Medicaid's Chickens Come Home to Roost

When the General Assembly passed a budget this past session, I voted "No" for a variety of reasons. One of them was because I thought that the Budget was "balanced" using some very risky strategies. You can read my comments here - Harry Byrd Rolls Over.

One of these was counting on about $400 million of federal Medicaid "stimulus" monies that had been approved by the U.S. House and Senate but were stuck in a conference committee waiting for a final compromise and President Obama's signature. Over the last two years, the Federal Government has reimbursed Virginia's Medicaid expenditures at $0.60 on the dollar instead of $0.50 on the dollar to help with state budgets. The idea was to extend that one more year. That was nearly three months ago.

The Virginia Medicaid Program cares for our low-income, elderly, and children. It cares for our most vulnerable citizens and Virginia's Program is the second most restrictive in terms of eligibility in the United States.

Today, I received an email from the House Budget Staff indicating that federal stimulus monies still were not approved yet and that the adopted Budget has restrictions that were triggers to start July 1, 2010 without the federal money. In order to be prepared for the spending reductions, Virginia is going to start announcing these "service changes." They are not going to be pretty.

If this comes true, first you are going to hear about the poor being denied medical care because more doctors and hospitals will stop accepting Medicaid patients. Then you are going to hear about service disruptions to the severely disabled. You are going to hear a loud scream from hospitals like Fairfax INOVA that gives birth to more children paid for by Medicaid than any other facility in Virginia. Finally, you are going to see a nice fat health insurance increase in your paycheck.

However, this is exactly what I warned about when the Budget was adopted. If we had assumed these cuts were going to occur, the State Budget might have been structured very differently because these kinds of program changes would not have been acceptable. Instead, a massive service disruption is about to hit down on our state's sick, elderly, poor and least capable of bearing these expenses - our most vulnerable.

If you want to see what's coming. Read my prior article - Second Class Citizens? - and watch the video embeded in that post.