Big Decisions Loom for Medicaid
WASHINGTON, Oct. 13-More than 250 patients a day-children getting vaccines, elderly pneumonia sufferers, pregnant young women-pass through the Greater New Bedford Community Health Center.
“Approximately 50 to 55 percent of the patients we see are on Medicaid, so obviously it’s very important,” said Peter Georgeopoulos, executive vice president and chief financial officer of the center.
The future of Medicaid-on which more than a third New Bedford residents depend-will be at stake in upcoming weeks as congressional committees debate how to shave $10 billion from the program’s budget over the next five years. Medicaid, financed by the state and federal governments, pays for health care for low-income persons.
Some call the anticipated changes inappropriate cuts, while others characterize them as much-needed reform.
“Medicaid is already strapped for cash,” said Jodi Seth, spokeswoman for the House Energy and Commerce Committee Democrats. “Obviously [cuts] would have a devastating effect on states and the people who depend on [the program]: pregnant women, children, seniors.”
A budget resolution passed by Congress in April requires a $10 billion reduction in spending on entitlement programs over the next five years. It is widely expected that this money will come from the Medicaid budget.
Another element of the budget resolution calls for $70 billion in tax cuts. Some Democrats say it is inappropriate to continue reducing tax revenue while cutting programs for the needy.
“If the President wants to restore fiscal responsibility, he should insist on shared sacrifice and roll back his tax cuts for the wealthiest Americans instead of cutting the lifeline many kids need to get immunized and see a doctor,” said Sen. John Kerry in a statement to the Standard-Times.
Kerry is a member of the Senate Finance Committee, which is charged with making the Medicaid cuts.
The federal budget for Medicaid in the current fiscal year is $157 billion.
Those who support the spending reduction characterize the upcoming legislation as a reform package, rather than a budget cut. They hope that allowing states more flexibility in the way they administer the program would cut costs while actually improving quality of care.
“States should have greater flexibility to better target scarce resources and offer coverage that better meets each patient’s needs,” said Rep. Joe Barton (R-Texas), chairman of the House Energy and Commerce Committee, in an editorial last month.
Though specifics are not yet available, the suggested reforms include measures to reduce fraud, target wasteful spending and increase Medicaid recipients’ financial responsibilities.
Some congressmen, concerned that such measures could reduce the ability of the most disadvantaged to receive needed health care, are hesitant to sign on to the leadership’s proposals.
“Reduced access is most likely the biggest concern,” said Jill Gerber, GOP spokeswoman for the Senate Finance Committee. “The discussion hinges upon whether that’s a legitimate concern or whether there’s enough waste in the system to cut back.”
One possible reform would require some recipients to pay premiums for their Medicaid coverage or increased co-payments for services. Some critics are concerned that such measures could prevent people from seeking treatment.
“You don’t want patients delaying necessary care for want of some co-payment money,” said Paul Wingle, spokesman for the Massachusetts Hospital Association. “When they do that, their health fails and a preventable problem becomes a medical emergency.”
In Massachusetts, hospital officials are concerned about the possible effects of the budget cuts. Even at the current level of funding, hospitals are not receiving enough money to cover the services they are providing, said Wingle.
“In Massachusetts at least, every time we serve a Medicaid patient we lose money,” said Wingle. “It’s a reduction any way you look at it-the labels are a product more of spin than of substance.”
In the greater New Bedford area, need is even greater due to above average poverty levels.
“We have a disproportionate share of Medicaid patients,” said Joyce Brennan, spokeswoman for Southcoast Health Systems, which includes hospitals in New Bedford, Fall River, and Wareham. “Any cut in an already underfunded program is going to be substantial for us.”
