Republican plans for Medicaid reductions could force the sale of family homes, cars and even furniture as a condition to placing an elderly spouse in a nursing home, President Clinton said on Saturday.
“I don’t think it should be a precondition that if a husband has to go into a nursing home, his wife has to go into the poor house,” the president said in his weekly radio address.
Clinton said another provision “buried” in proposed GOP cuts in the Medicaid program would eliminate all national standards for nursing home care.
The Senate Finance Committee voted early Saturday to overhaul Medicare and Medicaid to save $450 billion over the next seven years as part of the GOP’s program to bring the federal budget into balance by 2002.
The committee also decided to make 10 percent of senior citizens pay sharply higher premiums for some Medicare services.
Health and Human Services Secretary Donna E. Shalala said Saturday that Clinton would veto the bill.
“I cannot believe that the richest country in the world can’t afford to take care of its poorest citizens, and that justice will be determined by geography, by the generosity of the place where the poor happen to live,” she said.
“The president will veto any bill that takes these enormous sums out of a health care system that cannot absorb this much this fast,” Shalala said.
Medicaid growth would be cut at least 10 percent a year to 4.9 percent to save $182 billion. Nearly all federal rules for the health safety net for 36 million low-income children, families, elderly and disabled people would be eliminated and the program converted into block grants to the states.
When they passed their Medicaid overhaul more than a week ago, House Commerce Committee Republicans said they believed states were every bit as likely as Washington to protect the elderly.
Both the House and Senate plans would reduce Medicaid spending by $182 billion over seven years by limiting the growth of the program to about 4 percent a year, instead of the current 10 percent.
The committees would eliminate the federal guarantee of benefits, just as Congress appears poised to do for welfare. Instead, states would set benefit levels, eligibility standards, payment rates and much else.
Clinton said the Medicaid cuts threaten a return to the era in which many patients were overmedicated, physically restrained and cared for by “undertrained nurses and fumbling technicians.”
“Congress should strip these outrageous provisions from the budget bill,” he said. “They’re inconsistent with our core values. … They are certainly not necessary to balance the budget.”
Clinton said the GOP cuts would deny nursing home care to 300,000 eligible seniors over the next few years and cut off home services to 300,000 more.
“This Republican budget would break this promise to our families,” he said.
“It ends the national commitment that any senior citizen, regardless of how much money they have or don’t have, will have access to quality doctors and good facilities.”
Responding for Republicans, freshman Rep. Dick Chrysler of Michigan said Congress has a responsibility to balance the federal budget and Medicaid and Medicare must take its share of the reductions.
“We are taking responsible steps to continue meeting the commitments of these programs this year, and slow the rate of growth so that we can secure these programs for future generations,” Chrysler said.
The House Commerce Committee has approved Medicaid changes, but the House Ways and Means Committee has delayed taking up its version of the Medicare changes until Oct. 9.
House Republicans released the their Medicare bill Friday, and the Congressional Budget Office said it would hit their $270 billion savings target.
But the bill would generate only $31 billion of savings from encouraging seniors to switch to health maintenance organizations, $16 billion less than the Senate bill.
The Senate bill would generate $71 billion through higher premiums and deductibles on Medicare beneficiaries; the House plan would get only $54 billion in higher premiums.
The president said that although the rate of medical inflation in the Medicaid program needs to be reduced, the GOP cuts are “far, far more than the health care system can handle.”
“Let’s be clear, of course - of course - we need to balance the budget,” Clinton said.
“But we need to do it in a way that strengthens our families, enhances opportunity for Americans and honors our obligations to our parents.”
The president said he is especially concerned over a provision in the GOP proposal to permit state governments to force people whose husbands or wives need nursing home care to give up their house, furniture and family car before the spouse can qualify for any medical support.
“Think about it,” the president said.
“Who wants a Medicaid police with vast powers to seize your assets and put you out of your home and make sure you have nothing left to pass on to your children.”
The Senate’s Medicaid reform includes a Democratic provision to allow spouses to keep certain income and assets when a husband or wife goes on Medicaid in a nursing home.
Under present law, spouses and their families are protected from poverty and are permitted to keep income of about $15,000 a year and assets ranging up to $75,000.
Signed by President Reagan in 1989, the law prevents people from being forced the sell their house and car in order to qualify for Medicaid assistance.
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