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William Daroff

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Strong Medicaid System is Key to Supporting Nation's Children, Poor and Adults with Disabilities

Posted: 06/22/11 08:23 PM ET

A program that more than 50 million children, adults with disabilities and older Americans depend upon for support with their health and long-term service needs is under attack in Washington. Medicaid, just like Medicare, is part of the fabric of this nation's health and we must not allow it to be unraveled.

This vital social service initiative offers assistance to Americans for whom disabilities and illness would otherwise present insurmountable barriers to living a life of dignity and seeking opportunity for themselves and their families.

Many of the Americans who receive support from Medicaid are some of our most vulnerable neighbors and they struggle to have their voices heard.

For more than a century, the Jewish Federations have served millions of Americans in need in communities across the country by supporting hospitals, facilities for the aged, and home- and community-based care services. We know first-hand the critical impact that the delivery of basic health and long-term care made possible by Medicaid has made in people's lives and the tragic consequences should this program be weakened by Congress.

These consequences will be felt in the emergency room of Mount Sinai Hospital in inner-city Chicago -- a miraculous place that treats destitute children, the working poor and older adults. A few weeks ago, an eight-year-old girl with diabetes arrived at Mount Sinai in a coma and her brain was swelling. Her family did not have access to health insurance but she qualified for Medicaid, which supported her two weeks in intensive care and saved her life.

Shredding Medicaid would also impair the care that Cedar Village in Cincinnati provides for its residents like Nelson. Around his 60th birthday in 2004, Nelson became disabled and had to stop working as a pharmacist. For the past seven years, he used his savings to care for himself and support his daughter. Nelson has already outlived his savings and with no other family, Medicaid now makes it possible for him to have housing, care and dignity. There are dozens of residents at Cedar Village in similar situations. If federal Medicaid funding gets cut in half this facility, and many more nationwide, will be forced to drop half their clients.

Block granting -- or placing a cap on -- Medicaid spending would create a falling anvil that flattens the program's good deeds.

Several prominent proposals in Congress would resurrect the barrier to 50 million Americans' dignity and opportunity that Medicaid removes.

If we lower federal support for the program, the costs and liabilities will simply transfer to the states. Fiscally squeezed under a block grant proposal, states would have no financial choice but to sharply restrict enrollment, eligibility and benefits for populations they currently serve. Many vulnerable people who currently qualify for Medicaid could end up uninsured, including those whom states are required to cover, such as poor children, pregnant women and those with disabilities who are in the workforce.

If Medicaid spending were capped in each state, reimbursement rates for physicians and care providers would fall so low that these providers would have to end their relationship with Medicaid. This would squeeze access to health care and leave those who are disabled, ill or frail on the street.

We understand the turbulent fiscal situation in our country. Though Medicaid reform could be part of our fiscal solution, reform must be implemented constructively.

From our vast experience working with programs for Americans who receive Medicaid support, we propose two solutions that would maximize efficiency without cutting critical services:

First, the United States should curb regulatory restrictions on Medicaid flexibility. Institutional care can be expensive and is not always necessary. Often, more cost-effective home-based and community-based care is better from a health and financial perspective and would be more widely used if the current waiver requirement was waived.

Second, we can cut through another costly piece of red tape by promoting investments in health information technology and greater efficiency in the provision of care. We should take full advantage of today's technology to match patients more efficiently with providers.

We know from decades of caring for Americans like the girl at Mount Sinai and Nelson at Cedar Village that the support Jewish Federations provide would not be possible without a strong Medicaid system. To preserve the health and long-term care to millions of vulnerable Americans who we know need our help more than ever, we stand ready to work with Congress and the Obama administration on practical solutions that will achieve long-term savings without harming the neediest in our nation.

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