PI Action alerts & updates ... 1997

Clinton Administration Considering Major Cuts
and Restructuring of Medicaid Program

50% of people with AIDS and 90% of children rely on Medicaid for healthcare and access to treatment.

The Clinton Administration is considering cutting as much as $30 billion from Medicaid over the next six years. In addition, it is considering implementing a “per capita cap” system on the program, which would set spending limits per person based on an average cost of health care delivery. This would most likely result in more people with HIV and AIDS not accessing effective treatments. Urge the Clinton Administration to protect this crucial health care program!

Action Needed:
Immediately call or FAX President Clinton, Secretary of Health and Human Services Donna Shalala, and Office of Management and Budget Director Franklin Raines. Urge them not to cut Medicaid. Tell them to continue to demonstrate the President’s leadership on this program as they attempt to draft a balanced budget.

Contact Information:

President Clinton
PH: 202-456-1111
FAX: 202-456-2461
president@whitehouse.gov
Donna Shalala
PH: 202-690-7000
FAX: 202-690-6608
email: N/A
Franklin Raines
PH: 202-395-4840
FAX: 202-395-3888
email: N/A

Sample Phone Message

“I am opposed to any cuts in Medicaid funding. In addition, I oppose any changes which would weaken the program, including per capita caps. Medicaid provides health care and treatment to roughly half of adults living with AIDS, and 90% of children, in this country. With promising new advances in treatment, it is inhumane to create additional obstacles to health care.”

Sample Letter:

Dear President Clinton/Secretary Shalala/Director Raines:

I am writing to oppose any cuts in Medicaid funding and any changes which would weaken the program. This includes a per capita cap system.

Insert a short personal note here. Explain if you or someone you care about relies on Medicaid. Otherwise, discuss the importance of access to health care and treatments.

Medicaid provides health care and treatment to roughly half of adults living with AIDS in this country and 90% of children. With promising new advances in treatment, it is inhumane to create additional obstacles to health care. I am counting on your leadership to once again protect this important safety net.

Sincerely,
Your name

Background Information:
Medicaid is government health insurance for low income persons. Currently, 36 million people, or one in eight Americans, receive Medicaid; over half of Medicaid recipients are children.

In some states, Medicaid is given a different name, such as Medi-Cal in California. Many states augment the federal program; for example, in California, Medi-Cal offers prescription drugs as a benefit. People living with HIV/AIDS depend heavily on this program.

70% of public dollars spent on AIDS care comes from Medicaid. Medicaid provides basic health care services to 90% of all children with HIV disease and nearly half of all adults with AIDS. Medicaid has become the only form of health care coverage available to many people living with HIV/AIDS because of discrimination, pre-existing conditions, decreased income, lifetime coverage limits, and other practices by private insurance companies.

Over the last two years, President Clinton has been a strong defender of Medicaid. He has fought against major reductions in Medicaid spending and in support of guaranteeing that all who qualify will receive benefits However, it appears that the President is willing to sacrifice much of his support for this program in order to balance the budget by the year 2002. While a $30 billion reduction in Medicaid spending is smaller than the amount proposed by Congress in 1995, it is important to note that Medicaid costs grew at a low rate (3.2%) last year.

In addition, at a time when many people living with HIV/AIDS are experiencing great benefits from new therapies, we can not afford cuts or changes in the Medicaid program that will diminish access and quality of health care. Already, studies have shown that many Medicaid recipients living with HIV/AIDS are receiving a lower level of care. These cuts would worsen the situation.

Furthermore, the proposed “per capita cap” system, which limits the federal payment for each Medicaid recipient, would disproportionately affect people living with HIV/AIDS and some other life-threatening illnesses, because the cost of their care is significantly higher than that of other Medicaid recipients. Since that cost would exceed the federal “cap”, states would have to cover more of the cost, resulting in possible restrictions in benefits or eligibility categories. For example, states could eliminate or reduce prescription drug coverage, currently an optional benefit.

Also, states which have shown lower expenditures even with high HIV/AIDS caseloads (such as California) would be penalized for their efficiency by receiving lower per capita rates. Finally, these proposed changes to Medicaid need to be looked at in the context of other recent changes to health and social service programs, including welfare, food stamps, and Medicaid waivers that are forcing people into managed care.

Many of these changes first target women and their children. The safety net for low-income people is already being dismantled, and now is not the time to add more financial burdens on states and localities as they attempt to fund programs that help those in need. Nor is it time to ask women who may be heads of low-income households to carry more of the impossible burden of expensive health care.