The chairman of the U.S. House Budget Committee, Paul Ryan, R-Wis., recently released the House Republicans’ alternative budget proposal for the next fiscal year. It is absolutely devastating to America’s working families and children, while preserving the Bush tax cuts for the wealthy.
At least two-thirds of the huge budget cuts in the House Republicans’ plan come from programs that help lower-income Americans: Medicaid, Pell Grants for college, food stamps and affordable housing.
The worst cuts are reserved for Medicaid — the federal-state program that helps vulnerable children, people with disabilities and the elderly obtain basic health care. The Republicans’ proposal would cut this vital program by almost one-third.
In New Mexico, Medicaid insures more than 550,000 people, including one-half of all the state’s children. It pays for well over half of the state’s nursing home beds. It is a critical source of funding for our rural health centers and major urban hospitals.
Medicaid already pays about as low a reimbursement rate as you can go. How are we supposed to provide this coverage with one-third as much federal money?
The House Republicans’ answer is simple: Come up with more tax money from New Mexicans, raise private insurance rates in New Mexico even more (we already have had the highest increases in the country), and/or just don’t provide care for these folks.
These are all unacceptable choices.
The Republican budget plan does the same thing to Medicare, the program that provides most health care coverage for Americans age 65 and older, including almost 300,000 in New Mexico.
Right now Medicare pays medical costs directly, taking a huge burden off the minds of senior citizens all over the country. It spends only 3 percent on administration, compared with the 15 percent or more at private companies.
The Republican plan would end Medicare as we know it and instead give each senior citizen a sum of money to buy commercial insurance. What a bonanza for the insurance companies! But what happens if the money is not enough to buy decent insurance?
Grandma and grandpa are on their own. If they are rich and can afford the coverage, great. But what if they can’t?
One of the many ironies of the proposed plan is that it does nothing to get national health care costs under long-term control. We have the most expensive health care system in the world but don’t get good results for all the money we pour into it. Almost all health care is provided by the private sector, and the costs have been growing for years at a much faster rate than inflation and income growth.
Since the federal government, mainly through Medicare and Medicaid, pays half of these rapidly rising costs, the projected growth in federal health spending is by far the biggest contributor to our long-run deficit problems. If our health care cost only as much as it does in Europe (where people are often healthier and live longer than Americans), we would not have the anticipated future deficits. Rather, we’d have budget surpluses.
The Federal Health Care Reform law passed last year has many ideas designed to control increasing health care costs. These include more preventive care, better coordination of care (especially for the elderly and chronically ill), and more. The Republican plan would repeal health care reform and throw all these good ideas out the window.
So in trying to slow down federal budget deficits, the Republicans propose eliminating the only instrument we have to control a major contributor to those deficits: exploding health care costs.
Here’s a better idea: Keep the Health Care Reform Act so we can keep working on cost control and tell the House Republicans to go back to the drawing board with their short-sighted and heartless budget plan.
Rep. Danice Picraux is immediate past chairwoman of the state Interim Committee on Health and Human Services.