Romney’s Medicaid cuts would be devastating to nursing home care and the disabled

September 17, 2012

Posted by AzBlueMeanie:

During his DNC Convention speech, former president Bill Clinton raised a subject that had been largely ignored by the media until then — the Romney/Ryan proposed cuts to Medicaid that would immeidately affect many seniors on Medicare (the "dual eligibles"). DNC 2012: Bill Clinton’s speech at the Democratic National Convention (Full transcript):

Now, folks, this is serious, because it gets worse. And you won’t be laughing when I finish telling you this. They also want to block grant Medicaid and cut it by a third over the coming 10 years. Of course, that’s going to really hurt a lot of poor kids. But that’s not all. A lot of folks don’t know it, but nearly two-thirds of Medicaid is spent on nursing home care for Medicare seniors who are eligible for Medicaid. It’s going to end Medicare as we know it. And a lot of that money is also spent to help people with disabilities, including a lot of middle-class families whose kids have Down’s syndrome or autism or other severe conditions. And, honestly, just think about it. If that happens, I don’t know what those families are going to do. So I know what I’m going to do: I’m going to do everything I can to see that it doesn’t happen. We can’t let it happen. We can’t.

As everyone knows by now, Clinton departed from his prepared text and was winging it for much of his speech. Sarah Kliff at Ezra Klein's Wonkblog at the Washington Post fact-checked this portion of Clinton's speech, and found that his prepared text on this subject was accurate. Fact-checking Bill Clinton on Medicare:

Lots of folks don’t know this fact… because it’s not true. Clinton here is referring to the 9.1 million seniors who are low-income or disabled, making them eligible for both entitlement programs. In health wonk terminology, they’re referred to as the “dual eligibles.”

Dual eligibles certainly cost more than other Medicaid enrollees, like children and pregnant women. But there’s no evidence to support that these patients eat up two-thirds of the Medicaid budget. Kaiser Family Foundation looked at this issue in an April 2012 brief. It found that, “Although these ‘dual eligibles’ accounted for only 15 percent of Medicaid enrollment in 2008, 39 percent of all Medicaid expenditures for medical services were made on their behalf.”

Clinton’s prepared remarks on this point, however, were quite different. Here’s how those went: “Almost two-thirds of Medicaid is spent on nursing home care for seniors and on people with disabilities, including kids from middle class families, with special needs like, Downs syndrome or Autism.” That checks out: the Congressional Budget Office estimates that 63.5 percent – or $148 billion – of federal Medicaid spending ($251 billion in total) goes towards the elderly, blind and disabled.

Bloomberg News last week looked at this issue and found Medicaid to Lose $1.26 Trillion Under Romney Block Grant – Bloomberg:

Republican presidential nominee Mitt Romney would strip Medicaid of $1.26 trillion over nine years as part of a plan to do away with the open-ended approach to funding the U.S. health-insurance plan for the poor, a Bloomberg Government study found.