Bush administration targets medical care for the poor

The cost of the program is shared between the states and the federal government. The purpose of the audits is to challenge reimbursements put in by the states for the federal share of treatments.

Such an attempt to shift a larger share of Medicaid costs onto the states would wreak havoc on those denied Medicaid services as a result. Budgets for state services are still reeling from the impact of the recession and the collapse of the stock market bubble.

Enacted in 1965, Medicaid established the right of those with low incomes to obtain basic medical care, including hospital care (inpatient and outpatient), physician services and nursing home care. It was among the last social reforms carried out at the end of the postwar boom, along with Medicare, a government program to provide health care to the elderly.

The cost of Medicaid has skyrocketed, increasing 63 percent in the last five years. The total tab is expected to exceed $300 billion this year, of which the federal budget is due to contribute $190 billion.

The high cost is a direct product of the corporate restructuring that has left more and more workers to be forced into low-wage jobs, or without jobs altogether. These workers now meet the low-income requirements to sign up for Medicaid. Today, the program encompasses more than 50 million beneficiaries, while another 45 million workers are left without health insurance at all, not even Medicaid.

Bush’s point man in the attack on Medicaid spending is Michael Leavitt, designated to take over the Department of Health and Human Services. Before taking over a year ago as head of the Environmental Protection Agency, he earned his spurs as governor of Utah. The Medicaid “reform” he enacted there involved various restrictions of services to the poor, such as limiting the numbers of prescriptions allowed to recipients.

He is touted for setting up a program for formerly uninsured workers at no cost to the federal government. What is not widely publicized is that the cost of the program was financed by cutbacks in benefits for other Medicaid participants. The new program limited recipients to only four prescriptions a month. Hospital care and mental health benefits were excluded entirely.

One unnamed Medicare official was quoted in the New York Times as saying that these are the types of changes that are in the offing. “That’s the direction the administration wants to go,” said the official.

Besides the benefits cuts imposed under Leavitt, officials are considering allowing states to impose higher co-payments and restricting eligibility without obtaining federal waivers, as would now be required.

Speaking of Bush’s plan to shift billions of Medicaid costs away from the federal government and onto the states, one governor, Republican Mike Huckabee of Arkansas, described it in the following terms: “To balance the federal budget off the backs of the poorest people in the country is simply unacceptable. You don’t pull the feeding tubes from people. You don’t pull the wheelchair out from under the child with muscular dystrophy.”

Medicaid currently insures a quarter of the nation’s children, close to 20 percent of whom live below the poverty level, by conservative estimates. Huckabee’s doomsday scenarios are exactly what the Bush administration is contemplating.

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http://wsws.org/articles/2004/dec2004/medi-d31.shtml