Fitzsimon File

Medicaid is back in the news today, as the national health care policy group Families USA released a report showing that North Carolina stands to lose more than $500 million next year if the Bush Administration gets its way.

The Administration wants to slash federal funding that states receive for a wide variety of services including rehabilitation, school-based transportation, case management and payments to hospitals.

Unless Congress steps in, states will have to drop the services or come up with the money to pay for them, which in North Carolina's case would take all the money expected from next year's revenue growth, leaving nothing to pay for increased school enrollments, teacher and state employee pay raises and other basic needs.

The attack on Medicaid by the Bush Administration is not new. Politicians love to bash the program and complain about its rising costs. In North Carolina that often includes parroting the misleading claims of the market fundamentalist crowd that the state's Medicaid program is overly generous and includes too many optional benefits that the state does not have to provide.

Those benefits include services like include eye care, prosthetics, prescription drugs, speech therapy, and ambulance service, which are hardly optional for people who need them.

It's not just Republicans who take offensive shots at one of the most successful and efficiently run public programs. Democrats are prone to complain about it too, especially when they are not running for higher office.

The most recent example came in the 2005 General Assembly session when the Senate passed a budget that cut 65,000 people who were blind, aged, or disabled off the Medicaid rolls, shifting many of them to Medicare where they would lose vital services and leaving several thousand without care altogether.

Senator Kay Hagan, was one of the Senate budget chairs that session and repeatedly defended the Medicaid cuts, complaining the program had to be brought under control. One of her Co-Chairs, Senator Linda Garrou, disputed the notion that the move would reduce benefits, though Senate President Pro Tem Marc Basnight openly admitted it, while still defending the Senate proposal.

The House budget did not include the proposal to cut 65,000 people from the Medicaid rolls and thankfully neither did the final version of the budget, though Hagan and other Senate leaders defended the idea for months after the General Assembly adjourned.

Hagan is now a candidate for the U.S. Senate and recently told the News & Observer that part of the solution to the nation's health care problems was to increase funding for Medicaid.

She's right this time. Medicaid does deserve more funding. As advocates pointed out in 2005 , Medicaid is now a much greater share of the state's budget because health care costs overall are rising significantly and more people, particularly children, need coverage, though the costs continue to rise less than private health care.  

Of the 1.6 million people in North Carolina covered by Medicaid in 2006, 941,000 of them were children. People who are blind, aged, or disabled make up 29 percent of the recipients but account for 69 percent of the Medicaid dollars. Children and pregnant women are the next largest categories of people covered.

Medicaid is not a health care program for most adults, even if they are abjectly poor. And it also operates with far less administrative costs than private insurance plans.  

President Bush is dangerously wrong about Medicaid and his proposal would either devastate North Carolina's program or force lawmakers to make deep cuts to education and other vital services.  Let's hope Congress stops the insanity.

The leadership of the State Senate was wrong about Medicaid in 2005 too, though it appears at least one of its members has now come to her senses, which is some measure of progress.

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This entry was posted on Tuesday, April 22nd, 2008 at 6:19 pm and is filed under Fitzsimon File. You can follow any responses to this entry through the RSS 2.0 feed.