Bush to Seek Cuts in Medicaid, Benefits

Sat Jan 22,12:28 AM ET

By ALAN FRAM, Associated Press Writer

WASHINGTON - President Bush (news - web sites) is readying a new budget that would carve "savings" from Medicaid and other benefit programs, congressional aides and lobbyists say, but it is unclear if he will be able to push the plan through the Republican-run Congress.

White House officials are not saying what Bush's $2.5 trillion 2006 budget will propose saving from such programs, which comprise the biggest and fastest growing part.

But lobbyists and lawmakers' aides, speaking on condition of anonymity, say he will focus on Medicaid, the health-care program for low-income and disabled people. Medicaid costs are split between Washington and the states.

Many expect him to propose giving states more flexibility in using the $180 billion in federal Medicaid funds each year, but to limit the program's growth on a per-patient basis � in effect forcing the states to find ways to save money.

Bush may also propose trimming doctors' reimbursements or weeding fraud from Medicare, the health insurance system for the elderly and disabled, the aides and lobbyists said.

He may seek savings from agriculture and other benefit programs as well in the spending blueprint he will send to Capitol Hill on Feb. 7.

There has not been a serious effort to pluck savings from such programs � called entitlements because the benefits go automatically to anyone who qualifies � since 1997.

After two straight record federal deficits that peaked at $412 billion last year, many Republicans are eager to constrain government spending by curbing the growth of benefits. By law such programs, which consume nearly two-thirds of the budget, grow to keep pace with inflation and ever-larger numbers of recipients.

Conservatives � including the chairmen of the House and Senate budget committees, Rep. Jim Nussle (news, bio, voting record), R-Iowa, and Sen. Judd Gregg (news, bio, voting record), R-N.H. � may want to go even further than whatever savings Bush proposes. Many of them consider Bush's goal of halving the budget deficit by 2009 too timid, and see the coming retirement of the 76 million baby boomers as threatening to snowball federal spending.

"There's this demographic tidal wave coming at us," Gregg said in a recent interview. "We've got to adjust our retirement structure to maintain a strong program for retirees" while making sure younger people won't "be taxed to the point where their lifestyle is significantly reduced."

Other Republicans, recalling past Democratic attacks when such programs were targeted, are wary. Veteran Rep. Christopher Shays (news, bio, voting record), R-Conn., said many lawmakers would support such cuts if they would balance the budget in the short term but would be unwilling to "take a big hit" for incremental deficit reduction.

By proposing an overhaul this year of Social Security (news - web sites), the biggest benefit program at more than $500 billion annually, Bush has asked GOP lawmakers to risk angering senior citizens worried about the retirement and pension program.

Simultaneously pursuing savings from other programs would only increase many legislators' heartburn.

They would face the wrath of doctors � major GOP contributors � should Bush propose limiting the Medicare payments physicians receive. Governors of both parties are already trying to head off any effort to trim Medicaid, while farmers, veterans and other groups would be sure to combat any efforts to curtail their benefits.

"It's obviously going to be a very difficult lift," Nussle said recently.

"Everyone has a program, everyone has a constituency, everyone has a point where they lose their courage to reform a government that is too big," he said. "Republicans need to wake up. You can't have tax cuts without spending restraint and get to a balanced budget."

Among the fastest growing benefits is Medicare, which increased by an estimated 8.1 percent last year and is projected to pass $320 billion this year. Bush is considered unlikely to seek major savings from a program to which he and lawmakers added expensive prescription drug benefits less than two years ago.

According to Congressional Budget Office (news - web sites) estimates last fall, Medicaid spending grew by 9.4 percent while Social Security costs expanded by 4.5 percent.

The budget office projected last September that this year's deficit will hit $348 billion, and stay in the $300 billion range through 2010. The office plans to release its newest estimates on Tuesday.

In 1997 President Clinton (news - web sites) and the GOP-run Congress enacted a compromise aimed at balancing the budget in five years. Most of the $130 billion in five-year savings came from reducing health providers' Medicare reimbursements.

That deal capped two years of battling in which Democrats criticized then-House Speaker Newt Gingrich, R-Ga., for proposing Medicare savings. Republicans suffered losses at the polls due to that clash, and Gingrich said in an interview this week that for Bush to prevail this time, he will have to persuade voters to support his proposed savings.

Although I think health care is a neceesity and I may not agree with the President in this area. I am glad that he is having "compassion " for taxpayers like me by cutting my tax bill.

Although I am not a fan of President Bush, I do think we need to do something about the high cost to taxpayers for these programs. In defense of him it is up to each state to set the programs needed.I have seen reimbursement rates twindle down to next to nothing and think this is highly unfair to the health professionals.Doctors didn't go to school for 12 years to be paid $7.00 for his service.
Living in the great state of New York has been anything but kind to it's taxpayers. The Medicaid program established for this state is the best in the whole United States.If I can not afford to get dental care such as routine exams, cleanings etc. why should my state provide it to the so called "poor" driving cadillacs around.We all know this exists.Spend the money catching these thieves.
Another area needing reform are the Pharmaceuticals, who have led this nation down the tubes. They tell you they spend most of their profit on research, yet I just read an article by AARP that this is not true. Most of their profits are spent on advertising!!!!Drugs are given the green light by the FDA when we don't have enough data supporting their( Drug companies) findings.Then after so many deaths they are recalled.Can we recall the dead people?
If Bush truly wants to set the tone for this country, then he had better start cutting back on all the "Pork Barrel" spending,that Congress gets away with, and stop patronizing the Big Drug and Oil Companies.
Lastly I get the sense with the dollar in so much trouble abroad, that all the over spending we have done on this senseless war he now has to cut back on Home programs to make up for the continued rise in the deficit.This deficit was not created by over spending in this country on programs needed for the poor, but on a war that perhaps should never have been.

Norie, the problem with health costs is the hughe profits of the pharmaceutical companies and HMOs. Also I do not see any starving doctors, but they are not the problem. Doctors do not have to participate in insurance company plans or in Medicare, but most of them do.

Herb sees , everyone and everything but the failed liberal policies at fault...spoken like a true Lib. Your hatred for eveything Conservative and republican is showing again.

I hope our President puts the money he shaves on Medicaid towards Medicare. It should go to people who have worked all their lives and deserve it.

Mike, I am glad that the Liberals started and are supporting Social Security and Medicare. The Republicans are trying to destroy them while trying to make pharmaceuticals and wall street more wealthy.

There needs to be universal health care so that everyone will be covered.

Mike I know you could care less because for most of your life your salary, healthcare and retirement has been paid by the taxpayers. Fortunatly rather than depending on you, people still have access to social security, medicaid and medicare. Even the President gets free medical coverage and will get a hefty retirement paid by the taxpayers. He never will worry about needing social security or medicare for himself.

I don't see many compassionate people on this Board.

Herb, what Mike gets for the rest of his life is no comparison to what it is owed to him and the rest of the police, or firemen for sticking their butts out for saving the lives of many. Put things in perspective will you.
Socialized medicine has its problems too, like waiting lists to have elective surgery years long.
And I beg to differ with you, I see many, many compassionate people on this forum.

quote:

Originally posted by Norie:
[qb]Although I am not a fan of President Bush, I do think we need to do something about the high cost to taxpayers for these programs. In defense of him it is up to each state to set the programs needed.I have seen reimbursement rates twindle down to next to nothing and think this is highly unfair to the health professionals.Doctors didn't go to school for 12 years to be paid $7.00 for his service.
Living in the great state of New York has been anything but kind to it's taxpayers. The Medicaid program established for this state is the best in the whole United States.If I can not afford to get dental care such as routine exams, cleanings etc. why should my state provide it to the so called "poor" driving cadillacs around.We all know this exists.Spend the money catching these thieves.
[/qb]

Norie, there are many people who get maedicaid who do not fit this profile. An example is my mother. She worked as a chambermaid for 25 years. When she retired, all she got for a pension was $145.00 a month plus $600.00 from Social Security.
As she aged & her health decilned (cancer, diabetes, heart problems, 3 strokes & cancer again)her medical costs skyrocketed. Medicaid paid for a home attendant for 3 of the last 6 months of her life. Then they changed the icome levels & she was no longer eligible for medicaid. She was wheelchair bound & incontinent. For the next 3 months, I would bathe her every morning & make her breakfast. A neighbor would provide her lunch. Then after work, I would change & bathe her, make her dinner, clean the house. After 3 months I was exhausted and on the verge of a physical breakdown. Finally, she asked me to put her in a nursing home. I did & she was dead within 6 weeks.

Thanks Norie, but with anything Herb and afew other people who hate cops, I take it all with a grain of salt. I have earned my money. The taxpayers have gotten their moneys worth.

I realize that there are needy people, but what I was referring to was the cheaters and thieves who use the Medicaid system to benefit themselves.This is doctors, pharmacy's, therapist as well as Joe Blow who applies for benefits but really in not entitled.There are many out there.As far as your mom goes Dennis, I had the same experience with my mother in law.I also took care of my dad at my home till he died here.
I just got hit with our own Health Insurance bill and it has gone up another $90.00 per month, per person. There is no end in sight, and the government needs to do something ASAP!!!!!!

I agree to the cuts that are proposed by our Pres. I work at putting Medicaid Providers in Jail in NJ. If you witnessed the millions of dollars that these so called doctors, pharmacists, lab owners and Invalid Coach Providers steal from the Medicaid system on a yearly basis, you would be dumbfounded. To those people that feel that Medicaid does not reimburse the providers enough, I say don't accept Medicaid. When a provider signs the contract to provide Medicaid Beneficiaries medical help, they know ahead of time what the reimbursement rate is. Nobody is putting a gun to their heads to be a Medicaid provider.

So I say, lets put more law enforcement towards the investigation and ultimate conviction of these people, then we have a program that does not rape the average tax payer.

Will I do agree with what you say but if all the docs refuse the medicaid assignment then what happens to the millions who get medicaid? Where do these people get their medical care from?
Keep on putting these thieves in jail!

Norie,

Thanks for those kind words. I got 3 1/2 years of putting these scumbags in jail, so hopefully, the kids that are coming up will take over and be as diligent as me and my fellow collegues who will be retiring around the same time as me.

There are many doctors who provide medical care and follow the rules of the system. So I don't think that there will be a shortfall of providers. If we could ever get rid of those that take advantage of the system, then there would be more money in said system, therefore, the reimbursements would go up.

There is a big problem in my area with Medicaid providers. No one wants to accept it, and I can't say that I blame them. Drs. sign up for the two year minimum, I believe there is some kind of incentive for them to do so, and when the contract is up, they drop it. I know single working mothers whose children have Kidcare that can't get a Dr. to see them. The only places that accept it are the hospital clinics, and it takes months to get an appt.
I have to say that I have no "compassion" when my taxes are raised to support these programs, but I am not eligible for them. If I don't have employer sponsored health ins, we have no health insurance at all. If there is going to be no tax break for me, then someone had better start helping ME out.

Karyn
It all goes back to the low amount of reimbursement that Medicaid provides, which is directly caused by the amount of monies the Medicaid system does not have because of the millions that are being bilked by the providers who only wants to make a quick hit and make his or her mony to support those mansions that they live in.

This problem is going to be with us for a long time. I have the same rage that you do in regards to my taxes paying for a system that is inadequate.

I hope things work out for your friends who are having trouble finding providers in their areas.

quote:

There needs to be universal health care so that everyone will be covered.

My thoughts exactly. It's only a matter of time, really. Employers will demand it, with costs soaring as they are. If not, it's the Boomers who will bring this crisis to breakingpoint when they need healthcare.

And social medicine does quite well. According to the World Health Orgnization, which studies and ranks the world's heallthcare systems, the U.S. ranks 37. France is number 1. (2000 report)

Greg, where is the money going to come from?

Maybe France will give it to us .....