Obama’s Medicaid Cuts Add Cost in Kansas
The Kansas legislature at least recognized Parkinson’s cuts were perhaps less than bright. The legislature is proposing to shift funds from the general fund monies normally allocated to services for the disabled to cover the waiver costs. However, this still leaves these agencies with major budget shortfalls and hard choices to make. One Kansas agency has lost 30 jobs and cut administrative salaries by 10 percent across the board.
More money out of the economy at a time when we need more, not less.
In the meantime, according to Greg Jones of Southeast Kansas Independent Living Inc., 65 people in the state of Kansas have died while waiting for the sorts of services the waiver provides.
Kansas is far from the only state facing these woes. According to the Western New York Law Center, multiple states are either cutting the waiver program entirely or limiting Medicaid benefits in other ways. Even a cursory Google search brought up news story after news story of states cutting the waiver program in an attempt to save money.
I grant that in economic times like these everyone is having to make cuts, but these are stupid.
The solution to the problem is really quite simple — and therefore apparently beyond the capability of Secretary of Health and Human Services Kathleen Sebilius to understand. Simply require in-home services to be reimbursed in the same way as nursing home services.
We now have the so-called Patient Protection and Affordable Care Act. If the goal of that “reform” was really to save costs and make sure people were covered, this would have been a simple way to do so.
The real problem here is cookie-cutter solutions imposed from the outside forcing states to make tough choices which cause the most vulnerable citizens to fall through the cracks.
The real solution is to give states the freedom to solve their own problems, not mandate solutions from the outside. Too often, those simply make the problems worse.
In the meantime, people continue to die waiting for help, or stack up in nursing homes they are unlikely ever to leave. If all of the people waiting for in-home services were to go into a nursing home tomorrow it would overwhelm the system — there are simply not enough beds for them.
A little common sense in where money is spent and where the budget is cut would go a long way to solving budget crises nationwide.
Unfortunately, common sense is anything but common.
Obamacare’s “cost savings” come from being able to cut the healthcare budget and call it that. That’s it. Good luck with anything else.
I spent five years caring for my Mother at home after she had two strokes, one that took 95% of her eyesight and the 2nd that took away her judgment and the ability to recognize danger. I left a good paying job to do this, exhausted all our savings, hers and mine, to support us. Everyone tried to force me to put her in a nursing home, but we tried that for two weeks and, although there was nothing wrong with her brilliant mind, they consigned her to the Altzheimer’s wing, kept her tied in bed or in a wheelchair, put her in diapers and wouldn’t allow her to feed herself. She begged me to get her out of there before they killed her.
Had she stayed, Medicare/Insurance would have picked up the full tab, but instead, there was no financial aid available to me for doing the same job, only better, and with a lot more love. Not only that, but I end up being penalized since I lost all those working quarters toward my own social security benefits, not to mention that it is near impossible to break back into the working world when you are in you are in your late fifties and have a five year gap. And I now have no savings left to take care of myself in my senior years.
We live in California. There is something very wrong with a system that penalizes you for saving the government money. I couldn’t even claim my Mother as a dependent since she had some income from her own social security.
What this article does not discuss is that “optional” services probably cannot be legally eliminated, once offered by a state. States moving to eliminate such optional services are sued and the courts rule that the optional services may not legally be eliminated based on the “integration mandate” in the Americans with Disabilities Act. This requires state services to be provided in the “most integrated setting” available. If eliminating optional home and community-based services in the community means that Medicaid clients will need to move to a nursing home in order to receive services the integration mandate is violated, because nursing homes are considered institutions. Most likely the court will block the cut, regardless of the costs to the state. Many states seeking to reduce their Medicaid costs by eliminating optional services in the community have been blocked by the courts under this theory – most notably and recently in California and Washington States.
Actually Cathy, the courts haven’t blocked the cuts. States are reimbursed for nursing home stays by the federal government, but the law does not require the government to reimburse for “waiver” services. What the waiver does, is allow medicaid dollars to be spent on “non medical” care. In the past, the government has reimbursed all medicaid costs. Moreover, the states are not cutting the waiver entirely, but cutting the wavier budget. I could perhaps have made that more clear.
What happened, in Kansas at any rate, is that the Governor cut medicaid funding by 10% across the board. As federal law says nursing home stays _must_ be paid for, what the state cut was the amount of total waiver dollars available. It is not that the waiver is no longer in force, it is, but fewer people can now _get_ the waiver and the waiting list is longer.
As the requirements for the waiver are the same as for a nursing home stay, simply increasing the number of waivers approved would actually save the state money.
In many states, including mine (Washington State), home healthcare workers on the state payroll are required to join the SEIU. Wouldn’t it be a hoot to have the rank and file SEIU home health service providers joining with tea partiers to lobby the states together on this issue? It would totally turn the MSM on it’s ear!