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once in a while you get shown the light in the strangest of places if you look at it right

5.10.2005

Sick Priorities

Washington conservatives are firmly placing their boot onto the necks of the most vulnerable Americans – poor children, the elderly, pregnant women, and people with HIV/AIDS. Under the cover of high-profile fights over Social Security privatization and judicial filibusters, Congress has voted to slash Medicaid – the country's premier health program for the poor – by $10 billion over the next five years. Now, with the budget-crunching over, governors and state legislators have devised "sweeping changes" to deal with Congress's cuts, under which many low-income Americans will have to pay more for care and states will have "more latitude" to reduce and limit services. Governor Mike Huckabee (R-AR) put these priorities in perspective: "[T]o balance the federal budget off the backs of the poorest people in the country is simply unacceptable. You don't pull feeding tubes from people. You don't pull the wheelchair out from under the child with muscular dystrophy."

FISCAL RESPONSIBILITY A LA CARTE: Why target Medicaid to begin with? Conservatives claim it's all about reducing the federal deficit, and point to the fact that federal and state spending on Medicaid has "grown an average of 10 percent a year over the last five years – much faster than federal or state revenues." But the reasons behind that growth show that targeting Medicaid is regressive and unnecessary. Medicaid has actually "contained spending, limiting annual per capita growth to 6.7 percent between 2002 and 2004," compared to 12.5 percent for private health insurance premiums. Its overall costs have increased because "enrollment grew by nearly 40 percent since 2000" thanks to the recession that "left many families without health coverage, squeezing states." Without Medicaid, the number of uninsured would have been much higher. Meanwhile, conservatives have cleared the way for $106 billion in new tax cuts over five years (as part of a budget that will "increase deficits over the next five years by $168 billion") while moving forward with pork-packed energy and transportation bills.

PICKING ON THE WEAK: So what's the real reason for going after Medicaid? Political analysts say "congressional leaders picked a program whose low-income beneficiaries were relatively less politically active. 'The poor and the disadvantaged do not vote,' said Rogan Kersh, a political science professor at Syracuse University who follows health-care issues."

THE DEEPEST CUTS: The severity of America's health care crisis is seen most vividly in the extreme moves some states are making to deal with cuts in Medicaid funding. A few states have pushed through wholesale cuts in coverage; Tennessee is dropping more than 300,000 people from its Medicaid rolls, while Missouri is cutting off 90,000. Meanwhile, New Hampshire yesterday became the first state in the nation to make "the poorest of the poor – even families with no income at all – contribute to their coverage." (Oregon tried a similar strategy two years ago, charging $6 to $20 a month for poor adults in an optional program, and "enrollment dropped by half in less than a year, from 100,000 to 51,000.") A newspaper in New Hampshire called the proposal an 'infamous moment' in the state history "comparable to the time a state senator suggested homosexuals should be allowed to donate blood 'as long as they donated all of it.'" (See American Progress's state-by-state analysis of the Medicaid cuts.)

IMPROVING MEDICAID THE RIGHT WAY: Plenty of options exist to improve Medicaid's performance without cost shifting to states or reducing coverage for people in need. A report by the Kaiser Commission on Medicaid and the Uninsured reveals that all fifty states and the District of Columbia enacted some form of cost-containment measures in response to the rising cost of Medicaid in the past two years. American Progress has compiled some of the most progressive of these measures, like basic drug reimportation programs, multi-state prescription purchasing pools, and small business health insurance pools. Read about them in our issue brief on "Improving Medicaid's Performance."
|| doug, 13:30

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