Amid the larger scuffle on budget-cutting this year, some in Congress are looking for convenient excuses to roll back programs designed to give low-income Americans a hand up in life.
Proposed cuts from the House are a direct attack on working Americans — but they are just a warm-up.
Some are planning an all-out assault on Medicaid, which provides affordable and comprehensive health care for more than
68 million people, including children, individuals with disabilities, pregnant women and seniors.
Those who have never liked Medicaid or the idea of providing health care to low-income people have waged a steady campaign against it. Once again, they are hiding behind budget numbers to mask the reality of what their proposals would do to real people across America.
Medicaid is an extension of a guiding principle of our nation’s founding — a shared responsibility for the greater good of all.
After almost 50 years, Medicaid has been a lifesaving part of what we do as a government — covering 40 percent of the births, 50 percent of long-term care and, along with the Children’s Health Insurance Program, 34 percent of the kids in our country.
Medicaid is also an economic engine supporting millions of homegrown jobs at hospitals, nursing homes, community health centers and doctors’ offices.
Unfortunately, Medicaid is routinely the scapegoat for “runaway entitlement spending.” This is despite the fact that the average cost per Medicaid beneficiary is significantly lower than under private insurance, even with Medicaid’s more comprehensive benefits and significantly lower cost-sharing.
Medicaid opponents argue that the program should be turned into a block grant, like CHIP. But CHIP’s relatively small population of 8 million healthy children is a fraction of the 68 million people, including 33 million children, covered by Medicaid, many with complex and unpredictable health care needs.
Those who favor making Medicaid a block grant want to severely limit federal support for Medicaid. That would force cash-strapped states to make deep cuts to services and increase the number of uninsured.
Opponents of Medicaid would also repeal the maintenance-of-effort protections in health care reform.
That would put coverage for 27 million Americans at risk in the next two years. Cutting health care for Americans is not a realistic solution.
Medicaid opponents falsely claim that the expansion included in health care reform will cost the states $118 billion over the next 12 years.
In fact, the federal government, not the states, will pay for the vast majority — 92 percent — of the Medicaid expansion over the next 10 years. The Congressional Budget Office estimates state costs of only $60 billion, or 2.6 percent more than they would have spent without health care reform, through 2021.
There is no question that states continue to face serious economic challenges because of the recent recession. Instead of arbitrary cuts to Medicaid, Congress should seek to strengthen Medicaid by:
• Implementing health care reform, including the maintenance-of-effort requirements.
• Supporting the Medicaid and CHIP Payment and Access Commission, which will provide objective policy and data analyses to help states and the federal government improve health care access, make payments more efficient and increase quality for patients.
• Covering all benefits for dual eligibles — who account for
40 percent of Medicaid costs — solely under Medicare.
• Resolving Medicare’s $4 billion liability to the states for Social Security Disability Insurance enrollees.
In his 1964 speech at the University of Michigan, President Lyndon Johnson asked a new generation of future leaders: “Will you join in the battle to give every citizen an escape from the crushing weight of poverty?”
As our nation recovers from the worst economic downturn since the Great Depression, we are still having this conversation.
The need for education, job training, health care and community development programs is as strong as ever. While reducing our federal deficit will not be easy, there are some programs that should be off-limits to steep and damaging budget cuts.
Medicaid does exactly what it was designed to do all those years ago — provide a safety net for low-income Americans. There are many worthwhile and positive ways that we can improve the program, but trashing Medicaid for political gain — or cutting it as an easy fix to avoid making tough decisions — should not be an option.
The point of a representative democracy is to serve all. We should not allow short-term deficit-cutting to tempt us into targeting a program that assists one of our most vulnerable populations.
Sen. Jay Rockefeller (D-W.Va.) is chairman of the Senate Finance Subcommittee on Health Care.