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Whatever long-term budget cuts – needed as they are – come out of Washington, it’s good to bear in mind that cuts have costs and consequences.
Advocates for health-care services for the poor and elderly point to the example of Medicaid, a program run by the states but largely funded by Washington. It covers one in six Missouri residents and 35 percent of the state’s children. Nationwide, it covers two-thirds of those in nursing homes.
In Missouri, the program accounts for about one-quarter of the state’s budget, and recall that six years ago the state lowered the eligibility requirements – to the tightest in the country, advocates say – and thereby dropped 100,000 people from the program.
The U.S. House has passed a budget that would cut federal money for Medicaid by 5 percent next year, 15 percent the year after that and 33 percent in 10 years. And, crucially, the federal government would switch the program to state-by-state block grants, which history shows is Washington’s way of signaling that it’s looking to get out of the game entirely. It’s basically telling the states, “Hey, your problem – not ours.”
That budget ultimately won’t pass in the Senate or get the president’s signature, but it’s an opening bargaining position, and it illustrates the delicate, complicated decisions policy-makers face.
Simply put, is this the time to be liquidating even more jobs?
Advocates for Medicaid argue that lower reimbursements to nursing homes, for example, would cost nurses and others their jobs. Drawing on federal statistics and economic models, Families USA projects that a 5 percent cut in Medicaid would mean a $291 million hit to the Missouri’s budget, $634 million in lost overall economic activity statewide and 5,300 jobs at risk. At 15 percent, those figures for our state jump to $872 million from the budget, $1.9 billion in economic activity and 16,000 jobs.
That’s assuming the state doesn’t pick up any of the slack, but given Missouri’s history of cutting this program, what reason is there to think the General Assembly would now go the other way?
So give the advocates this much: Medicaid is mostly about getting shots and filling cavities for kids and a modest degree of comfort and care for people in the twilight of their lives. Cutting it doesn’t make sense from a health standpoint, and might not make sense economically.
The country’s finances are a mess, and big changes to big programs – Medicaid, Medicare, others – are in the air. None will be painless. Even liberal Democrats in Congress are coming to acknowledge that things have to change. But Congress still can be smart, judicious and compassionate as it works through these issues. That’s what citizens have a right to expect.
Whatever long-term budget cuts – needed as they are – come out of Washington, it’s good to bear in mind that cuts have costs and consequences.
Advocates for health-care services for the poor and elderly point to the example of Medicaid, a program run by the states but largely funded by Washington. It covers one in six Missouri residents and 35 percent of the state’s children. Nationwide, it covers two-thirds of those in nursing homes.
In Missouri, the program accounts for about one-quarter of the state’s budget, and recall that six years ago the state lowered the eligibility requirements – to the tightest in the country, advocates say – and thereby dropped 100,000 people from the program.
The U.S. House has passed a budget that would cut federal money for Medicaid by 5 percent next year, 15 percent the year after that and 33 percent in 10 years. And, crucially, the federal government would switch the program to state-by-state block grants, which history shows is Washington’s way of signaling that it’s looking to get out of the game entirely. It’s basically telling the states, “Hey, your problem – not ours.”
That budget ultimately won’t pass in the Senate or get the president’s signature, but it’s an opening bargaining position, and it illustrates the delicate, complicated decisions policy-makers face.
Simply put, is this the time to be liquidating even more jobs?
Advocates for Medicaid argue that lower reimbursements to nursing homes, for example, would cost nurses and others their jobs. Drawing on federal statistics and economic models, Families USA projects that a 5 percent cut in Medicaid would mean a $291 million hit to the Missouri’s budget, $634 million in lost overall economic activity statewide and 5,300 jobs at risk. At 15 percent, those figures for our state jump to $872 million from the budget, $1.9 billion in economic activity and 16,000 jobs.
That’s assuming the state doesn’t pick up any of the slack, but given Missouri’s history of cutting this program, what reason is there to think the General Assembly would now go the other way?
So give the advocates this much: Medicaid is mostly about getting shots and filling cavities for kids and a modest degree of comfort and care for people in the twilight of their lives. Cutting it doesn’t make sense from a health standpoint, and might not make sense economically.
The country’s finances are a mess, and big changes to big programs – Medicaid, Medicare, others – are in the air. None will be painless. Even liberal Democrats in Congress are coming to acknowledge that things have to change. But Congress still can be smart, judicious and compassionate as it works through these issues. That’s what citizens have a right to expect.
