Critics Say More People Are Going to Die Needlessly Due to Legislative Inaction –
Watch this shocking video to see what legislators are saying about the inevitability of many people dying due to the budget shortfall. –
By Glynn Wilson –
MONTGOMERY, Ala. — More sick babies, old folks and poor people are just going to have to die. Sorry. When it comes to a constitutional mandate to balance the budget, by god, tough choices have to be made.
That is, hint, hint, unless thousands of people come out of the woodwork and surround the Capitol grounds and let the politicians hear from them. Inside, what some news wires used to call “lawmakers,” openly admit they are not hearing from Medicaid recipients or their advocates. Their phones are ringing off the hook, however, from people willing to offer campaign contributions for passage of a bill that would create a special, shiny new tax credit for anyone willing to refurbish old plantation mansions.
That’s the New South Alabama style.
That’s the message coming out of the state capital from mostly white Republican men this month in what some critics are calling the new Republican “Death Panel.”
That’s what they come up with when trying to forge public policy to fit the desires of ignorant, conservative constituents — fueled into a hateful budget cutting rage by commentators on talk radio, Fox News and the right-wing tea party blogs.
Even the conservative doctor governor now ensconced in a titillating alleged sex scandal that apparently doesn’t really involve sex — just an embarrassing tidbit of early phone “sexting” which just happened to get recorded apparently by his now ex-wife — had the gall to veto the budget that cut another $85 million for the state Medicaid agency. It seems now the governor who campaigned and got reelected on a promise to refuse a billion dollars a year from the Obama administration for his people’s health care under the Affordable Care Act seems to have more heart than state Senators like Trip Pittman, chairman of the joint House and Senate committee charged with figuring how to gut the social service agency even more.
As our previous reporting shows, estimates indicate that as many as 3,669 people have already died in the state over the past three years due to the state’s refusal to expand Medicaid with federal health care dollars. That’s about 1,223 people a year. How many more must die?
In a presentation to the committee state Medicaid Commissioner Stephanie Azar explained why the agency asked for an additional $100 million this year. The budget proposed by the Legislature gave them a mere $15 million increase for a program that had already been denied about $3 billion in federal money so the Republicans running for office could make political points in the last election cycle.
In a true bit of political demagoguery, legislators have been quoted as saying the agency, which accounts for about 38 percent of the General Fund budget, is guilty of “cannibalizing” other state agencies in its needs to help the young, old, poor and sick. That accounts for about one-fifth or a little more than 20 percent of the state’s population.
Everybody admits the program is critical for the state’s health care system, especially without the federal money the state turned down. All hospitals and most doctors, especially pediatricians, depend on Medicaid to stay in business. There are already stricter eligibility requirements than most states, and most states took the federal money to expand Medicaid and cover almost all their citizens with some level of health care.
There seems to be a debate still in Alabama about whether “able-bodied” people who COULD work are living off the “gov’ment,” although the debate doesn’t seem to involve the poor job market in many parts of the state. How are they going to work if there are no jobs? A man or a woman of working age who is not physically or mentally disabled can only qualify for Medicaid benefits if they have a child under 19 who is eligible and they report an income of less than $2,892 a year. Yes, you heard that right. The threshold is $2,892 a year.
The poverty line pay rate for a family of four in the state is considered to be $23,834 a year. The number who fall below that line is 883,371. A little more than 1 million of Alabama’s 4,716,105 residents qualified for Medicaie for this fiscal year, which began in June.
The goal of the new Medicaid hearings seemed unclear even to the mainstream media reporters and bloggers who cover the State House. The Republicans who control both the House and especially the Senate have indicated no willingness to reconsider the 2017 General Fund budget, approved earlier in April over the governor’s veto.
Pittman, who has been busted for ethical problems in the past for accepting a $639,000 contract to lay boom in Mobile Bay while he was involved in oversight of how to spend Baldwin County’s share of the BP oil spill disaster money, was put on the spot Wednesday (see video). But in the end, he predicted some level of Medicaid cuts would survive the session, mainly because he is hearing more from people who want the old house tax credit than those who want to see Medicaid fully funded.
“At some point these impacts have to be felt,” he said, quoting Republican Senator Del Marsh of Anniston. “Some of these cuts will be made. Those impacts will have to be felt, and people will react to what ultimately happens.”
Cuts already mentioned include outpatient dialysis for kidney disease, meaning many clinics would close, as well as hospice care and even reimbursements for prescription drugs for seniors. The state would also cut a small supplement to primary care physicians, meaning many of them, especially in rural areas, would change their practices to stop taking Medicaid patients — or even give up on Alabama and move to another state to practice medicine.
“If we were to cut any of these providers . . . we would have the possibility that some of these providers would close,” Azar testified before the committee on Wednesday.
Before the hearing, in a press briefing called by Alabama Arise and a coalition of other non-profit groups, Troy pediatrician Nola Ernest said half the doctors polled in a survey said if Medicaid is not fully funded, they would either stop treating Medicaid patients or move to another state (see video).
After the hearing, Azar said the governor had not yet decided what cuts to make to fit the new budget. So there may still be time to lobby Governor Robert Bentley to do the right thing. The Legislature may not listen to him, but maybe it’s worth a try?
Azar’s presentation, which is now available online, showed how two-thirds of the $6 billion program is paid for by the federal government from federal taxes. The state only has to come up with 11 percent of the money that serves a little more than a million people, the only thing keeping many of them alive. Hospitals themselves absorb a significant share of costs by charging Medicaid patients less than those with private health insurance.
And no, a majority of those who qualify for and recieve Medicaid services are not black. In fact, 45 percent of them are white.
While there has been a 30 percent increase in eligible Medicaid patients since 2008, Azar showed how the state agency has kept the cost per recipient level over the past 8 years. She debunked the notion out there in some forums that growth in the program is “out of control.”
Furthermore, the state does not determine who is eligible, she said. It is a federal program.
Rather than looking at a billion dollars a year in increases from the feds, the state is losing $73 million in one-time money this year.
In one of the few questions asked by committee members during Azar’s presentation, Decatur Republican Senator Arthur Orr seemed to be searching high and low for some category of individuals the lawmakers could boot from the program, including those who cut grass for a meager living and do not make enough to owe taxes. The yard man’s kids might be eligible for Medicaid. Horror of horrors.
He also pressed to see if the Legislature could do anything about people living in $100,000 homes who “refuse” to work. Nope. Nothing they can do there either. Again, the feds determine eligibility and the value of your home has nothing to do with it. You can even have one car and still qualify. What a shame, especially if a car is essential to get to any jobs in the South, a region where the very idea of mass transit runs tantamount to Communism.
Some people in the crowd and Senator Linda Coleman, a Democrat from Birmingham, pointed out that there are many old people who live in homes they inherited from relatives or paid for in their working lives but do not have adequate retirement income to pay for private health care.
After the hearing, Chairman Pittman faced a small contingent of reporters and bloggers still covering goings on in Montgomery, a dwindling group shrunk from 22 reporters who covered that beat 25 years ago.
He admitted that the federal government pays for most of the program, but used the opportunity to try to make points for the Republicans in the upcoming presidential election by blaming the problem on the feds, an age old tactic in Alabama going at least back to the days of George Wallace.
He made clear that lawmakers want to dig into the requirements of the federal Centers for Medicare and Medicaid Services, including checking people’s net worth like is done for Food Stamps and Welfare recipients. They want to look at certain types of doctors they don’t like, maybe abortion providers? They want to see if they can boot some of those who receive Social Security disability payments, a program “that may be too liberal,” Trippman said, and “not discerning enough on whether somebody is really eligible.”
“There are needy people out there who need help,” he admitted. But they wish they had the power to “ensure that those receiving the services really do need the services. Because there is enough need out there and right now there’s not enough money to be able to cover those.”
When confronted with the question of turning down the federal billions, he claimed taking it would only have been a short term solution.
“When you cover more people you’re not going to save money,” he said, although studies showed that the high paying jobs in the health care industry that would have been funded by the federal subsidies would have more than paid for the increased cost to the state by expanding Medicaid and covering everybody.
“The federal government would have covered those initial costs, but the reality is, the federal government is running trillion dollar deficits,” he said, another issue the Legislature has no control over or even a say so in the process.
He denied playing politics with people’s lives, even though he seemed to acknowledge that some people would just have to die.
“We all die sometime,” he said in response to a reporter’s questions. “We’re all mortal. We all have a finite period of time on earth. I think sometimes we confuse saving lives with extending lives.”
In a state where a “right to life” and saving the unborn children who are victims of abortions is a litmus test issue for anyone running for public office, Pittman complained that “We’re spending more than 40 percent of the money on children in their first year of life.”
He added: “We’re spending a lot of money on the elderly, at the end of life. I think as a society we need to debate and look at all of these things. If not, you’re going to get into rationing.”
He said tough choices have to be made, “and we’re all going to have to come to grips with our mortality. It’s just a fact of life.”
Football season doesn’t start until August, he said, so maybe if the media would just do its job, we can have a real debate on these “real and difficult issues.”
“They’re not going away,” he said. “They have reached critical mass.”
He turned to the national presidential election coming up in November 2016.
“I would argue that of all the issues coming up in this election, health care is the biggest one,” he said. “It is the biggest challenge we face. Attempts have been made, and I at least give the Democrats credit. They are reaching out there and trying to do some things. Mr. (Bernie) Sanders has some plans on what he wants to do.”
Senator Linda Coleman, one of the few African-American women in the Legislature, a Democrat from Birmingham, countered the argument that taking the federal money to expand health care would not have helped with the state budget. She said it would have helped set up the Regional Care Organizations the state is now turning to.
“If we had taken that money when it first came out … we could have already had that taken care of,” Coleman said. “Then we would have been well on our feet to do that. Right now we just cut our noses off to spite our faces. All the other states have taken that money. They’ve taken our money because part of that money was our (federal tax money) but we didn’t take it. And so we’ve backed ourselves into a corner. To me that is very short sighted that you would hurt your people not to take this.”
See This Extra Video
The national mainstream media, including the Washington Post, seems to think the sex scandal involving allegations of an affair between Republican Governor Robert Bentley and a married, female aide not even on the government payroll (see this is not even a gay Republican hypocrite sex scandal or a scandal involved misuse of taxpayer money) has the state so shut down no business is being conducted. But in fact, the Legislature is in session and about to kill thousands of people by cutting Medicaid by another $85 million after the governor and Legislature refused a billion a year from Obamacare, federal money for health care.
© 2016, Glynn Wilson. All rights reserved.