Granholm to order deep cuts in Medicaid

[Bozita]

Source: Detroit Free Press

Granholm to order deep cuts in Medicaid
BY PATRICIA ANSTETT • FREE PRESS MEDICAL WRITER • MAY 1, 2009


Gov. Jennifer Granholm is expected to order significant Medicaid cuts Tuesday that could force layoffs, program closings and postpone projects and improvements at Michigan hospitals, doctors' offices, nursing homes and community mental health facilities, according to the state's largest hospital association.

Spencer Johnson, president and CEO of the Michigan Health & Hospital Association, said the association learned Friday from key legislative leaders, including several appropriations committee members, "there definitely will be cuts" in the Medicaid budget and he expects a 4% across the board cut in provider payments.

The cuts could grow from $10 million to $33 million because Michigan would lose federal matching funds if the state cuts its contribution to the program.

It's unclear whether the governor will order cuts in Medicaid reimbursement rates to HMOs, Johnson said.

Read more: http://www.freep.com/article/20090501/NEWS06/90501068/Granholm+to+order+deep+cuts+in+Medicaid

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Don't miss the comments below the article. Some of them are just unbelievable.

[bluestateguy]

1. She should raise taxes

Income taxes, car tag fees, sales taxes, and property taxes.

I'm all for cutting spending, but at a certain point, you have to draw the line.

[Psephos]

2. So that more people and businesses who pay taxes will leave?

That hasn't worked out so well here.

[defendandprotect]

5. Agree --

[blue_onyx]

7. She did in 2007

and that took shutting the government down (although only for a few hours) in order to get the tax increase passed. The chances of her getting the congress to go along with another tax increase is very slim.

[notadmblnd]

16. all that has already been done.

perhaps you don't understand? We have no jobs here. People who have no jobs, pay no taxes.

[groundloop]

20. Why not try.....

Another TAX CUT. That should fix any problem you can think of.

:sarcasm:

[Raspberry]

21. Well, actually--

--if business taxes were lower, maybe businesses (and jobs) would move into Michigan

[blue_onyx]

22. High business taxes are not Michigan's issue

We are, at worse, rated in the middle of the pack as far as tax burden is considered. The idea that cutting taxes solves everything is a worn out GOP Reaganomics principle that has failed MI and our country.

[roamer65]

23. Here is Michigan's tax problem.

The flat rate state income tax. It needs to be a progessive/graduated income tax. However, we will have to rewrite the state constitution to do it.

[tomm2thumbs]

3. we need to raise taxes on teabags

oops, little late

[defendandprotect]

4. A Democrat -- ????

[SharonAnn]

6. Like Bredesen in Tennessee who cut TennCare. If there's no money, something's

got to give.

[defendandprotect]

10. Federal Government should subsidize the Medicaid account . . .

the losses are based on Congress severe reductions of taxes on wealthy -- all states

are in trouble because of it --

[Baby Snooks]

19. I've never understood why it doesn't...

Telling states they have to pay a percentage is merely telling states they can cut off who they want to. Which as we're seeing several states are doing. Although some have done so all along.

[No Elephants]

14. By definition, we are talking about people who are sick but can't afford

to pay for treatment.

My son's good friend died because he did not seek treatment--no medical insurance. By the time my son and another friend physically forced him into an Emergency Room, the doctor said he was too far gone to treat.

That should never happen in America. Never.

[brentspeak]

8. She doesn't have much choice

Washington abandoned Michigan to the "free" trade wolves a long time ago, and now there's nothing but unemployment. No money in the coffers.

[blue_onyx]

9. absolutely

I think people forget that MI has been in recession for 8 years because of the US auto industry. Granholm increased taxes in 2007 and won't likely get congress to pass another tax increase any time soon. We've increased fees and cigarette/alcohol taxes many times. She's been cutting little by little but now she has nothing left but important things like Medicare. It's sad but she has to do something.

[defendandprotect]

11. Much of this is happening because of the loss of taxes from t he wealthy . . .

they should be restored -- the states are suffering because of it --

And, meanwhile, the Federal government should step in to restore that lost income!!!

[blue_onyx]

17. Yes, the federal gov. should

It's frustrating that MI has lost more jobs than New Orleans/Louisiana did after Hurricane Katrina and yet we haven't gotten federal aid.

[susanna]

12. Thank you, brentspeak.

I was trying to articulate this exact same thing in earlier, abandoned posts. You did it in far less words than I could. Here's my final summation...cut to the quick, as it were:

Double-digit unemployment = too few taxpayers = eventual and painful cuts.

I am (unfortunately) not surprised by this. :-(

[Mnemosyne]

13. The ignorance in many of the comments is

unfathomable!

Thanks for post, Bozita.

[Vinca]

15. One more reason for single payer, universal healthcare.

Medical services wouldn't be affected to a state having economic problems.

[aejlaw]

18. ABUSES TO MEDICAID

There are some abuses to Medicaid here in Michigan that could be remedied. For example you are allowed to keep your "Homestead" and still qualify for Medicaid. Your "Homestead" can consist of a home situated on 1,000 acres of land and still qualify as a "Homestead". You can own a "Homestead" in Gross Point worth millions and qualify for Medicaid. You can transfer everything you own to your children and after a waiting period qualify for Medicaid. With nursing home costs at $5,000 plus a month don't think for a minute that the wealthy do not take advantage of these provisions. You can have several millions of dollars in cash and shelter it by buying a nice "Homestead" or "spend down" your cash by making improvements to your present "Homestead". Of course once you die your children will inherit your "Homestead" tax free and the state and federal government are out of luck for all of the medical and nursing home care they have provided. Its called "Medicaid Planning" or some such thing and it is widely used and abused here in Michigan and probably all over the country, and there are lots of other little tricks used to circumvent the original purpose of these programs. Unfortunately these cuts will apply "equally" to everyone whether or not you need help. I don't blame Governor Granholm for any of this. She inherited this mess from Republican Governor Engler. She has had to work with Republican controlled legislatures for her tenure. She is required by law to balance the budget. So she makes cuts while trying to protect the schools and health care programs, but she has run out of options. In Michigan we are witnessing "The Starving of the Beast" which Grover Norquist and his think tank fellows so delight in. Unfortunately the Beast turns out to be us.

[eilen]

24. Medicaid cuts -- an unavoidable situation.

Healthcare and education account for over half of all state budgets so I think it is unavoidable in economically challenged states. There are different things state governments can do to decrease expenditures such as tighter requirements to qualify for benefits and limiting certain kinds of benefits as well as requiring a spend-down or copay-- Until the system is overhauled and transformed to a more global coverage for all Americans, it is sadly up to the states to soldier on, each alone in their own endeavors to care for their least fortunate and highest risk citizens.


In NY we have a 5 year look back for Medicaid (so far as investments and property other than the principle residence) but I think you can still own your home and a vehicle and be eligible to receive it; however, your income must be low and meet requirements. If you are entering a nursing home, mostly the homes start out accepting medicare or if you are medicaid pending, you must spend down (thus the 5 year lookback--they get the info, and tell the family what the cost to keep their parent there. They take not only medicaid, but also your SS income except a small amount. The medicaid does not really cover all the NH expenses but once you are out of everything else, they have no choice.

This is part of the reason people choose to keep their parent home, so they don't lose the property or other assets. Sometimes this leads to adult neglect and abuse. Personally, I think it is a good thing for people to care for their elders. One way I think government could keep costs down is to provide some in-home monitoring/health care assisting the family in the way of adult daycare, respite, assist with ADL's (2 hrs of home health aides 3x a week for example) and community resources as well as monitoring the health (physical and mental) of the parent to prevent hospitalizations and to intervene when it is apparent they truly require more assistance (like a home aide at night to keep the senile parent from wandering unsafely and falling, or setting the house on fire, and allow the family to get some sleep). This can be done through community -health, visiting nurses. This keeps the tax base stable as well as communities.

State Medicaid, Medicare and the DHH should work together to promote prevention programs as well as crack down on fraud perpetrated not just by recipients (which is a popular group to point the finger at) but also the providers. I am sure many are aware of the changes in reimbursement on hospitals who receive frequent admissions (within 48 hours in some cases) and in pts who acquire bedsores and nosocomial infections like MRSA and VRE. This has resulted in hospitals discharging pts even sooner to avoid occasion for bedsore formation etc. This is another place I see the role of community health expanding-- managing the chronic diseases that precipitate hospital admissions such as heart failure, diabetes, cancer treatment complications such as dehydration, COPD, uncontrolled pain conditions.

So while it is incumbent upon state leaders to look for cuts in expenditures in order to manage their shrinking budgets, it is my hope that they look outside the box and make meaningful changes in the way the care is managed so that they can continue to serve just as many people that need it but doing it "smart".