across the nation. We are also concerned about the failure of mainstream welfare reform monitoring groups to address these important matters. Their negligence helps to conceal the continuity between welfare racism as we have shown it to be expressed in the states’ rights era and the ways in which it is being expressed in the present. Most important, their failure deprives welfare rights organizations of the kinds of knowledge needed for effective educational campaigns, legal and legislative action, grassroots organizing, and social protest.

State control results in racist implementation of welfare policy- ever been to Idaho?

Neubeck, Professor Emeritus of Sociology at the University of Connecticut, Cazenave, Associate Professor of Sociology at the University of Connecticut, 2001
(Kenneth, Noel, Welfare Racism: Playing the Race Card Against America’s Poor, p 187-188, AS)

Such denial of poor people of color their rights to information, applications, and assistance is not, of course, limited to New York. Let us move our attention to a drastically different setting—the largely rural, predominantly white, western state of Idaho. By 1998, this state had reduced its welfare rolls by the astonishing figure of 77 percent through the implementation of harsh welfare reform policies. Idaho adopted an extraordinarily restrictive two-year lifetime limit on TANF benefits. The benefit levels for poor families were penurious, limited to $276 per month regardless of family size. 39 A study by Tufts University’s Center on Hunger, Poverty, and Nutrition described Idaho as “the state whose policies were most likely to worsen the economic condition of the poor.” As the center’s research director put it, “Idaho has effectively made itself the worst place in the nation to be poor.” 40 Although Idaho is overwhelmingly white, with people of color making up less than 10 percent of the state’s population, in 1998 17.4 percent of the state’s TANF recipients were people of color. Most of those recipients, reflecting the composition of Idaho’s poor, were Latino/a or Native American; the state’s African-American population is quite small. 41 It must be noted here that Idaho is said to possess a particularly intolerant environment when it comes to people of color. The state is, for example, the home of numerous right-wing extremist groups, including highly visible white supremacist organizations. This environment could not help but affect the treatment of poor families of color needing assistance, including assistance with health care. There has been a sharp drop in Medicaid’s coverage of poor families nationally, concurrent with states’ implementation of welfare reform policies in the 1990s. 42 Since this drop in health care coverage appears linked to racialized welfare policies and their effects on people of color, we include this example here. Given that people of color are overrepresented in the individual states’ poverty populations, this decline in Medicaid participation has exacerbated existing racial disparities in access to health care. Children of color who are living in poor families are especially vulnerable to health problems and thus are disproportionately harmed by a lack of Medicaid coverage.  In 1997 the federal racial state expanded Medicaid to provide health care coverage for the children of those low-income working parents who, while ineligible for standard Medicaid, could not afford to purchase private health care insurance. This included many children of single mothers who moved from welfare to work. By 1999, however, the new Children’s Health Insurance Program (CHIP) had enrolled only a fraction of the 3 million to 4 million children estimated to be eligible nationally.

States are forced to implement paternity establishment procedures and threatened with reduced funding if they fail to do so.

Solomon-Fears, Specialist in Social Legislation Domestic Social Policy Division, 2003
(Carmen, Paternity Establishment, p. 25, JMP)

Under federal law, if a state fails to implement the CSE state plan requirements (Sections 454 and 466 of the Social Security Act), the Office of Child Support Enforcement (OCSE) cannot approve of the state’s CSE program. Under the law disapproval of a state’s CSE plan requires suspension of all federal CSE payments, after an appeals process. Moreover, the TANF title of P.L. 104-193 provides that the Governor of a state must certify that he or she will operate an approved CSE program as a condition of eligibility for a TANF block grant. Thus, if a state did not comply with the CSE procedures concerning paternity establishment (Section 466(a)(5) of the Social Security Act), it could be in jeopardy of losing its federal CSE funding. If a state has to update its TANF plan while the state’s CSE plan is in disapproval status, that state’s TANF block grant funds also would be in jeopardy.

Turn—state distribution of welfare discriminates against minorities

Brown, University of California at Santa Cruz Politics Professor, 03
(Michael, Sandford Schram et al., Bryn Mawr College Graduate School of Social Work and Social Research social theory and policy instructor; Joe Soss, American University School of Public Affairs Government Associate Professor; Richard Fording, University of Kentucky Political Science Associate Professor, Race and the Politics of Welfare Reform, P. 68-69, JD)

TANF’s experience so far is quite different because the financial windfall masks the underlying conflict between needs and resources. Incentives for states to substitute federal for state dollars and geographically disperse the remaining funds, juxtaposed with the changing racial composition of the TANF caseload, pose the obvious question: how will states respond to a caseload composed mostly of women of color who face severe obstacles to permanent, well-paying jobs as economic growth diminishes?
Given white electoral majorities, state and local politicians have few incentives to develop a work-related safety net for poor black and Latino: communities. White Americans remain profoundly hostile to policies• that appear to be distributing benefits by race, while generously supporting policies that help all the poor. One recent survey found that only 5 percent of least prejudiced whites expressed any support for race-specific policies but 8o percent said they would support race-neutral policies Other surveys have produced similar results (Sniderman and Carmifle 1997, 107 Quadagno 1974, 17z—73). Yet the underlying structure of racial  inequality in the United States—residential segregation, labor market discrimination, gaps in income and wealth—will inevitably undermine pretensions to a so-called race-neutral safety net whether it is conditional on work or not. African American women and Latinas are not only higher proportion of the TANF caseload today, they are geographically concentrated. Almost 6o percent of the TANF caseload is concentrated in the nation’s 89 largest urban counties, where the large majority of poor black and Latino families live. The combination of perverse fiscal incentives and white hostility to any policy that appears to disproportionately benefit blacks may once again leave poor African American women and Latinas isolated and bereft of needed aid. Sharp reduction in funds for inner-city communities is unlikely. Instead, funds will be incrementally siphoned off from other programs and shifted away from urban jurisdictions and poor inner-city communities.


Devolution results in state imposed punitive measures like time limits and family caps, aimed at kicking persons of color off the welfare rolls.

Soss, American University School of Public Affairs Government Associate Professor, 03
(Joe, Sandford Schram et al., Bryn Mawr College Graduate School of Social Work and Social Research social theory and policy instructor;; Richard Fording, University of Kentucky Political Science Associate Professor, Race and the Politics of Welfare Reform, P. 244-246, JD)

Our analyses of time limit and family cap policies focus our attention squarely on race as a central problem for welfare reform. In debates over welfare in the 1995, the quintessential “welfare queen” was often portrayed as a black woman with a long-term addiction to the dole and a willingness to use childbirth as a way to prolong and increase her welfare check (Fraser and Gordon 1994; Lubiano 1991). Welfare reform raised the possibility of using new tools to combat these problems: time limits provided a way to cut off long-term recipients and the family cap offered a way to end benefit increases for childbirth. Based on evidence drawn from two levels of analysis, we conclude that race played a major role in shaping public and governmental responses to these policy options.
At the individual level, several important conclusions stand out. First, the traditional racial divide in welfare opinion persisted in r996. Like other Americans, a majority of black people supported key elements of reform, but the level of this support was consistently weaker than what we find among white people. Relative to whites, African Americans in 1996 expressed significantly more positive feelings toward welfare recipients, more support for welfare spending, and less support for family caps and time limits. Second, our analysis of white support for family caps and time limits reveals relatively minor demographic divisions. The results suggest a broad base of support rather than concentrated support in particular subgroups. Third, we find that support for these reforms was driven by a variety of nonracial attitudes. The strongest support came from white people who identified themselves as conservative, embraced individualistic values, rejected egalitarian values, and preferred punitive approaches to crime. Fourth and finally, our results underscore the crucial role that racial and ethnic prejudice played in white support for get tough welfare reform. Among white Americans, support for reform appears to have been fueled to a significant degree by prejudice against both blacks and Hispanics Such prejudice proved to be a significant influence on white support in all four of our models, and in every case, it emerged as the most powerful predictor of white support for get-tough reform. • In our state-level analysis, we find that adoption of family caps and strict time limits was unrelated to any factor other than the racial composition of the rolls. From this evidence, we can only conclude that the devolution revolution” has created openings for new forms of racial inequality in the U.S. welfare system. For example, because states with more black recipients have adopted stricter policy regimes, black families. are now more likely to participate under the most punitive program conditions. Such policy disparities not only can produce inequalities in the distribution of resources, they also subject citizens from different social groups to systematically different treatment at the hands of government. Thus, a black woman who conceives a child while receiving welfare is now less likely than a white woman to live in a state that offers additional aid for the child. Likewise, a black client who misses a meeting with a caseworker is now disproportionately likely to live in a state where this single infraction results in a termination of benefits for the full family. White clients committing this same infraction are more likely to live in states that respond in a more lenient fashion. To illustrate the importance of such disparities, it is worth considering a single policy in some detail. In the period after 1996, sanctions emerged as one of the most pivotal TANF measures. Among policy factors, they became the strongest predictor of state caseload decline (Rector and Youssef ‘999). From 1997 through 1999, approximately 540,000 families lost their entire TANF check due to a full-family sanction, and these families tended to fare worse (socially and economically) than families that left for other reasons (Goldberg and Schott 2000). Our analysis of state policy choice in 1997 suggests that one might expect a racialized pattern of vulnerability to sanctions to emerge in the ensuing years. An analysis of 1999 caseload data confirms this prediction three years into the life of the TANF program.’° Among TANF recipients in 63.7 percent of black families were participating under the threat of a full family sanction, while the same was true for only percent of white families. If somehow one could have waved a magic wand of racial justice and made the black percentage equal to the white percentage (53.7 percent), the number of African American families at risk for full-family sanctions in 1999 would have been reduced by about 102,ooo families. Not surprisingly, state-level studies from this period indicated that TANF exits due to sanctions (rather than income increases) were higher among black families than among white families (Lower-Basch 2000).

Empirically proven- state and local welfare control is ineffective, racially biased, and particularized by locality, lead to arbitrary administration, and preventing effective monitoring.

Piven, NY University Graduate School and Center of the City Distinguished Professor   , 03
(Sandford Schram et al., Bryn Mawr College Graduate School of Social Work and Social Research social theory and policy instructor; Joe Soss, American University School of Public Affairs Government Associate Professor; Richard Fording, University of Kentucky Political Science Associate Professor, Race and the Politics of Welfare Reform, P. 323-325, JD)

The conclusion that emerges from these different approaches to an examination of American welfare is harsh but indisputable Welfare policy and practice in the United States is infused with racial biases Still, that said, there are historical differences that bear both on our understanding of the racism of the new welfare system, and on our ability to think about the contours of genuine reform. There are good empirical grounds for thinking that American welfare is less racist when the role of the federal government enlarges, and when the system is more tightly bound by law and regulation. There are several reasons. One is simply that state and local governments find redistributional policies politically difficult. They are especially susceptible to threats from business and affluent residents to move out of the jurisdiction if taxes are raised to pay for programs that benefit those less well off. As a consequence, employer groups in particular have great influence on subnational governments, and they use that influence to shift the state and local tax burden to the working and middle class who cannot easily threaten to move. Not surprisingly, in a regressive tax system, expenditures that are seen as benefiting the minority poor are more likely to provoke popular resentment.
Another reason that federal policies are at least potentially more benign to minorities was suggested by Grant McConnell many years ago: “As the most important and influential local interests gain power by being placed in a small sphere, the least influential lose power” (105). Moreover, “The informal structure of the small community will usually be able to suppress a challenge before it becomes overt (107).
Finally, because devolution of responsibility for welfare to subnational governments produces a myriad of particularistic welfare systems, it reduces the power of subordinate minorities to monitor and enforce such rights as they have, thus smoothing the way for more discretionary and arbitrary patterns of welfare administration. Perhaps it is needless to add that minorities have not fared well in American history under local and discretionary rule.

Federal action key- the feds set up and maintain the FPLS database for collection of child support.  Federal law requires state maintenance of TANF-relate IV-D systems.

Smith, professor of government @ Cornell University, 2007
(Anna, Welfare Reform and Sexual Regulation, p. 126-128)

The federal government pays for the majority of costs incurred by the states as they set up and maintain their TANF-related IV-D (paternity identification and child support enforcement) systems. It is responsible for the overall design of the automated databases used in the system and provides technical support to the states to ensure systemwide compatibility and multistate cooperation in those cases in which the payer resides in a different state. The federal government provides highly specialized assistance to the states to help with the location of the payers and the collection of payments. It maintains a Federal Parent Locator Service (FPLS) and makes Internal Revenue Service data available to the states for these purposes. The federal courts also work with local family courts and social service administrators to put pressure on payers to admit paternity, submit to a child support order, and make regular payments. 30 The FPLS gathers a complete list of the payers sought by all fifty states and sends the list to every federal department and agency. The latter must compare the list against their own databases on a weekly or biweekly basis and report any matches to the FPLS.3’
The PRA expanded the role of the FPLS as well. If any parent in a case handled by the IV-D agency is having difficulties with respect to the enforcement of child custody orders or visitation rights, the FPLS must assist that parent.3’ Take, for example, a typical payer retaliation scenario: the payer strikes back against the TANF mother by suing in family court for joint custody or visitation. If the custodial mother does not abide by the custody or visitation arrangement ordered by the family court and moves out of town to avoid the payer altogether, the payer can request assistance from the IV-D agency to help him to track her down. The payer is also allowed to secure the address of the custodial parent even if he does not obtain custody or visitation rights. Under a ‘997 amendment to the PRA,33 the FPLS must disclose the address of the custodial parent to the noncustodial parent at the latter’s request. Only those cases in which a local court has determined that such disclosure may result in harm to the custodial parent or child, given sufficient evidence of domestic violence or child abuse, are exempt.
Since the 1988 Family Support Act, the states have been obliged by Congress to upgrade their IV-D databases. Under the PRA, the states have to continue to maintain state-of-the art databases that mine information about the payers from a wide variety of public and private sources. On a quarterly basis, the states must obtain reports from private financial institutions that detail the accounts of all of their private clients. The states must check to see if any of the missing or delinquent payers are present in the financial institutions’ records.34 Each state must also operate its own version of the FPLS. At the state level, the locator service typically searches in telephone directories, tax files, motor vehicle registries, and employment and unemployment records. Working with the FPLS, each state must conduct searches for all of the payers who are sought across the country, thereby facilitating multistate cooperation. It must regularly upload its own child support enforcement records onto an automated registry that is compatible with the one used by the FPLS.3’ Once a payer is ordered to pay child support, the state can request credit reports from consumer credit agencies to assist the IV-D agency to calculate the payer’s payment schedule.6




CITIZENSHIP

Multiple sites of resistance are critical to democratic empowerment in the face of sovereignty

Connolly 7 (William E., Johns Hopkins, Wolin, Superpower, and Christianity, Theory and Event 10:1, 7/1/9) JLR
I agree with Wolin that fugitive democracy is both an indispensable source of energy for pluralism and equality during hard times and that it is also ripe for hijacking by ugly, repressive forces. I merely add that in such a world positive democratic movements on behalf of egalitarianism, ecology and diversity must be active at several sites, including local involvement, country-wide social movements, direct pressure on corporate structures and church organizations, participation in national party politics, and cross-state citizen networks to press Superpower from inside and outside at the same time. It is if and when actions at these multiple sites resonate together that the prospects for positive democratic achievement improve.

b. Allowing for each state to implement its own policies reifies borders and the discrimination that immigrants currently field in the healthcare system – federal action is key.

2. Perm Do both: Effective policy must begin with federal action

Park 4 (Seam, J.D. Candidate, Florida State University College of Law, Georgetown Immigration Law Journal, AOO)
Legislative reform can help solve the numerous problems associated with illegal immigrants and their inability to access health care. Reform must start with the federal government by repealing legislation that bans state officials from preventing their state officials from sharing information with the INS. Next, states must utilize this regained authority and pass limited cooperation ordinances in order to provide security for illegal immigrants that desire to access care. Finally, states should utilize their authority and pass legislation providing, at least, prenatal care and treatment for chronic and debilitating diseases. It should be duly noted that legislative reform is not going to be a "cure-all" for every problem associated with illegal immigrants and their ability to access and receive proper health care by any means. However, legislative reform would provide part of the solution to arguably the most important problem regarding health care for the illegal immigrants, barriers to access.

3. Only double solvency matters – Universal resistance to line drawing is critical to restoring the political against bare life – Their CP exccludes the aff, making the meaning to life inarticulable

Edkins & Pin-Fat 5 (Jenny, University of Wales Aberystwyth, and Véronique, University of Manchester, “Through the Wire: Relations of Power and Relations of Violence,” Journal of International Studies, Vol.34 No.1, pg 12-14, AD: 6-30-09) JLR
The grammar of sovereign power cannot be resisted by challenging or fighting over where the lines are drawn. Whilst, of course, this is a strategy that can be deployed, it is not a challenge to sovereign power
per se as it still tacitly or even explicitly accepts that lines must be drawn somewhere (and preferably more inclusively). Although such strategies contest the violence of sovereign power’s drawing of a particular line, they risk replicating such violence in demanding the line be drawn differently. This is because such forms of challenge fail to refuse sovereign power’s line-drawing ‘ethos’, an ethos which, as Agamben points out, renders us all now homines sacri or bare life.

4. Supreme Court will strike down

Neill 2 (Alexander, St. Mary's University School of Law, Candidate for J.D., May 2003,  St. Mary’s Law Review on Minority Issues, lexis, AD: 6-30-09) NS
In 1971, the United States Supreme Court issued a landmark decision regarding the rights of illegal immigrants. Graham v. Richardson n57 involved Pennsylvania and Arizona laws that conditioned the receipt of welfare benefits on the possession of United States citizenship or residence in the United States for a specific number of years. n58 The court reasoned that because the law made classifications based on alienage and national origin, they were "inherently suspect and subject to close judicial  [*416]  scrutiny." n59 Applying this strict scrutiny standard, the court struck down the state laws as violating the Equal Protection Clause of the Fourteenth Amendment. n60 The court also stated that the state laws were in conflict with powers delegated solely to the federal government. n61 The significance of the Graham decision is the recognition that illegal immigrants are protected by the Constitution. However, the extent of this protection remained largely undefined. n62

5. Federal funding restrictions means states can’t afford coverage

Ortega 9 (Adrianne Ortega, Boston University School of Law, 2009; M.P.H., Boston University School of Public Health, 2006; ã2009, “And Health Care For All: Immigrants in the Shadow of the Promise of Universal Health Care”, American Journal of Law and Medicine, 35 Am. J. L. and Med. 185, DA: 6/30/09) AOS
Besides harming immigrants themselves, lack of non-citizen health care coverage burdens the hospitals and states that absorb the costs of treating undocumented immigrants.  n26 Federal law shifts the burden of covering immigrants' health care to the states by prohibiting states from caring for  [*188]  non-citizens with federal funds, but allowing them to pass laws and independently fund health care for non-citizens.  n27 Twenty-two states affirmatively provide health care to immigrants by supplementing federal health care funding with state funds - particularly for prenatal care and the SCHIP children's health insurance program.  n28 Most of the states that have extended coverage are those with historically high rates of immigration.  n29 Many financially strained hospitals have resorted to repatriating undocumented patients to their home countries.  n30 These hospitals transport immigrant patients who cannot pay their hospital bills back to their native countries without federal oversight or regulation.  n31 Faced with a tension between humane treatment of patients and the financial bottom-line, hospitals effectively sentence non-citizen patients to death.  n32    

 State action is racist-moral imperative for federal action

Hull 97 (Elizabeth, Graduate Faculty of the New School for Social Research at Rutgers, “The Unkindest Cuts: The 1996 Welfare Reform Act’s Impact on Resident Aliens”, 33 Gonz. L. Rev. 471, AOO)
Also, the Court found the two schemes objectionable because they required the states to determine for themselves the immigration status of anyone seeking benefits—a requirement, significantly, which the Welfare Reform Act also imposes.169 Determining a person's immigration status is the sole prerogative of the federal government, not only because doing so is a technical and sensitive process, but also because, if states assumed this responsibility they would inevitably make erroneous determinations and thus contravene the constitution's requirement that there be a "uniform rule."' There is, finally, a morally imperative reason for restricting states' activities: individual states are more susceptible to xenophobia than the federal government. This is because aliens tend to congregate in particular communities, possibly generating localized anti-alien movements that could give rise to legislation adverse to their interests."'

State programs would trigger federal funding sanctions

Neill 2 (Alexander, St. Mary's University School of Law, Candidate for J.D., May 2003,  St. Mary’s Law Review on Minority Issues, lexis, AD: 6-30-09) NS
Generally, the PRA states that "illegal" aliens are not eligible for State and local benefits absent an "affirmative" State law to the contrary. n9 Mr. Cornyn's opinion states that the Texas legislature has enacted no such "affirmative" law. Therefore, hospital districts in Texas are not allowed to provide free or discounted non-emergency care to illegal immigrants. n10 The opinion goes on to state that there could be legal consequences or federal funding sanctions imposed for continuing to provide such services to non-citizens. n11 Among the legal consequences mentioned in the opinion are the forfeiture of federal funding and sanctions for the hospital districts that make an "unauthorized expenditure of public funds." n12 The opinion has drawn sharp criticism from hospital administrators across the state for being both a "misinterpretation of the law and bad public health policy." n13

States would lose millions in federal funding

Hull 97 (Elizabeth, Graduate Faculty of the New School for Social Research at Rutgers, “The Unkindest Cuts: The 1996 Welfare Reform Act’s Impact on Resident Aliens”, 33 Gonz. L. Rev. 471, AOO)
In the past, the federal government provided assistance through "entitlement programs," such as Aid to Families with Dependent Children ("AFDC"), which it funded jointly with the states, and the Department of Health and Human Services ("HES") that monitored each state's performance to ensure compliance with federal standards.' Under the Welfare Reform Act, however, entitlements have been converted to block grants that states now administer largely according to their own discretion, with the federal government taking an unprecedented "hands off' approach.' Although states are still required to submit their welfare plans to HHS, the agency's involvement is minimal because "[i]t's not our role to make judgments on the substance of state programs."127 As a consequence, states tailoring programs to their particular needs also incur daunting financial responsibilities. Before 1996, states could accommodate anyone who qualified for federal entitlements since every outlay was subsidized by Congress.128 Under the new Act, however, federal money comes in the form of block grants, and in pre-determined amounts.' Over a six-year period, states will suffer a $54 billion loss in revenue ($27 billion from cuts in Food Stamps alone)'" while at the same time an estimated one million immigrants will be needing their services."' During periods of high demand, therefore, even those states committed to the welfare of their alien residents may be unable or unwilling to secure it, especially if doing so means curtailing benefits to citizens or raising taxes.132 States are now experiencing administrative as well as financial headaches. The Washington Post reports that in order to satisfy federal requirements, state officials must now check the citizenship status of anyone applying for or receiving benefits."' States that fail to comply with the Act's mandates—by missing a deadline or issuing food stamps to ineligible aliens—risk the loss of millions of dollars.'

States don’t have the budget to expand social services

Perez 8 (Tom, MPP and JD, “Today’s Topics in Health Disparities- Immigration and Health Care: What Are the Policy Choices?” March 12, 2008, http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=2517 accessed 7/1/09) KSM
TOM PEREZ, M.P.P., J.D.: And as Leighton correctly said, a number of states have, indeed, attempted to pick up the slack. In Maryland where I live they made the decision in the mid-‘90s after immigrant reform to provide with state-only dollars coverage for pregnant women and children.
But what you’re seeing also now—and this is a trend that’s not limited to immigrants—but as state budgets shrink, there are always efforts afoot to make eligibility more difficult, again, for including but not limited to immigrant populations. And some of the things that are being done are in my judgment regrettable but legal. Other things are, I think, regrettable and not legal.
And an example of the second category was a number of states that were as a condition of receipt of Medicaid or SCHIP requiring proof of the immigrant status of the entire family as opposed to the individual applicant. The only relevant question as it relates to immigration status is the applicant, him- or herself. And frequently in the SCHIP context, you have citizen children living in mixed families, and they only relevant question is the citizenship of that child, but frankly, I think many states were implementing this knowing full well that once that question was asked, it was going to chill participation.

California policies to provide social services to immigrants is unpopular AND would expend lots of money-federal incorporation is essential to California involvement

Park 4 (Seam, J.D. Candidate, Florida State University College of Law, Georgetown Immigration Law Journal, AOO)
Illegal immigrants placed significant burdens upon state and local governments because they were often left with the financial burden of providing essential social services to a needy, indigent population.  n19 Among these burdens in-cluded providing health care to illegal immigrants.  n20 States became increasingly impatient and hostile towards the fed-eral government because their inability to control the borders resulted in greater spending and  [*572]  cost in providing illegal immigrants with health care and other social services.  n21 California and Texas, states with high numbers of ille-gal immigrants, raised complaints that providing social services for illegal immigrants was hindering their ability to "provide necessary services to the rest of their residents."  n22
California's reaction to its citizens' negative public opinion regarding illegal immigrants, in conjunction with a statewide recession, came in the form of Proposition 187. The rationale for passing Proposition 187 was that:
The People of California "found and declared" that they had "suffered . . . economic hardship caused by the presence of illegal aliens in the state" and that they had "suffered . . . personal injury and damage by the criminal conduct of illegal aliens in the state." Californians thus "declared their intention to pro-vide for cooperation between their agencies of state and local government with the federal government, and to establish a system of required notification by and between such agencies to prevent illegal aliens in the United States from receiving benefits or public services in the State of California."  n23

Federal government must repeal 1st for any effective immigrant social services

Park 4 (Seam, J.D. Candidate, Florida State University College of Law Georgetown Immigration Law Journal, AOO)
Legislative reform requires three steps. The first, and most essential step requires the federal government to repeal Section 434 of the Welfare Reform Act and Section 642 of the Immigration Reform Law, which bans state and local governments from preventing communications with the INS. Next, state and local governments should utilize this reis-sued authority and pass limited cooperation ordinances, such as New York's Executive Order 124, which prohibit health care officials from offering immigration information to INS officials. Finally, after issuing limited cooperation ordi-nances, states legislatures should strongly consider utilizing the authority granted under 8 U.S.C. ß 1621(d)  n120 and pass affirmative legislation that will provide illegal immigrants state funded preventive health care.

Empirically, court has struck down state programs as outside state authority

Neill 2 (Alexander, St. Mary's University School of Law, Candidate for J.D., May 2003,  St. Mary’s Law Review on Minority Issues, lexis, AD: 6-30-09) NS
In response to the negative public opinion regarding the illegal immigration problem in California, voters passed Proposition 187 in 1994. n84  [*419]  The law was a sweeping restriction on the right of undocumented aliens to receive public education, health and social services. n85 Its passage was the result of a growing anti-immigration sentiment created by a large demographic shift caused by an increasing amount of immigrants and a statewide recession. n86 Proposition 187 reflected the public perception that illegal immigrants were becoming an increasing economic burden upon the State of California. n87 Thus, the goals of Proposition 187 were to discourage potential illegal immigrants and to force illegal aliens residing in the state to leave using the denial of public services as the means. n88 After the passage of Proposition 187, a number of lawsuits were filed challenging its validity on various legal grounds. n89 A federal district court consolidated the lawsuits into one action. n90 The district court eventually held most of the provisions in Proposition 187 were invalid, because California could not regulate immigration, which is a function reserved to the federal government. n91 Even though Proposition 187 was defeated, it served as a call to action for those in the federal government who oppose public benefits for undocumented immigrants. n92


__ VETERANS

Congress, specifically the Department of Veterans Affairs – manage veteran benefits.
U.S. Census Bureau – 2003
(U.S. Census Bureau, Statistical Abstract of the United States, Section 10, “National Defense and Veterans Affairs,” http://www.census.gov/prod/2004pubs/03statab/defense.pdf)

Department of Veterans Affairs (VA)—The Department of Veterans Affairs administers laws authorizing benefits for eligible former and present members of the Armed Forces and for the beneficiaries of deceased members. Veterans benefits available under various acts of Congress include compensation for serviceconnected disability or death; pensions for nonservice-connected disability or death; vocational rehabilitation, education, and training; home loan insurance; life insurance; health care; special housing and automobiles or other conveyances for certain disabled veterans; burial and plot allowances; and educational assistance to families of deceased or totally disabled veterans, servicemen missing in action, or prisoners of war. Since these benefits are legislated by Congress, the dates they were enacted and the dates they apply to veterans may be different from the actual dates the conflicts occurred. VA estimates of veterans cover all persons with active duty service during periods of war or armed conflict and until 1982 include those living outside the United States.


State based systems don’t meet veteran needs and are chronically overstreched
NCHV (National Coalition for Homeless Veterans), Mental Health and Addiction Services Needs of Veterans Experiencing Homelessness, 2/18/2004

Diminution in VA’s capacity to provide mental health and addiction services to veterans with disabilities has placed even greater burden on already oversubscribed and underfunded community mental health and addiction services systems as veterans unable to secure services from the VA turn to community care.  Veterans face barriers in accessing these state-administered community-based systems.  Veterans are rarely considered a priority group for community mental health or addiction services, for the very reason that system managers assume the VA is already “taking care of its own.”

Federal based inter-agency cooperation is key
NCHV (National Coalition for Homeless Veterans), Mental Health and Addiction Services Needs of Veterans Experiencing Homelessness, 2/18/2004

Recommendation 3:  Continue VA Participation in Interagency Activities — NCHV urges the VA to continue to actively participate in the various councils and committees established at the federal level that address issues pertinent to mental health and addiction services, including the Interagency Council on Homelessness, the advisory councils of the Substance Abuse and Mental Health Services Administration, and the Veterans Advisory Council to the Secretary of Labor.
Mental Illness and Addiction Treatment

Equitable national access is essential to VA credibility
Dr. Richard McCormick, 6-18-07, Center for Health Care Policy and Research at Case Western Reserve University

A truly excellent system of mental health care is marked by equity of access.  Two  veterans living in similarly densely populated areas of the country should not face  marked differences in the range of mental health services available to them. VA has made  great strides in providing primary medical care through a population based approach. A  similar population based approach to mental health services is needed. This will require a  paradigm shift. Each VA Network, and within those networks each facility, is responsible  for a well-defined geographic area. If VA is to fulfill its obligation as the provider of  choice for mental heath services for veterans, then each Network and each facility must  accept responsibility for assessing the needs of all veterans living within their geographic  area of responsibility and deploying adequate resources to provide a comprehensive  continuum of care that meets these needs. This will require them to utilize a variety of  service delivery approaches, matched to the population density of the areas they cover. 


Perm do both- gets double solvency- and solves the link to the DA

And permutation solves- States and Federal government can work together to meet housing needs.
Iowa Veterans Benefit Study ‘8 (“Veterans Final report and Recommendations” https://www.iowava.org/images/Veterans_Final_Report_2008.pdf)
While the federal government ultimately bears responsibility for veterans affairs, state and local governments are playing an increased role in addressing the needs of veterans by offering new or enhanced benefits and filling gaps in available federal benefits. The greatest role states are playing is by establishing an infrastructure, both state and local, of trained service officers who can assist veterans in filing claims for benefits. More than $680 million in federal benefits is distributed annually to Iowa veterans and their family members. These benefits are critical to ensure quality of life for our veterans and free up millions of dollars in county and state government budgets to be utilized for other essential services. Given the positive impacts on individual veterans and at the state level, Iowa must do all that is possible to increase the number of Iowa veterans receiving federal benefits, ensuring the health and well being of those who have served our country.

Recruitment woes will worsen --- only action from Obama on veterans can restore confidence in the military
Singer ’08      (Peter,- fellow @ Brookings 4-8 “Train and Protect Those Who Serve Us in the Military” http://www.brookings.edu/opinions/2008/0408_military_singer.aspx)
While today's focus is on the five-year war in Iraq, if we care about our nation's long-term security, we must also ask our would-be commanders in chief whether they will meet this leadership issue head-on? Or, do they plan to continue to dump what may be our deepest national defense challenge on the 28-year-old recruiting sergeants in the field? This predicament will worsen as the forces expand by roughly 100,000, or more, under current plans. It is for this reason our military desperately needs a commander in chief who can lead and motivate today's generation toward public service in the same way presidents Kennedy and Reagan did for past generations -- reaching out to youth as well as to the parents, religious leaders, coaches and teachers who influence them. Invasion is not all And, as demonstrated by the shameful events at Walter Reed hospital and the recent reports of homeless or out-of-work veterans, our newest generation of wounded warriors and veterans have earned the right to demand a commander in chief who is poised to serve them as well as they served us. Being a good commander in chief is not just about crucial invasion decisions; it is also about taking on the full responsibilities of leading those who serve. As Campaign '08 reaches its final run, it is time to get past the empty posturing and focus on the hard questions of who has the qualities needed to ensure our Millennial military will be ready and able to serve our nation's needs in the years ahead.

State level housing assistance not good enough- National strategy needed
Toby Hall 07, [Toby Hall is a writer for Sunday Mail, “Plight of Homelessness shames us all”. http://www.lexisnexis.com/us/lnacademic/results/docview/docview.do?docLinkInd=true&risb=21_T6945368014&format=GNBFI&sort=RELEVANCE&startDocNo=1&resultsUrlKey=29_T6945368017&cisb=22_T6945368016&treeMax=true&treeWidth=0&csi=244790&docNo=1]
But even innovative approaches at a state level will have limited impact while we fail to have a co-ordinated approach to housing nationally. We need a National Housing Strategy to tackle the root causes of homelessness and not just the symptoms. We need a plan that is national in scope, co-ordinated across governments and which has a long-term vision.
Chief on the list of any strategy should be affordable rental housing and home ownership. Affordable housing acts as both an important exit point from homeless services and also as a preventative measure against falling into homelessness.
All new residential developments in Australia should have affordable rental housing and home ownership as a central part of their mix.We welcome South Australia's target of 15 per cent affordable housing, including the five per cent high-need housing component, in all significant new housing developments.
A national strategy would need to consider how we can encourage private equity to come up with creative solutions to tackling affordability; as well as the ways to reduce or abolish the varying rates of stamp duty, establishment taxes and infrastructure costs where they apply to the development of low-income housing.

States can't finance veteran housing—budgets collapsing now
Demas 09 [Susan, politics staff writer for Capitol Chronicles. “Government Shutdown in Five states?” Capitol Chronicle. June 30, 2009. http://blog.mlive.com/capitolchronicles/2009/06/government_shutdowns_in_other.html]
It looks like California, Arizona, Indiana, Pennsylvania and Mississippi could be headed down the same road as Michigan in 2007 -- government shutdown. The states have until this week to pass their budgets and National Conference of State Legislatures analysts expect most to pass last-minute agreements. But for some states, especially California with a jaw-dropping $24 billion budget hole, it just might not be possible to pass a budget in time. As I reported a couple weeks ago, 30 states actually have worse problems than the Mitten State and 33 are weighing tax increases. The difference is, we've been slashing for years and don't have the reserve funds some states do. (We also don't have a toll road to sell, like Indiana, which has meant higher tolls and red ink for the state anyway). But for Michigan, the past could be prologue. There are no easy answers to solving the $1.7 billion budget hole and Gov. Jennifer Granholm appears to have joined the witness protection program. Come Sept. 30, we could be right where these five states are.
 
States can't solve human rights credibility—only federal action is perceived—Guantanamo proves
Center for American Progress 6/25/09 “Restoring Credibilty on Human Rights and Democracy http://www.americanprogress.org/events/2009/06/restoring_credibility.html
I think we really shouldn’t underestimate the extent to which the Bush administration damaged the image of the United States [in] the [Middle East],” said Issandr El-Amrani, publisher of a popular group of blogs on Egyptian and Middle Eastern affairs, Arabist.net. El-Amrani encouraged attendees to “be realistic about how long it will take to repair that damage” at a panel discussion on restoring U.S. credibility on democracy and human rights in the Middle East. The Center for American Progress, the Project on Middle East Democracy, and the Heinrich Boll Foundation sponsored the event, which was hosted at the Center.Claudia Hillebrand, a professor of international politics at Aberstwyth University, and Heather Hurlburt, the executive director of the National Security Network joined El-Amrani on the panel. Brian Katulis, a Senior Fellow the Center for American Progress, moderated the discussion.The panelists focused on the U.S. detention center at Guantánamo Bay, Cuba, which remains at the forefront of conversation on the United States and human rights because of the prison’s questionable conditions and harsh interrogation techniques associated with it.The Obama administration pledged to close the prison by January 22, 2010, but the panelists were divided on the likelihood of meeting this goal. Hurlburt predicted that Guantánamo would be closed within the year “because there is so much personal credibility riding on it,” but she also thinks “that means it will be closed in a way that makes a lot of the human rights community unhappy.” Hillebrand thought that closing the prison was a difficult task that was not likely to happen by the end of 2009. Hurlburt and the other panelists attributed the delays in closing Guantánamo to unforeseen challenges instead of inactivity by the Obama administration. “In every instance, I think the problem has just turned out to be more complex, and—what Obama was left by his predecessors—more problematic than they had understood coming in,” said Hurlburt. The absence of comprehensive files on detainees at Guantánamo was the first major setback for the Obama administration, according to Hurlburt, who said that the records weren’t “kept to the standards they would have been kept, for example, if we had known from the beginning that they would face civilian trials.” Finding places to keep and try the detainees has been another obstacle to closing the base. The European Union’s adoption of an agreement on Guantánamo that allows member nations to share information and house detainees was a recent step forward on this issue. But under those provisions if a detainee were determined to be a security risk to Europe, then no member nation would be allowed to hold that detainee. Delays to closing Guantánamo have allowed both “legitimate security concerns to arise as well as an opportunistic political opposition,” said Hurlburt, so that “you now have sort of wildly exaggerated fears coursing around the country and political figures seeking to take political advantage out of this.”Panelists also looked at other options for improving U.S. credibility abroad. El-Amrani favored civilian trials for those in the U.S. government responsible for torture. “If I remember correctly, President Obama said, ‘Now is the time for reflection, not retribution,’” said El-Amrani, who said he disagreed with the president. “I think this is the time for retribution. I think retribution would be extremely politically effective.” But retribution may not be the only option for restoring our image. Hurlburt advocated for a better appeal system for detainees. “The first thing to look for in any measure that the administration puts forward” is whether or not there is review built in and a way for a person to challenge his or her status, she said.Many human rights advocates would like to see immediate action on Guantánamo, and official detention and rendition policy changes from the Obama administration are due in July. El-Amrani explained that in the Middle East there is a trend toward a “wait-and-see” approach as that deadline approaches. “Let’s see if he can actually deliver,” he said

Only the Federal Government ensures good quality       
Iowa Veterans Benefit Study ‘8 (“Veterans Final report and Recommendations” https://www.iowava.org/images/Veterans_Final_Report_2008.pdf)
Many changes such as eligibility, level of services provided, and others are frequently made to the federal veterans benefits system. Complicating the issue, local budgets for county veterans service offices and the level of training of state and county veterans service officers vary greatly across the state. As a result, the operating hours of county service offices and the quality of services provided at the local and state levels vastly differ. A federal veterans benefit quality assurance and training team will ensure a high standard of federal veterans benefits claims filing services are provided at the local and state level. Counties and the state will be able to maximize federal benefits claims for Iowa veterans, lessening the financial burden on local and state governments.