by Max Brantley
Paul Krugman writes on the devastation that Mitt Romney will bring to Medicaid if elected.
Arkansas Republican advertising is trying to blunt this clear outcome by talking about attacking waste and being smarter with dollars. This is sheer nonsensical trivia against the sums involved. Voucherizing Medicaid to the states — after stopping the planned Medicaid expansion of the Obama administration — will require enormous cuts in poor states like Arkansas that receive huge benefits from Medicaid.
And, contrary to what Republicans want you to believe — that Medicaid is nothing but a program for a bunch of 47 percenter parasites — these cuts will deprive health care to children of working families (destruction of Mike Huckabee's great achievement) and end nursing home care for tens of thousands of parents of working Arkansans who'll suddenly find themselves the new caretakers of infirm relatives. Any Republican who tells you otherwise is not telling the truth. Krugman:
So, about coverage: most Medicaid beneficiaries are indeed relatively young (because older people are covered by Medicare) and relatively poor (because eligibility for Medicaid, unlike Medicare, is determined by need). But more than nine million Americans benefit from both Medicare and Medicaid, and elderly or disabled beneficiaries account for the majority of Medicaid’s costs. And contrary to what you may have heard, the great majority of Medicaid beneficiaries are in working families.
For those who get coverage through the program, Medicaid is a much-needed form of financial aid. It is also, quite literally, a lifesaver. Mr. Romney has said that a lack of health insurance doesn’t kill people in America; oh yes, it does, and states that expand Medicaid coverage show striking drops in mortality.
So Medicaid does a vast amount of good. But at what cost? There’s a widespread perception, gleefully fed by right-wing politicians and propagandists, that Medicaid has “runaway” costs. But the truth is just the opposite. While costs grew rapidly in 2009-10, as a depressed economy made more Americans eligible for the program, the longer-term reality is that Medicaid is significantly better at controlling costs than the rest of our health care system.
Ernie Dumas explained this in detail on the Arkansas level this week.
Medicaid, which serves 800,000 Arkansans and affects that many more family members, faces two big questions when the legislature gathers: (1) Can the state make up a $350 million to $400 million shortfall in state Medicaid match? (2) What will happen when Republicans block the expansion of Medicaid under the Affordable Care Act, which carries some relief for the state's Medicaid crisis as well as insurance for the largest share of the state's uninsured?
Because the state has fared a little better than much of the country since 2006, lowering its poverty rate against the country as a whole, its matching share for Medicaid has risen from 25 to about 30 percent, but only theoretically. President Obama's stimulus act pumped $750 million into the state's coffers for Medicaid from 2009 through 2011, reducing the state's match to 20 percent. It produced state budget surpluses and let the state's Medicaid trust fund grow for two years. Now the trust fund is vanishing and the state will enter the 2013 fiscal year next July needing an extra $350 million or more to maintain nursing home care, the institutions and community services for disabled children and adults and hospital and physician care for low-income children.
The teabaggers vow to end this socialism. The human cost will be staggering against the dollars "saved."