NEW YORK – As Congress contemplates cuts to Medicaid, legislators are placing in peril the overarching goals of the program in covering low-income, disabled, and older Americans in favor of expeditious budget cuts, James R. Tallon Jr., president of the United Hospital Fund of New York, said at a meeting sponsored by the New York Academy of Medicine.
“Congress has moved to address Medicaid in terms of budget reconciliation, in terms of $10 billion in federal savings over 5 years,” Mr. Tallon said. “Here's the question: Is it right to take this step toward repealing a major building block of the 20th century domestic policy to pass a budget resolution? Is it right to change fundamentally America's largest health care program under expedited reconciliation of procedures? Congress seems headed in that direction.”
According to the Department of Health and Human Services, Medicaid covers 41 million Americans; that number has grown steadily in recent years.
The number of uninsured Americans is projected to grow to 56 million by 2013. National health spending continues to soar as well, from $1.7 trillion in 2003 to a projected $3.4 trillion in 2013, Mr. Tallon said.
“There is no doubt we're going to hear a lot of personal responsibility rhetoric. Before this is over, you're going to hear the program ridiculed, you're going to hear beneficiaries demonized, and you will be assured that all of this is for our own good.
“If other congressional debates are a guide, there will also be a lot of misinformation brought in,” he said.
Other forces are driving the proposed cuts as well, Mr. Tallon said.
Among them are the rewriting of Medicaid regulations through a waiver process to shift responsibility away from Washington and to shift administration of Medicaid programs to private insurance companies.
Medicaid is the “workhorse” of the American health care system, Mr. Tallon said.
It was designed to provide health benefits for low-income children and adults; to provide comprehensive coverage to disabled beneficiaries who do not have access to other health insurance, including Medicare; and to supplement Medicare for the elderly and disabled who need long-term care, who exceed the benefit limit for acute care services, or who cannot afford Medicare.
“In our current economy, we are off track,” Mr. Tallon said.
“We face major risks from Washington–the long-term objectives of some are simply to limit the federal financial burden and to shift to states the cost of the uninsured and of Baby Boomers' long-term care. The consequences of the current debate will be with us for decades,” he commented.
The current proposals for cutting Medicaid are not viable because there is no alternative to Medicaid for the populations it serves, he said.
“There is no private sector alternative to health insurance for the poor. The insurance industry does not serve this market,” Mr. Tallon said.
“There is no private insurance market for high-cost, chronically ill or disabled individuals. Before Medicaid, this was a state responsibility. The reason we're able to have an insurance industry is because the government picks up the tab for these high-risk, high-cost individuals over the long term,” he said.