Tuesday, November 13, 2012

UPDATE: 75,000 to feel Medicaid cuts (and that's before the Republicans get started)

Posted By on Tue, Nov 13, 2012 at 8:01 PM

POUND OF FLESH: Jonathan Dismang, rising Republican senator, wants poor people to put some skin in the game.
  • POUND OF FLESH: Jonathan Dismang, rising Republican senator, wants poor people to put some "skin in the game."
Even with revenue growth and surplus, Arkansas will fall short of meeting existing needs for money to support the Medicaid program, legislators heard at budget hearings today. Early word suggests (Arkansas Business/AP) the need for as much as $200 million in cuts. UPDATE: By a variety of cost-cutting strategies, state officials apparently think they can bring down the budget shortfall and necessary cuts to $138 million. A lot of money, though a relative small percentage of the overall program, which is near $5 billion.

Arkansas Advocates posted this photo which illustrates how the department got the shortfall down to $298 million, to be partially offset by $160 million in new and surplus state revenue.

That shortfall will grow worse in 2014 if Arkansas's legislature spurns federally paid Medicaid expansion. Expansion in time would cure many of the state's existing problems because the feds promise full funding of the expanded Medicaid program for three years, which will produce significant savings in some existing expenses.

UPDATE: An afternoon session started fleshing out the impact of the Medicaid cuts. Stephens Media reports.

Some 75,000 people will be affected. 10,000 to 15,000 people who now get Level 3 nursing home care - help in basic functions and including some people with diminished mental capacity will be cut off state assistance. This will have a significant impact on families, a state official said. It should go without saying.

A number of low-income working people will lose insurance. About 20,000.

Medicaid will stop covering adult dental services. Back to pain for 40,000.

Reimbursements to health care providers will be trimmed. They're people, too, of course.

This is all, of course, the Beebe budget. Before Republican majority tax cuts. Before Nate Bell and his ilk get through with slashing government help for the moochers and parasites. The cuts are roughly tripled because state spending reductions reduce the big federal match.

Soon-to-be second-term Sen. Jon Dismang did little to demonstrate his supposed reputation for something akin to moderation by chastising Beebe for not presenting a plan sooner. Why, he said, perhaps Republicans could have come up with something smart, like a co-pay to "influence patient behavior." He wants people to have "skin in the game."

Those nursing home patients with Alzheimer's? Maybe we could cut a pound of flesh off them to give Dismang some skin. Or maybe if they had to pay a $10 monthly copay they'd find the marbles they've lost. Or maybe those people with poverty-level jobs who couldn't afford health insurance? We'll put their skin in the game when, without coverage and their health problems nearing crisis level, they get some emergency room care that they can't pay for, but a hospital sucks it up or taxpayers do. There's some more skin for you, Senator Dismang.

The new majority hasn't yet been seated and I'm already fed up with bullshit cliches. Skin in the game. Co-pays. Co-pays are coming in some areas and they may raise some token amounts. But they won't solve the basic health needs of hundreds of thousands of poor people, some disabled, some working to hang on by the skin of their teeth, some children. To suggest otherwise is just dishonest. Nate Bell is at least honest. Time to stop wasting our money on the takers, he'd say. Cut taxes for the makers and maybe the leeches will be inspired to become makers, too. They'll be lighter and require less feeding, what with all their skin flayed off.

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