As Predicted, Medicaid On Chopping Block in Debt Limit DealBy: David Dayen
Thursday June 16, 2011 9:21 am
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Well, here we go. The debt limit deal is rounding around to entitlement cuts, and to the surprise of absolutely no one, Medicaid has become the target.
The Medicaid program for the poor is facing significant cuts in an emerging bipartisan budget deal as Republicans seek to shrink entitlements and Democrats protect other priorities <...>
Officials familiar with the talks in both parties say they expect Medicaid to be the biggest source of cuts in federal entitlement programs in whatever compromise emerges. Social Security, the government’s largest entitlement, is not expected to be cut at all and Democrats’ top priority in the budget talks has been to limit cuts to Medicare, the program that provides health care for seniors.
Republicans have proposed turning the Medicaid program into a block grant to states, with few strings attached. That idea is seen as a non-starter in the face of opposition from the White House, which is fighting cuts to Medicaid rolls.
There are signs of bipartisan support among lawmakers for less drastic changes, such as legislation to give states more flexibility to cut the number of people who can use the program.
What could happen is a loosening of “maintenance of effort” requirements. States have certain obligations on enrollment and benefits that they have to maintain or they risk losing federal funding, and under these new laws, those requirements will be removed, allowing states “flexibility,” which is a euphemism for throwing people off Medicaid. When 41 Senate Democrats vowed never to block grant Medicaid by capping federal expenditures, they pointedly did not talk about maintenance of effort. Any flim-flam about how block granting is unacceptable but MOE is fine should not be considered credible.
This would be brutal for the poor, particularly in Republican states, but even in blue ones. Governors are champing at the bit to cut enrollment and increase cost sharing. State budgets are still strained, and Medicaid is among the highest expenditures. Much of Medicaid spending goes to keep poor seniors in nursing homes, so a lot of the cuts would get targeted there. Which means that you can call this the “Force Your Mother-in-Law to Move In With You Act.”<snip>
More:
http://news.firedoglake.com/2011/06/16/as-predicted-medicaid-on-chopping-block-in-debt-limit-deal/:kick: