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Everyone knew NC Medicaid would be cut drastically: What I said on June 2, 2011

Below is a post I wrote last June right before the GOP budget got passed over Governor Perdue’s veto.  The idea that Republicans now can somehow claim ignorance about the effect of the huge cuts they made to Medicaid last summer is breathtaking and simply a rewrite of the facts.  I am amazed that anyone in the media is falling for that sort of historical revision.  In fact, the budget language itself anticipated that the so-called “savings” GOPers were hiding behind wouldn’t materialize.

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June 2, 2011

Here are some hard facts.  NC GOPers are about to pass a budget that will cut $750 million from NC Medicaid over the next two years or about $2 billion in total once you add in the loss of federal matching money.  Medicaid pays for health care services largely for lower income children, older adults, and people with disabilities who make up 81% of all people getting Medicaid in NC.  No non-disabled adult without kids in NC gets help with health services from NC Medicaid.  A parent of a kid getting Medicaid might qualify, but they have to make under $442 a month in income.

Now we know its older folks, people with disabilities, and kids who are affected by these cuts, what exactly is on the table to be eliminated?  It’s got to be something big to save $2 billion over two years.  Well, there’s where GOPers are passing the buck.  They make a variety of undefined cuts to Medicaid and then say this in their budget bill:

[If] savings are not being achieved at a rate sufficient to yield savings in the amount required by subsection (a) of this section, the Secretary of Health and Human Services shall, to the extent required in order to achieve savings at the required rate, take whatever actions are necessary, including the following…”

“The following” includes two main ways.  First cut rates we pay hospitals and doctors who see Medicaid patients and second, reduce so-called “optional” services for adults.   But take note.  NC GOPers won’t be deciding what services to cut.  They’ve instead directed the Perdue Administration’s Department of Health and Human Services to make those painful decisions.

So, what exactly will have to go in “optional services” to help get $2 billion in savings?  Here’s a list of some of the key ones.  And they don’t sound so optional to most people:

Organ transplants

Drugs

Medically necessary prosthetics or orthotics

Hospice and palliative care

Physical therapy, occupational therapy, and speech therapy

Dental coverage

Intermediate care facilities for the mentally retarded

Hearing aids

Let’s just be clear here.  Some of these services I just listed are going to be eliminated.  Because some services to kids can’t be eliminated, the burden will fall mostly on the elderly and people with disabilities.  You simply can’t cut $2 billion from the Medicaid budget and not eliminate some or many of these services.  It’s just that GOPers have done a good job of making the Perdue Administration do the elimination and, presumably, take the heat in a few months.

This may be a great political tactic and fun for those folks in Raleigh who aren’t poor, elderly or disabled and needing an organ transplant or a tooth fixed.  Of course, members of the General Assembly, the only part-time state workers in NC who can sign up for life for the state health plan, will never have to worry about such a situation.  It’s only their constituents who will be in trouble.

12 Comments

  1. Alex

    October 28, 2011 at 10:37 am

    Support for Obamacare is really waning even among Demorats ! People are finally figuring out we have no way to pay for this ill-conceived plan.

  2. AdamL

    October 28, 2011 at 10:41 am

    Huh?

  3. david esmay

    October 28, 2011 at 12:15 pm

    Alex, people have no way to pay for medical care period. Physicians earnings in the US are more than double that of other industrialized nations and our cost of healthcare is two to four times as much, who do you think is driving this? The two highest paid ceos in the country represent an insurance company and a pharmaseutical company. Your statement is beyond asinine.

  4. Alex

    October 28, 2011 at 12:24 pm

    If you ever read the newspaper David, recent polls support exactly what I’m saying. I don’t understand why you can’t present your point, and not always try to attack someone. You must have had a very unhappy childhood.

  5. Adam Searing

    October 28, 2011 at 1:19 pm

    The NC GOP’s decision last summer to cut funding for eyeglasses for seniors and home health care, etc instead of keeping a 1 cent sales tax has absolutely nothing to do with the federal government. These Medicaid cuts were largely unnecessary and purely a state decision. That’s the point here. The GOP budget was passed over the veto of the Governor, was widely opposed, and now the chickens are coming home to roost. Those who made the decision to hurt health care for the vulnerable might want to avoid the blame they so richly deserve, but creating a fake federal bogeyman isn’t going to cut it. GOPers knew exactly what they were doing.

  6. Jimmy

    October 28, 2011 at 1:35 pm

    I think you are wrong in this article when you say there no adults without children who have Medicaid coverage in this state. I have seen many adults without children in my practice who have a Medicaid card. I don’t know the particulars about how they obtained it.

  7. Adam Searing

    October 28, 2011 at 1:58 pm

    I should have been more clear – adults 18-64 who do not have kids do not qualify for Medicaid in NC no matter how poor they are. If an adult is older – 65 and over or if they are 18-64 and have a serious disability, then they may qualify for Medicaid if they are very poor. Medicaid covers only the so-called “deserving” poor – the elderly poor, the poor with serious disabilities, poor children, and a (very few) parents of those kids. The particulars are here:

    http://www.ncdhhs.gov/dma/medicaid/who.htm

  8. AdamL

    October 28, 2011 at 4:28 pm

    Jimmy, in most cases a childless adult must be disabled to get Medicaid.

  9. Frances Jenkins

    October 28, 2011 at 5:42 pm

    You as bad as the Perdue administration to put a spin on everything to make Democrats look better. The Democrats created this situation, corruption, lack of oversight and the lack of ability or want of employees to comply with federal law. The Democrats have been in control for many years and they are responsible for this situation. I think Progressive Pulse should have to file a campaign report for the Democrats because you are their arm.

  10. FishOutofWater

    October 29, 2011 at 6:41 pm

    The NC Republicans look like family crushing, child hating, money grubbing liars because that’s what they are. As long as they get theirs they are happy to let the uninsured die because they can’t afford drugs. Dems have tried to stop the evil mammon worshiping Republicans but they have been ignored and overridden. Here’s to voting them out before more people suffer.

    And to you right wing trolls, why do you hate older people? Did your parents abuse you?

  11. Frances Jenkins

    October 29, 2011 at 8:22 pm

    Facts, Facts, corruption of the Democrat Party of NC put North carolina in this position. You can run but you can not hide from the truth!!!

  12. david esmay

    October 31, 2011 at 12:24 pm

    What polls Alex? Are you refering to polls conducted by the insurance industry. Deceptively worded polls conducted by the Heritage foundation or Civitas? The ABC News/ Washington Post poll of October 20, 2011 shows Americans support universal health insurance 62% to 32% over current employer based insurance, and the vast majority of Americans are dissatisfied with the cost,structure, and direction of the current healthcare system. As for my childhood, it was Tom Sawyer and Leave it to Beaver, couldn’t have been more idyllic, we never wanted for anything. Coincidently my mother co-authored two books on gerontology, and was the director of a large healthcare center operated by the Methodist church, so I’ve always been exposed to the exorbitant costs of the health care system and its effect on seniors and the poor. Why don’t you stop hiding behind an alias and own your statements.