Editorial: Medicaid at Risk

by Matt Goldberg
Director of Community Relations
Jewish Community of Louisville

In trying to tackle our nation’s soaring deficit and national debt, most proposals from both major political parties have sharp reductions in spending, increases in taxes/closing tax loopholes, or a combination of both. It is plainly understood by all that our annual national deficits are unsustainable and that painful sacrifices will have to be endured.  However, no deficit reduction plan should include cuts that affect our most vulnerable, specifically cuts to the national Medicaid program.

Medicaid is the joint federal/state program that pays for medical assistance and long-term care for low income and elderly Americans, and it is the principal source of health and long-term services for more than 50 million children, adults with disabilities and elderly. It primarily covers low-income people, and it is one of the main funding sources for nursing home care.

Some of the plans under consideration for controlling the national deficit include federal funding caps and block grants, which would have an enormous impact on the plan as we know it. These caps and grants would shift the burden for Medicaid dramatically to already cash-strapped states, which by necessity would be forced to cut services and/or increase taxes.

Eligibility, enrollment and benefits would be sharply restricted, creating an even greater burden on our overcrowded health care system. Long-term care and nursing care would be dramatically altered for the worse. 
If the block grant and/or funding cap is enacted, there will be massive layoffs in healthcare and social services employment, dampening our economic recovery, leading to our federal government being forced to increase spending on programs such as unemployment compensation, food stamps, etc.

Of course, Medicaid (like all entitlements) needs reforming, and there are plenty of ways to make this program more efficient and cost effective. Eliminating waste and fraud and promoting efficiency of care can go a long way to making Medi-caid a much more cost effective program.

If cuts are completely unavoidable, stakeholders (like national associations for healthcare providers, seniors, and religious entities like Jewish Federations of North America) should be invited to the negotiating table so that cuts will have the smallest possible negative impact on providing care.

Political considerations should not be a factor with this program, as there is no alternative being proposed by either political party. Our values as Jews inform us to help ensure the sustenance of those who need it. As imperfect as Medicaid is, it is a program that is meeting the needs of an ever-increasing number of Americans and it must be preserved and maintained.

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