The Democrats threw down the gauntlet at their convention in Charlotte this week, putting health care front and center and warning the Republicans that they won't get away with more of the health care fear-mongering they've been stirring up for years. This strategy was solidified on the second night of the convention when President Bill Clinton, in the words of former George W. Bush speechwriter David Frum, "detonated the H-bomb of the 2012 campaign: the Medicaid issue."
President Clinton electrified the delegates and millions of television viewers with a stark warning about the GOP's plans: "They also want to block-grant Medicaid, and cut it by a third over the coming 10 years," he said. "Of course, that's going to really hurt a lot of poor kids. But that's not all. Lot of folks don't know it, but nearly two-thirds of Medicaid is spent on nursing home care for Medicare seniors who are eligible for Medicaid."
Clinton's observations on Medicaid exposed the big lie that Romney and Ryan's health care plans won't harm current seniors. The truth-challenged Republican candidates always point out that their plan to voucherize Medicare and increase the medical costs of seniors by thousands of dollars a year won't affect anyone who has already turned 55. But they don't just want to eliminate Medicare as we know it. The Romney-Ryan block-grant scheme would make immediate and steep cuts to Medicaid that would lead to as many as 30 million Americans getting dumped from the program. Two-thirds of Medicaid spending is for seniors and people with disabilities.
Ryan and Romney also dodge another part of their plan that will hurt current seniors -- repealing Obamacare, which will re-open the Medicare prescription drug "donut hole" and eliminate prescription discounts that have already saved 5.4 million seniors $4.1 billion.
When Romney and Ryan push for deep cuts to Medicare and Medicaid, it isn't about health care policy or deficit reduction - it's to give massive tax breaks to the richest Americans. These unconscionable tax cuts average up to $250,000 for millionaires.
Ever since Ryan proposed his draconian budget in 2011, we have been pointing out that Medicaid is as important as Medicare to the economic security of seniors and their middle-class families. This is no courageous innovation from the GOP vice presidential candidate, as his press agents would have us believe. It's a cost-shift of billions of dollars that will bludgeon state taxpayers and dramatically limit care to children, the elderly and working families.
Medicaid Is Central to the Economic Security of Seniors and Families
Medicaid is a lifeline for seniors, children, working families and people with disabilities. It creates jobs by pumping dollars into local economies. It keeps open the doors of local hospitals and community health centers. Medicaid keeps millions of middle-class families from going bankrupt because of nursing-home and in-home care.
Medicaid benefits about 60 million people directly, and it plays a huge role in our lives: It's the backbone of nursing home care for seniors. It enables low-income people to survive and work their way up to a better life. Sixty-five percent of people who receive Medicaid are in working families.
Medicaid is how the poorest children get sorely needed medical care. Half of Medicaid recipients are children. The program serves millions of people with severe mental and physical disabilities and helps them live independently in their own homes. About half of Americans report some personal connection to Medicaid, because they have received health coverage or long‐term care themselves or have a friend or family member who has gotten this type of assistance.
The Romney-Ryan Medicaid plan would decimate families and communities. It would throw millions of seniors out of nursing homes. The average cost of nursing home care in the U.S. is $74,800 a year, while the median household income is only about $52,000. So middle-class families would be slammed with crushing health care costs for their parents while struggling to make ends meet, to save for their own retirement and to send their kids to college. The math just doesn't work. At the same time, children and people with disabilities would go without needed care. Huge costs would be shifted to state governments. Jobs would be lost. The economy would be hurt.
How would the Romney-Ryan Republican Medicaid scheme work? Under the current system, state Medicaid programs receive federal matching funds based on the number of people in need and the costs of care in that state. Under the GOP's block grant proposal, states would instead receive lump sums set in advance and capped. The Republican plan eliminates Medicaid's guarantee of coverage and would slash $810 billion in services over the next decade, beginning immediately. Federal spending on Medicaid would be cut by 34 percent in 2021 and 44 percent by 2030.
States wanting to maintain current Medicaid service levels wouldn't be able to. The reality is that those states would be forced to make substantial and painful cuts. Fewer people would be covered, and their benefits would be scaled back. Some states led by Republican governors would impose especially deep cuts. What's more, the block-grant plan would shift hundreds of billions of dollars in costs onto doctors and hospitals, sending private health plan premiums even higher.
Three million jobs would be robbed from our national economy, jeopardizing our recovery at a time when job creation should be the top priority. Millions of children in low-income families would have to make do without adequate medical services, hurting their quality of life and the quality of their education. For example, children with conditions like unmanaged asthma and chronic allergies would miss school and find it difficult to concentrate when they are in class, compromising their performance and limiting their educational and economic prospects.
Combined with other pressures like cuts in college aid, working and middle class families would fall farther and farther behind. All of this would be made worse if states choose not to expand Medicaid under the Affordable Care Act.
Romney and Ryan's plans to repeal the ACA, decimate Medicaid and end the Medicare guarantee aren't just an attack on health care - they're part of a comprehensive effort to undermine the economic security of all of America's families to pay for tax cuts for the rich and corporate interests like Big Oil. We can't preserve and expand the middle class if people don't have affordable health care they can count on.
The improvements Obamacare is bringing to Medicaid, Medicare and the private health insurance market are touching all of our lives in countless ways. Kids with pre-existing conditions are getting health care. Seniors are able to afford their prescriptions. Young adults can stay on their parents' health plan. Women can now get no-cost birth control and preventive health care services - and control their own bodies, plan their families and make their own health care decisions. These are just some of the many benefits of Obamacare that are already changing the lives of millions of Americans.
In Charlotte, the Democrats rightly celebrated the President's signature achievement and made clear they're going to run hard on it. Paul Ryan has said bring on this debate, so it's game on. Thanks to President Clinton, that debate now must include Medicaid.