Budget Cuts May Get Stalled at the Waiver Request
by Brian Leubitz
The nasty budget that the Governor just signed included some MediCal cuts. Unfortunately for the legislators and the Governor, and perhaps fortunately for some Medi-Cal recipients, the cuts must be cleared by the federal government in order to continue receiving important federal funds. The problem is that the cuts are really far too deep, if allowed to proceed, Medi-Cal recipients would find it even more difficult to find a doctor that accepts Medi-Cal and get the services they need. In other words, it puts lives of Californians at risk.
But that’s not the only issue, as there is always something to the political side of Medicaid. If it were a simple matter of acceptable cuts, this batch would probably not fit the definitions. But, in an article entitled “Liberal governor’s request for Medicaid cuts puts Democrats in tough spot”, the Hill points out that the administration might want to avoid poking Jerry Brown in the eye. Of course, you’ll need to take the Hill with a big grain of salt, as they called Jerry Brown a “liberal Governor.” You know, the guy who slashed our budget, that man is out of control with his liberal-ness.
But I digress from the point:
President Obama and congressional Democrats have been put in a tough spot by California Gov. Jerry Brown’s (D) request to cut Medicaid spending by 10 percent.
Brown says he needs to make the cuts to the state Medicaid program, known as Medi-Cal, to ease his state’s severe budget woes. But advocates say cuts of that size would be devastating to California’s most vulnerable residents.
The federal Centers for Medicare and Medicaid Services (CMS) – and, by extension, the White House – must choose between helping a Democratic governor who has been a leader on healthcare reform and signing off on a policy that advocates say would be devastating to people with disabilities.
CMS also has to weigh the potential fallout from the decision, because giving California carte blanche to make Medicaid cuts could open the floodgates for other states to make similar requests. (The Hill)
In other words, this cut would ripple not only through California, but far beyond. Other states, seeing a chance to cut a big line item that they aren’t so fond of anyway, will come knocking on the federal doors. As goes California, so goes the nation, or something like that.
But if Jerry Brown is the “liberal” here, well, might as well be Dennis Cardoza on the other side:
“If the proposed cuts in the Medi-Cal rate go through,” Cardoza recently wrote to CMS Administrator Donald Berwick, “I am deeply concerned that [some] providers [of services for the disabled] will have no option other than to close their facilities.”
We risk losing many group facilities with these cuts. We risk losing many doctors with these cuts. Pharmacies may stop taking MediCal soon too. One more thing to consider: children with MediCal actually have a lower access to medical care than uninsured children.
Cutting Medi-Cal more at this time just means that this problem gets worse.
Brown is willing to lose this fight over MediCal. That just puts more pressure elsewhere and helps to convince the electorate that the status quo must change. I see his position as being, yes, liberal, because forcing the issue now so as to lead to reforms on Prop 13, easing restrictions on taxes and fees, and getting voters to agree to get rid of this horrible situation requires them to recognize how horrible the situation is.
I’m not usually much one for Leninism, but this is one of those situations where the situation probably does have to get worse before it gets better. The anti-revenue position has to be exposed as completely absurd. How else do we do it other than this? Persuasion hasn’t worked (when it’s even been tried.)
for single-payer for the state.
Imagine this: You make $1600/mo on Social Security. You’re too young for Medicare. So Medi-Cal is your only option. But, if you’re over 60, you only qualify if it’s a medical emergency.
Under the new rules, if you make more than $1100/mo, you pay up to $1000/mo as your “share of cost.” That means you would have a whole $600/mo left for housing and food.
This is actually happening to a 62-year-old friend of mine. His state disability is about to run out. If he takes early retirement, he’ll make too much money to qualify for the Medi-Cal treatment that is currently keeping him alive.
If he’d been able to get treatment before his life was at risk, it would have been cheaper and the outcome would have been better. As it is, the treatment that saved his life may have been no favor if he winds up homeless and starving. In that case, the 20 days of hospitalization Medi-Cal just paid for will have been a very bad investment indeed.
The system was already massively broken. This will simply make it worse. And people like my friend will die.
To anybody who suggests that charities can take up the slack, believe me, he’s tried. Everybody has told him quite frankly that the money is just not there. One lady told him people are waiting years for disabled housing. Where they’re waiting, I’m not sure.
If you believe that human beings are disposable because they had the bad luck to get sick, then this will be okay. If not, you should be outraged. You should also remember that it could happen to any of us.