The U.S. Senate passed a six-month extension of Medicaid funding by a vote of 61-38. That’s the good news. But the picture is anything but rosy, and there are no clear skies ahead. This result is only a progression towards funding approval – and that was only possible because Republicans Susan Collins and Olympia Snowe joined with all the Democrats to provide the minimum 60 votes necessary. Did that pass the bill in Senate? Nope. That’s just what it takes to move it to the Debate stage.
What exactly is being debated? Well, first off, the bill isn’t all about Medicaid. Education and other aspects are also bundled in. The complexity of the legislation seems to be part of the hold-up. Senate’s current form of proposed legislation would taper off the Federal involvement in supporting the states, which currently includes a 6.2% bonus to the state governments. This bill proposes cutting that to 3.2% during the first quarter of 2011, and then drop it by 1.2% more in June of 2011* (see Update at the end of this piece).
Proponents of the cuts claim that keeping the higher Federal portion of Medicaid intact “costs $16.1 billion over a 10 year budgeting period.” But it won’t occur over ten years, just 6 months – such figures tend to cloud the issue with misinformation. The current bill totals $26.1 billion, and includes $10 billion for education and schools. The bill’s overall intent is to provide financial assistance to the states, which continue to run in the red against their budgets.
At risk is the Medicaid payment for millions of patients. Physicians cannot afford to absorb such losses themselves, and the final result may very well be that doctors have to start turning away Medicaid patients. As it is, many physicians rightly consider taking Medicaid to be a form of community service, as their pay rate is substantially lower than standard and customary fees to begin with. Asking doctors to take any less simply is not feasible.
Why is Congress unwilling to address this circumstance and issue directly, and provide its own bill, separate of any other piggyback riders or issues? Health care and Medicaid funding are not optional. Medicaid is an obligation We The People have to those who have paid in to that fund most of their lives. It seems ill-advised and inappropriate to play Politics As Usual when people’s lives are on the line.
*UPDATE: Our source in this story was ModernHealthcare. A subsequent interpretation by the New York Times is less specific, but seems to claim that Medicaid would be increased to the states, not decreased. We will get this sorted out and post the actual facts as soon as possible. Meanwhile, the point remains that this is just another 6 month bandage, and that doctor’s Medicaid and Medicare payments should be addressed separately, directly and fairly.
You can rely on Medical Justice to continue to act as your watchdog on these important issues.