Editorial: Medicaid

$15 million cuts big deal in states like West Virginia

The Register-Herald, April 27, 2005

As governors weigh proposed Medicaid cuts, most from both political parties share concerns about a measure that would shift more of the financial burden to states. The proposed $15 million in cuts have been called "marginal and minor" by those who support them.

However, they are anything but minor and marginal for states such as West Virginia. Cuts could mean pregnant women could have to visit local emergency rooms for prenatal exams. Senior citizens and people with disabilities would struggle even harder with prescription drug costs.

When it comes to the impact on state budgets, it's important to consider that current law will drop federal Medicaid matching funds by $36 million to 29 states, including West Virginia. An additional $15 million cut would increase that shortfall.

Like it or not, Medicaid is a major lifeline for health care in this state. Without it, thousands of West Virginians would fall through the cracks of the health care system.

We support better management of the system and cutting costs that will not directly impact the quality of health care.

Governors trying to arrive at a united position on how to effectively lower Medicaid costs will have a difficult time finding common ground. Poorer states, such as West Virginia, stand to lose far more than states with more money.

Reaching an agreement hasn't been easy in a debate that began in January before President Bush proposed cutting Medicaid spending growth by an estimated $40 billion over 10 years. Governors united to oppose cuts, but they haven't publicly gone farther on ways to save money.

Understandably so.

Medicaid has grown faster than inflation and is estimated to cost more than $300 billion in total this year. The program serves 53 million people.

General ideas circulating among the governors include:

-- Adding deductibles or for medical care for Medicaid recipients, forcing patients to share costs and discouraging misuse of the system.

-- Making it more difficult for senior citizens to transfer their assets to relatives or others so that they fall within Medicaid eligibility requirements - and the program would then pay for nursing home care. One proposal would allow states to examine an individual's finances in greater depth.

-- Trying to find ways to discourage businesses from dropping health insurance or otherwise shifting employees to Medicaid, possibly through tax credits that would encourage low-income people to hold on to private health insurance.

These types of measures, which help cut down on Medicaid fraud so that those who need governmental assistance get it, are far more reasonable than a $15 million slash across the board.