Balancing federal budget on the backs of the poor
Let's hear it for the US Congress, who has decided that so many poor people are benefiting from Medicaid that it must be cut. Our pockets are being assaulted too heavily by these poor and disabled citizens and by GOD something must be done.
So they have now given states the right to cut services and eligibility; to require copayments from people who already can't pay their bills because "this will reduce utilization" (watch out, all you ERs); to decimate EPSDT requirements; to offer the poor "health savings plans" (can you figure yours out? If so, can you come explain them to my impoverished families who have never had any practice budgeting money? Thanks.). In short, they are holding poor people responsible for using the entitlement they were granted and actually used. Fancy that.
But in Congress-speak, they have said that while they are cutting Medicaid, they aren't really cutting Medicaid. They are leaving it up to the states to decide what to do.
So let's see: my state (Virginia) is already notoriously stingy in benefits to poor and disabled people. Don't believe me, check out any state ranking for expenditures and/or services to this population. So stingy, in fact, that when a call comes into my program from an out of state family with a child whose special health care needs are being met adequately in their current state of residence, we tell them don't! Don't move to Virginia.
I cannot imagine Virginia seeing the opportunity to cut benefits and not doing so.
Well, I don't have any easy answers, but I know this from experience: if you push poor and disabled people out of Medicaid and primary care, they will simply show up in your ERs as uninsured poor people. We have poor people who get sick in America. This should be a shock to someone?
We are going to pay for helping poor people with health care problems one way or another, and decreasing use of primary preventative care by removing the ability to pay for it, seems counterintuitive to me.
But what do I know?
The other alternative might be to criminalize being poor in America, and get these darn people off the street and into...somewhere. Or shoot them all. That would certainly solve the Medicaid budget crisis.
Maybe I'll bring this up to the President one day, when he's vacationing on his ranch.