Mar ‘11
16
The Medicaid Program is a Tsunami Which Might Drown State Education Funding
Talk to Ray Sheppach, the executive director of the National Governors Association. He will tell you that state revenues increased at an average rate of 6 ½% a year from 1978 to 2008 and this allowed states to keep up with both rising eligibility for the state-federal health program, and with rising costs of health care. Since the recession hit, there’s been no increase and it will be 2014 before states get back to the 2008 revenue level. He talks like Medicaid, with the addition of A.C.A., could bankrupt states unable/unwilling to increase taxes. So what are the choices? (1) Increase the federal matching rates for state spending, as the A.C.A. has done. Republicans won’t let that happen. (2) Go to federal block grants to the states to cover some specific categorically eligible. That likely means cuts in benefits to a lot of needy. (3) Reduce payments to providers. Which is what states do already and results in providers dropping Medicaid patients.
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Dave, I agree that it makes no sense to cut program funding when the number of people needing the funding is growing, in large part because of the economy. But, raising taxes or revenues, however that is done, tends to be a forever kind of thing with the legislature and political establishment. Voters like me who don’t trust the government to reduce revenues and spending when the economy improves and government coffers grow at healthy rates again (6.5% per year is more than I have ever received for a annual raise) will need some assurance that government can wean itself of the additional revenue source when the time comes.
I’m not sure how to accomplish that, but I do like reading your thoughts about this and other issues. Keep them coming. You are a reasonable voice in a very loud room these days, and I’m hoping your persistence pays off in the end.