Barbour Calls For Rationing Care In Medicaid

Throughout the health care debate, Republicans characterized Medicaid as a “medical ghetto” and blasted Democrats for proposing to expand the program.” “We’ve heard eloquent statements about how moving 15 million low-income Americans into a program called Medicaid, which is a medical ghetto, is not health care reform,” Sen. Mike Enzi (R-WI) said on the Senate floor in November of 2009. Rep. Virginia Foxx (R-NC) even suggested that people are better off uninsured than insured under Medicaid.

And while Republicans may think they’re too good for Medicaid coverage, a 2005 Kaiser Family Foundation poll found that 74 percent of Americans consider Medicaid very important and most would oppose cuts to the program. In fact, the economic downturn has greatly increased the number of Americans dependent on the Medicaid program, with enrollment increasing by 8.5 percent in fiscal year 2010. But this increased eligibility has also blown a hole is state budgets and is forcing governors and legislators across the country to limit spending on the program. The Clarion Ledger is reporting that Gov. Haley Barbour (R-MS) — a potential presidential contender in 2012 — is “pushing to cut Medicaid payments to hospitals, nursing homes and other providers in a sweeping proposal that critics say could curtail access to health care”:

Barbour built a large part of his 2012 fiscal budget on a proposal to return rates for providers, excluding physicians, to fiscal 2010 levels, a move the Division of Medicaid says could save about $60 million.

Barbour says this and other reforms could free up some $82 million in Medicaid expenses for education, public safety and other state functions. […]

“We’re going to look at his proposal and we’re going to look real hard for what is good in it, but very few of the governor’s proposals on Medicaid policy have been something that would improve the program,” said House Medicaid Committee Chairman Dirk Dedeaux, D-Perkinston. “Most of the things he proposes are ways to cut the program. In these economic times, that program has a very high demand serving a number of people who have lost their income.” […]

What Barbour proposes would amount to a 4 percent cut for nursing homes and an 8 percent cut for hospitals and other providers, the governor’s office reports.

Medicaid officials said they, like counterparts at other agencies, were charged with finding ways to trim costs in harsh economic times for the state.

The federal government bolstered the Medicaid budget with stimulus money — the feds putting up about 85 cents for every 15 cents the state contributed. That rate resets next year to roughly a 75–25 split.

Barbour’s actions are certainly no anomaly (and if anything, call for a serious conversation about Medicaid reform and possibly federalizing the Medicaid program). According to the Kaiser Family Foundation, state spending on Medicaid rose an average of 8.8 percent — the biggest increase in eight years and the second biggest jump in two decades. Consequently, at least 20 states have reduced or restricted benefits in 2010, 39 cut or froze reimbursements for doctors and hospitals, 14 states have plans to cut benefits and 37 to restrict fees in 2011.


All of these cuts will have the effect of reducing access to providers — who already complain that they are greatly underpaid by the program — and may cause providers to reduce services and staff. But Barbour’s cuts are particularly noteworthy because they come from a Governor who has become the GOP’s national spokesperson against health reform. He regularly conflates cuts in Medicare with rationing, arguing that the health care law would undermine access for both patients and devastate providers, and has railed against the law’s Medicaid expansion.

But here he is advancing a proposal that would destabilize Mississippi’s health care system and all concerns about limiting patient access to providers are out the window. After all, these cuts are necessary to free-up state dollars “for education, public safety and other state functions.” Never mind that Mississippi has “the highest poverty rate in the nation and some of the sickest people, with the country’s highest rate of heart disease and the second-highest rate of diabetes.”

Barbour only reiterates the sheer hypocrisy of the Republican attacks, for not only is he cutting deep into Medicaid, but he’s also contributing to the very same kind of “medical ghetto” that his party so vehemently opposed expanding.