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Thursday, December 20, 2012

The alternatives to Medicaid expansion are not pretty

Posted By on Thu, Dec 20, 2012 at 12:51 PM

You know Arkansas Republicans keep saying that there's a magic potion for the $140 Medicaid shortfall that doesn't require taking $700 million in free federal Medicaid money to serve more of the state's working poor?

How it is just unfair to blame THEM if nursing homes are emptied because they won't go along?

How there have to be alternatives?

Look no farther than rock-ribbed Republican Louisiana, where GOP Gov. Bobby Jindal is refusing expanded federal Medicaid money and making cuts necessary to balance the existing Medicaid budget. Crippling blows to the LSU medical operation had already been announced. Now this:

Louisiana’s health department is acknowledging that planned cuts in the state’s Medicaid program will eliminate hospice care for all Medicaid recipients beginning in February.

Hospice care aims to make dying people more comfortable in their final months of life. In announcing reductions to hospice care funding last week, officials with Gov. Bobby Jindal’s administration said hospice care at nursing homes would not be eliminated.

However, Kathleen Meyers, a spokeswoman for the state health agency, confirmed there will be no reimbursement for hospice services beginning Feb. 1.

This fits the Republican ethos. Poor people deserve to suffer because they just didn't work hard enough. Moochers.

Earlier today, rising Republican Congressman Tom Cotton said this on Twitter:

Tax code & govt-support programs should encourage & reward work & accomplishment, a key to happiness:

Conversely, I guess, you should punish those who didn't work hard enough or accomplish enough to pay for medical care in their last dying breaths. This is the kind of thinking Rep. Nate Bell advances in making college scholarship recipients repay the money if they don't get a degree, no matter many extenuating circumstances.

Oh, by the way, the Louisiana plan to cut hospice care is just about as short-sighted as the Arkansas Republican idea to avoid nursing home cuts by slashing mental health services instead, with untold unhappy consequences.

While cutting hospice care is expected to trim the state portion of the Medicaid budget by $1.1 million, Boudreaux predicted it wouldn’t result in real savings because many dying people will end up at hospitals, where Medicaid will pay for at least a portion of their care.

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