“Supercommittee’ Must Leave Medicaid Alone

“Supercommittee" Must Leave Medicaid Alone

The so-called “Supercommittee” -- Congress’ Joint Select Committee on Deficit Reduction – continues down a partisan path, with little to show for its efforts to date except to potentially put Medicaid in harm’s way.

The Supercommittee is supposed to come up with a plan to reduce the federal deficit by at least $1.2 trillion over the next ten years.

There’s not much about the halting work that’s taken place so far that could be called “super.”   The joint committee continues to demonstrate the deep partisanship that’s all-too-familiar now in Washington, underscoring as well the gulf separating uncompromising ideologies of Republicans and Democrats.

Recently, a plan from Sen. Max Baucus, a Democrat, was rejected  by the Republicans (and some Democrats), and an alternative Republican plan was subsequently rejected by Democrats.  And so it goes.

The Supercommittee has a deadline for concluding its deliberations and reporting its deficit reduction plan.  The deadline is the day before Thanksgiving, and the irony is that there may be nothing to be thankful for when the Supercommittee concludes its work.

If the political impasse isn’t broken and no plan is forthcoming, it will trigger massive contingency cuts that would take effect at the start of 2013.

No matter what, there’s a lot at stake here, particularly when it comes to what we do to provide health care and services for Medicaid recipients, many of whom are among the most frail and vulnerable of our society.

Medicaid funding actually fares better in an impasse scenario because the legislation bars reductions in the program if the contingency cuts come into play.  Unfortunately, there’s nothing to prevent the Supercommittee from putting forth cuts in Medicaid.  Indeed, as the Greater New York Hospital Association (GNYHA) points out, even President Obama included significant Medicaid cuts in his recommendations to the Supercommittee.

The problem of going further down the road with any more cuts to Medicaid is that many states, facing their own fiscal crises, have already deeply slashed funding for the program.  This is particularly true of those states with large Medicaid budgets.  That includes, New York, where “Medicaid redesign” and other cutbacks have dramatically reduced spending by 15.5 percent, according to GNYHA.

There’s a double whammy to the actions by New York and other states.  Their cutbacks will trigger the additional loss of federal share of Medicaid funding for the eliminated spending.  Federal Medicaid payments are expected to decrease appreciably next year as a result of these cost-containment actions at the state level.

There is little ambiguity among most of the nation’s governors – Democrats and Republicans alike – who are opposed to any cost-shifting actions that would increase the Medicaid burden on the states.

Medicaid spending has already been cut to the bone, and anything further done at the federal level will have a devastating impact on the very vulnerable Americans who rely on this program to provide them with the appropriate health care that they need.

Health care providers are already hard-pressed to provide the services required, particularly as the economy continues to push individuals and families into poverty levels and make them eligible for Medicaid.  This is further straining a system of care that is stretched as thin as it could possibly be.

Some perspective:  A census report released recently shows a steady growth in the numbers of persons living in poverty in this country.  The 15.1 percent of our population that is now living in poverty is a historically high number since the significant declines in poverty achieved in the post-World War II era and as a result of Great Society interventions.

What’s happened most recently?  A decade ago, some 31 million Americans were living in poverty, according to the Census Bureau.  In the 2010 census, that number had jumped to 46.1 million Americans.

We are going backwards.

The lives of older adults, the poor and disabled persons were improved through the enactment of Social Security, Medicare and Medicaid.  Each of these programs faces challenges, but perhaps none more so than Medicaid.

While further cuts to Medicaid may well improve our nation’s fiscal picture, the cost in the lessening in health and well-being of our most vulnerable citizens is just too high a price to pay.

It would be an abandonment of the wise choices of more enlightened days of the past, when the desire of society to meet the health care needs of the poor was the pure motivation of our nation’s leaders.