The Governor is set to announce his budget sometime in the next ten days. The word from Richmond is that we have an approximate $1 billion shortfall. One of the big drivers of that is medical inflation reflected in our Medicaid budget.
Medicaid is a federal-state health insurance program for low-income and disabled people. It is also the only provider of long-term nursing care for many Americans, since Medicare coverage and coverage by most private insurance policies is quite limited. Virginia has one of the most restrictive programs in the United States - you have to be very poor to be eligible. Most rankings put Virginia at 48th in Medicaid expenditures and 7th in per capita income. In other words, we are a relatively wealthy state and we do not help the poor much.
A significant portion of Virginia's Medicaid population are children, elderly and the blind. Here's how Virginia's 881,075 Medicaid recipients played out in 2008:
- 480,392 Children
- 177,755 Blind & Disabled
- 140,716 Adults
- 82,212 Elderly
This is where the rubber hits the road. Last week, I sat down with a doctor on Route 1. He pointed out to me that he is one of the few general practioners who is willing to see patients whose expenses are covered by Medicaid and there are quite a few Medicaid patients in my district. He explained to me that he had few options when he had patients who needed to see a specialist.
He said the closest Rheumatologist he can refer to is in Winchester. The closest Orthopedic Surgeon is in Richmond or Charlottesville. Specialists refuse to participate in Medicaid because they are paid close to $0.60 on the dollar for their fees.
This far, the Governor is promising to increase secondary education spending, take about $110 million out of the General Fund for roads, fund our Rainy Day contribution plus the our required replenishment of the retirement money that was raised last year without raising taxes. I can only see one way to do this - significantly cut Medicaid. I hope that's not the case.
Making the poor, infirm, and elderly travel 240 miles round trip for a routine doctor visit is just wrong. Also, every time we cut Medicaid hospitals make it up on the back of patients with private insurance. It's one of the reasons that healthcare costs are out of control.
Underfunding of Medicaid has been going on for years, especially in Virginia. This kind of budgeting is not sustainable and I hope that the Governor does not focus most of his cost cutting on Medicaid. If so, the 44th District is going to take it on the chin.