OP-ED

Don’t Forget Medicaid

As we wait for the white smoke to emerge from the “grand bargain” negotiations at the White House, most Americans are already aware of the Republicans’ plan to dismantle and privatize Medicare and Social Security. But what many people may not realize is just how dangerous it would be to slash funding for a program that 60 million Americans rely on for their basic health care needs: Medicaid.

While it seems that just about every major industry or interest group has teams of lobbyists in Washington looking out for them, some of our most vulnerable citizens simply don’t have a voice in a town where unfortunately, money still talks the loudest.

Why? Medicaid covers only the impoverished and disabled, so it lacks a traditional advocacy base. This may be news to Republicans — but most poor people I know are spending all their time trying to find a job and put food on the table. Lobbying Congress just isn’t on these folks’ to-do list right now. Unfortunately, this means that my colleagues aren’t going to spend a lot of time over the next 30 days sticking up for the 60 million Americans who rely on Medicaid to pay their medical bills. That’s unfortunate, because if the Republicans are successful in turning the program into a block grant program that greatly diminishes funding to states, three awful things are going to happen — people are going to die, more jobs are going to be lost, and health care costs and taxes will actually increase.

The fact is that Medicaid is the insurer of last resort for those that reside on the fringes of our economy. But is also pays over 60 percent of all nursing home care in America. So yes, cutting Medicaid will deny health care to a lot of poor women and homeless kids. But it will also force states to choose between three pretty awful options — kick seniors out of nursing homes and onto the street, raise state tax rates to make up for the lost federal money, or change the rules to force younger family members to pick up the cost of their institutionalized relatives. One estimate suggests that the combined economic effect of these state-based adjustments will be an overall loss of two million jobs. And the worst of it all is that these Medicaid cuts won’t actually end up saving the federal treasury any real money. While some of these patients will die from a lack of care, more will simply get shifted to more expensive crisis care at our clinics and emergency rooms, costing the system more in both the short and long run. In my home state of Connecticut alone, turning Medicaid into a block grant would jeopardize nursing home care to 17,000 seniors and disabled residents, impair coverage to over 280,000 children and result in nearly $7 billion less in Medicaid spending.

What is equally alarming is that if the Republicans are successful in dismantling Medicaid during these closed-door negotiations, they may kill health care reform along with it. You see, though most of the 32 million people who will get health care insurance under the Affordable Care Act get it through a tax credit that allows them to buy private insurance, about half of the newly insured are going to be new enrollees in Medicaid. Health reform expands eligibility for Medicaid by raising income thresholds and bringing more poor men into the program. But if Medicaid funding gets gutted, then one of the most likely responses by states is to further undermine the already-terrible rates that Medicaid pays doctors. That means that fewer doctors will accept Medicaid patients just as we need thousands more doctors to sign up the program in order to cover the influx of new enrollees. Thousands of new Medicaid patients could find that they have insurance in name only, which is only slightly less cruel than having no insurance at all. And guess what — Republicans know this, which is why they are pushing so hard for huge Medicaid cuts.

There is a full-scale revolt brewing on Main Street now that people understand that instead of bringing forward any meaningful plan to create jobs in America, Republicans have been hell-bent on tearing apart Medicare and Social Security. But the result of this popular awakening cannot be that the cuts simply flow to Medicaid. Medicaid cuts shift costs to someone or someplace else. But more importantly, a choice to balance our budget on the backs of poor women and children and the disabled would speak something putrid about our nation. One of the great things that makes us Americans is the communal sense of decency and responsibility. This recession has forced more and more families to turn to Medicaid and millions more to say, “there but for the grace of God go I.” If these cuts are allowed, we would be shredding the safety net that the most vulnerable members of our American family rely upon. Over the next few weeks, in order for justice and common sense to prevail, their voice needs become everyone’s voice.

Congressman Chris Murphy represents Connecticut’s 5th District and is running for the U.S. Senate

This piece originally ran at The Huffington Post.

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Rick BanastayyabOk BuchiteCraig "Quack" Vickstrom, M.D.Brad Hayami Recent comment authors
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Rick Banas
Guest

I agree that often times cuts to Medicaid programs push people to more expensive alternatives. Likewise, I think we fail to pursue innovative programs that can provide needed services more cost effectively. A number of years ago during a budget crisis, Illinois found that there were a significant number of people in nursing homes who really didn’t need to be in a nursing home. They were there because it was the only alternative for someone on Medicaid to get the assistance they needed. The state took an innovative approach and developed a program called Supportive Living. This Medicaid-waiver program benefits… Read more »

Peter
Guest
Peter

“Does DC have a magical cash multiplier that turns my $1 of taxes into $2?”

Yup, it’s called Blue State/Red State tax distribution.

http://voices.washingtonpost.com/ezra-klein/2010/04/the_red_state_ripoff.html

Craig "Quack" Vickstrom, M.D.
Guest
Craig "Quack" Vickstrom, M.D.

LOL!

tayyab
Guest

hey Chris, where do States get their money to fund their portion of Medicaid? The exact same Taxpayors So Chris how is it people will die, healthcare cost will increae, and jobs lost if I give my taxes to my state instead of sending them through the federal government so you can take a processing fee and send it back? Does DC have a magical cash multiplier that turns my $1 of taxes into $2? Of course not, the truth is by getting the federal government out of the middle we can create jobs, lower the cost of healthcare and… Read more »

tayyab
Guest

very nice info… i like this..

Ok Buchite
Guest

It’s really a great and helpful piece of information. I am satisfied that you just shared this useful information with us. Please keep us up to date like this. Thanks for sharing.

Craig "Quack" Vickstrom, M.D.
Guest
Craig "Quack" Vickstrom, M.D.

The fact that we still have to advocate for MedicAid only goes to show the failure of the Democrats’ (pansy) health care reform.

Brad Hayami
Guest
Brad Hayami

This is an interesting post.

Peter
Guest
Peter

++ to Margalit’s comment.

http://www.nytimes.com/packages/html/national/200904_CREDITCRISIS/recipients.html

http://www.nationalreview.com/corner/242731/did-tarp-money-really-get-paid-back-kevin-d-williamson

I like how the banks say they’ve paid back the TARP money when they’re getting zero based interest rate money from the FED to lend while the rest of us get next to zero interest rates on our savings.

Margalit Gur-Arie
Guest

“Then they should save in good times to pay the bills in bad times. Our current system rewards bad decision making.”

Is this a joke, Nate?

Like Google and GE being rewarded for not paying taxes? Like Wall Street being rewarded for stealing? Like the auto industry being rewarded for inability to compete?

Or is it OK to reward bad decisions for corporations so they have ample cash to afford the traumatic move of their headquarters to China?

http://www.washingtonpost.com/business/ge-healthcare-moving-x-ray-leadership-team-from-us-to-china/2011/07/25/gIQAHL65XI_story.html

Nate Ogden
Guest
Nate Ogden

and what does any of your ranting have to do with state rainy day funds? I can’t wait to hear this connection between state budgets and what ever it is your running on about.

So why did Obama name the GE guy to his job creation council? So he could learn how to move jobs?

Margalit Gur-Arie
Guest

Maybe “those” bad decision makers should also be handed a mop and placed at least 5 miles away from where the money is. Perhaps even hand them some orange overalls while they mop.

Nate Ogden
Guest
Nate Ogden

Your right Margalit what the hell is Obama thinking? FORTUNE — Since naming General Electric CEO Jeff Immelt to head a CEO-heavy jobs council back in January, the White House has faced some tough criticism from both the left and the right. Jeff Immelt on the job. The charge from labor-friendly liberals and free-market conservatives has been the same: the appointment represents pure crony capitalism. The leaders of the largest U.S. multinationals are hardly the best suited to give advice on domestic job creation, the line goes, when they spent the last decade eliminating 2.9 million jobs at home and… Read more »

Margalit Gur-Arie
Guest

Is it absolutely necessary to indict the President in every conversation, whether it has anything to do with the substance, or not?

Would “your folks” support taxing GE and all other corporations fairly, i.e. more than they pay now?

Nate Ogden
Guest
Nate Ogden

“Is it absolutely necessary to indict the President in every conversation” Every time you indict business I respond with the president, I think that then makes the questions do you need to indict business in every conversation? “Would “your folks” support taxing GE and all other corporations fairly, i.e. more than they pay now?” Your folks? Why do you have to be so racist, no thats not it, sexist, no thats not it, um partiest, ya don’t be such a partiest Margalit. Do I support what you said, no, theres a term for this type of question but I can’t… Read more »

Peter
Guest
Peter

“Whats the cut off for HUD housing?”

What cut off would you like to see? Many on housing assistance are elderly and disabled and children, maybe you think the street would get their asses off the public dole.

“Unemployement is up to 99 weeks?”

Well, that’s an end. Looked at how long it takes to get a job now? I wonder how bad the housing market would be if unemployment assistance was not available.

“How long is Disability?”

I don’t know, how long before the disabled find a cure? Who would you throw onto the street? Maybe evangelicals can go forth and heal.

Peter
Guest
Peter

“Most Medicaid patients in the ER absolutely do NOT need to be there.

Do you have a solution?”

Do you? This article was also a story on “Frontline”. It takes a bit of reading but has a lot of good research and directions to solutions, but the path isn’t easy – unless your solution is just toss them out on the street.

http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande?currentPage=1

Nate Ogden
Guest
Nate Ogden

take away their free emergency room visits for non emergency care open clinics inside 7-11 funded by an excise tax on tabacco, alchol, and snacks sold in that area Set up check points to check for the illegal importation of undertaxed goods into the hood tell cops to stop arresting people for drug violations, confiscate their drugs then sell them via the surplus/confiscated goods process using the proceeds to fund police, fire, and those 7-11 clinics Stop mailing or auto depositing welfare checks and food stamps. Have them check in at the beginning of a 5 mile trail and hand… Read more »

Edward Khamou
Guest

Interested in being certified for healthcare IT please take a look at our webinar:

To find out more about our HITU program:
http://www.emrapproved.com/healthcare-it-certification.php

Barry Carol
Guest
Barry Carol

According to a recent article in the WSJ, a mere 9.7 million poor elderly people eligible for both Medicare and Medicaid (dual eligibles) account for $300 billion of healthcare costs annually or fully one-third of the combined cost of the two programs. The article can be found at: http://online.wsj.com/article/SB10001424052702304453304576392194143220356.html There is enormous potential to better coordinate these programs themselves and the healthcare and custodial care provided to this very expensive to care for population. By contrast, children on Medicaid are comparatively cheap to insure. A large piece of the remaining TANF segment of Medicaid covers prenatal care and childbirth for… Read more »

steve
Guest
steve

” We have two classes of poor in this country, those that are content to be poor and live off their government benefits” You do realize that this argument was won in the 90s? People dont get to live indefinitely on welfare anymore. The real growth in govt spending is for the elderly, mostly in the form of Medicare. “hey Chris, where do States get their money to fund their portion of Medicaid?” The problem with states as sole payors for Medicaid is recessions. States are not, usually, allowed to run deficits. Having a mix of Federal and state funding,… Read more »

Nate Ogden
Guest
Nate Ogden

“You do realize that this argument was won in the 90s? People dont get to live indefinitely on welfare anymore.” Whats the cut off for HUD housing? Unemployement is up to 99 weeks? How long is Disability? “The problem with states as sole payors for Medicaid is recessions. States are not, usually, allowed to run deficits. Having a mix of Federal and state funding, mostly controlled by the states, means that states have a stake in keeping costs down (Medicaid is the cheapest payor) while letting the Feds smooth out revenue shortfalls.” Then they should save in good times to… Read more »

Nate Ogden
Guest
Nate Ogden

“This may be news to Republicans — but most poor people I know are spending all their time trying to find a job and put food on the table.” Are these real people or the ones you meet 3 seconds before a press conference supplied to you for political purposes? As a small business owner I find it hard to believe poor people are spendind much time at all looking for work or putting food on the table or they wouldn’t keep turning down jobs that don’t pay a high enough premium over unemployement. We have two classes of poor… Read more »