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.
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:
Medically necessary prosthetics or orthotics
Hospice and palliative care
Physical therapy, occupational therapy, and speech therapy
Intermediate care facilities for the mentally retarded
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.