SAN FRANCISCO–Any cuts to Medicaid pose a danger to African Americans and Latinos, groups disproportionately suffering from high rates of chronic disease and lack of health insurance, according to a study released last week.
According to the report “Medicaid: A Lifeline for Blacks and Latinos with Serious Health Care Needs,” about one in four African Americans and Hispanics with heart disease or who survived a stroke rely on the state- and federally-funded health insurance program for low-income Americans.
For example, of the more than 200,000 blacks with diabetes in California, 32.5 percent are on Medi-Cal (the state’s name for Medicaid), while among the states nearly 80,000 Latinos with diabetes, 28.4 percent are on Medi-Cal.
The report was released by a consortium of organizations, including Families USA, the American Diabetes Association, National Association for the Advancement of Colored People and the National Council of La Raza. It contends that any cuts to Medicaid would have dangerous consequences for the seriously ill people among them.
Cuts Possible From Congress’ “Super Committee”
The report comes as the congressional “super committee” debates ways to reduce the federal debt by $1.5 trillion over the next decade. The committee of 12 powerful members of Congress, half from each party, has been charged with crafting a plan for cuts or tax increases that Congress must vote up or down with no further debate.
Vying for the committee’s approval are Medicaid reduction included in the controversial deficit proposal passed earlier this year by House Republicans. It would have reduced the National Debt partly through sweeping changes to both Medicare and Medicaid.
Drafted by Rep. Paul Ryan, R-Wisc., who chairs the House Budget Committee, the GOP plan would overturn the new health care reform law. The Affordable Care Act (ACA) is designed to expand both programs and make it more attractive for doctors to accept Medicaid patients.
Under the GOP plan, Medicaid would switch to a block-grant system, meaning, the federal government would allocate a block of money to each state, giving them more flexibility in how they tailor their programs for the poor.
Although the GOP bill died in the Senate, Ryan’s ideas are now before the super committee. This weekend, however, the Democratic Governors Association (DGA) sent the committee its recommendations, opposing cuts to Medicaid because reductions would merely shift costs to states.
“We strongly oppose any block-grant approach, especially the one contained in the House-passed budget resolution,” says the DGA letter. The governors cite the Congressional Budget Office estimate that block- granting the program “would reduce federal funding for Medicaid by 35 percent in 2022 and 49 percent by 2030.”
“Instead,” suggests the DGA letter, “policy makers should find a way to implement patient-focused management tools, such as integrated care models like medical homes and other delivery system reforms that could improve quality of care and lower cost.” These community-care reforms are written into the ACA.
In California, the number of Medi-Cal patients is expected to grow from its current 7 million to 10.5 million by 2019, under the new law.
Currently, the federal government matches from 50-75 percent of the program’s funding, depending on the extent of poverty in each state.
“People Will Die”
Kathleen Stoll, deputy executive director of Families USA, noted that in general, “Medicaid is a pretty lean and efficient program.”
“There’s no loose change for states to take out of Medicaid,” she asserted, noting that cuts in the program could mean “people will die.”
Earlier this year, California Governor Jerry Brown released a proposal calling for $1.7 billion in cuts to MediCal to reduce the state’s budget deficit. Among other things, those cuts include reducing by 10 percent providers’ reimbursement and limiting physician visits to seven per year. The federal government is yet to approve those adjustments.
Meanwhile, providers have sued the state for proposing cuts in reimbursement. Based on that case, the U.S. Supreme Court is deliberating on whether to allow such parties to sue states at all.
(The Obama Administration argues that states should not be sued because the Department of Health and Human Services is mandated to enforce Medicaid’s standards of coverage, even though, patent-care advocates contend, the department lacks the staff to do so.)
It is as yet unclear how Medi-Cal patients would be affected by Brown’s proposed cuts. But Anthony Wright, executive director of Health Access, a health care advocacy group based in Sacramento, noted Medi-Cal cuts enacted in 2009, include the elimination of 10 medically necessary benefits, such as dental care.
Those cuts, Wright said, “are having a significant impact on hundreds of thousands of black, Latino and other Californians.”