March 28, 2014 in Editorial, Opinion

Editorial: ‘Tough times’ no longer justification for Idaho Medicaid cuts


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It looks like Idaho’s insistence on slashing aid for the truly needy won’t be allowed to hurt developmentally delayed adults.

On Tuesday, U.S. District Judge B. Lynn Winmill put a halt to $16 million in cuts, ruling that a case brought on behalf of 13 severely disabled people can proceed as a class-action lawsuit.

The practical effect of Tuesday’s ruling is that 3,600 Idahoans will see an increase in Medicaid funding as the case proceeds. The Idaho Department of Health and Welfare hasn’t decided how to respond, but the definitive nature of Winmill’s ruling makes a challenge look fruitless – and cold-blooded.

The case was prompted by the Legislature’s cuts to the 2011 Medicaid budget, which led to the state sending out notices to the families of developmentally disabled adults informing them that coverage levels for services and care would drop. How the Department of Health and Welfare decided the level of cuts for each client was a mystery, and that’s what prompted the American Civil Liberties Union to file a lawsuit.

The ACLU successfully argued that clients had no way of knowing how their cuts were determined, so they didn’t have a basis for launching a challenge. The judge asked Health and Welfare for details about its process, but he wasn’t satisfied with the generalized nature of the response.

Advocates say such cuts, if they must happen at all, should be done on a case-by-case basis, so that basic needs are met and people still have the opportunity to thrive at home or in community settings. The judge agreed, citing cases where severely developmentally delayed people were struggling to find assistance with eating, getting dressed and going to the bathroom. Some also lost educational and social opportunities.

The Legislature’s goal was to save money, but it didn’t give much thought to the consequences. As Winmill noted, the Medicaid cuts raised the risks that people would regress or become institutionalized, which shifts the system in the wrong direction, both financially and therapeutically.

While there’s been a lot of attention on Idaho refusing to expand Medicaid through the Affordable Care Act, what this case spotlights is that the current system has been damaged by stingy, shortsighted lawmaking. The aid to developmentally delayed people was only part of the Medicaid decimation that occurred during the recession, and the cuts have not been restored.

Jim Baugh, executive director of Disability Rights Idaho, told the Legislature in February, “Every study conducted in Idaho has reported a mental health system which is fragmented and concentrated on involuntary hospitalization with a huge percentage of people with mental illness being held in jails or in prison.”

Baugh noted that one way parents of mentally ill children can guarantee treatment is to have them charged with crimes.

Granted, legislators had to make painful decisions during the recession. But if Medicaid cuts aren’t voluntarily restored for the state’s most vulnerable citizens, then “tough times” is no longer a justification. It’s a choice, and that’s just cold.

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