Editor's note: This contribution by the late journalist I.F. Stone first appeared in our January 1975 magazine.
By Michael Ervin
President Obama was right to defend Medicaid from the Republican ax.
In his speech on Wednesday, April 13, Obama denounced the Republican "vision that says up to 50 million Americans have to lose their health insurance in order for us to reduce the deficit."
The Americans he was talking about included millions of people with disabilities who rely on Medicaid.
Obama was responding to the plan put forth by House Budget Committee Chair Paul Ryan, R-Wis., to restructure Medicaid as block grants.
Medicaid is an entitlement program, meaning those who qualify are guaranteed a minimum level of coverage for medical services. State and federal governments share the cost of paying for these services.
But under block grants, there would be no minimum level of coverage. States would receive a fixed amount of federal money each year to spend as they see fit. And that fixed amount would not be enough to cover everyone who needs it.
On April 4, 17 governors sent a letter to House Speaker John Boehner and other congressional leaders. The letter, initiated by Vermont Gov. Peter Shumlin, says, "We need federal policy that creates cost savings, not cost shifting."
The letter also says, "A Medicaid block grant imposed unilaterally by Congress on all states that would cap the federal government's share of costs and provide fixed annual funding below the projected growth of program costs is simply unacceptable."
It's simple math. With the federal government capping what it contributes, states would have to pick up the rest of the tab, whatever it might be. This will obviously leave state governments, the letter states, with "an untenable choice between increasing taxes, cutting other state programs, or cutting eligibility, benefits or provider payments."
People with disabilities who can't live without the support we receive from Medicaid are correct to fear what will happen if Ryan succeeds. Our assistance will quite possibly be cut off or severely curtailed. At the very least, we will be forced to pay out-of-pocket costs far beyond what we can afford.
Ryan and the Republicans don't appear to give a hoot about what happens to people with disabilities who depend on Medicaid. Obama needs to keep making the case for Medicaid, and the Democrats in Congress need to stand up to this onslaught.
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