Questions, answers on potential medicaid cuts

Published 7:02 pm Saturday, August 20, 2011

Q. What is happening in Washington?

A. The President and Congress have agreed to a deficit reduction plan that creates a Joint Select Committee on Deficit Reduction, also known as the “Super Committee.” of 12 Members of Congress to recommend $1.2 to $1.5 trillion in spending cuts over the next 10 years. Entitlement programs, such to Medicaid, Social Security, and Supplemental Security Income (SSI) are at risk to cuts.

Q. What is the timeline for Congressional action?

A. Our advocacy, the support of the Obama Administration, and champions in the House and Senate protected the Medicaid program from deep cuts in the first part of the budget reduction deal, but the stakes are even higher in the second part of the deal. Time is short. The Joint Committee must complete its recommendations by Nov. 23.

The Joint Committee will be soliciting recommendations for cuts from the appropriate Congressional Committees. We must step up our advocacy campaign to protect Medicaid from deep spending cuts by the Joint Committee that would shift costs to states and result in block granting.

Q. Are block grants to Medicaid still a threat?

A. Yes, block grants will still be a threat to Medicaid. In the House-passed FY 2012 Budget Resolution there were over $700 billion in cuts to Medicaid and the Obama Administration had proposed a $100 billion cut in federal spending. Thus, it will be an uphill battle to protect the Medicaid program from deep cuts that could result in block granting Medicaid. A block grant would give states a fixed amount of money for health care and long term services and would likely remove requirements (such as eligibility and service minimums and quality measures) for how the states spend the money.

Q. What is the problem with block granting Medicaid?

A. One major problem is that the costs do not go away, but would be shifted to already cash-strapped states. If states do not make up for the federal cuts (the federal government pays 50 percent or more of the costs of every state’s Medicaid program), the costs would shift again, to individuals and their families, to health care providers, to other federal programs or to local governments.

Q. What “bad choices” might states make?

A. Since the services to people with disabilities and the elderly are significantly more costly than health care coverage for children, states could decide to serve fewer seniors and people with disabilities and focus scarce health care dollars on children. Here are some possible choices states might be forced to make:

• Loss of home and community-based services and supports

• Move people back to institutions

• Tightening of eligibility for services

• More out of pocket costs for individuals and families

• Reduction or elimination of critical services

• Less availability of doctors and providers for care

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