Congress Targeting The Aged, Disabled

Walk down the halls of a nursing home. Notice the white-haired figures in their wheelchairs and beds. One might be your mother, your grandfather, your first-grade teacher from long ago. One might be you, someday.

These frail souls may not even vote, let alone understand the threat that’s hidden in the propaganda war in Congress.

Republicans are chanting that a slowing in the budget’s growth rate is not a cut.

Baloney. Consider Medicaid.

Two-thirds of Medicaid dollars go to health care for the aged and disabled. That’s because Medicaid is the final safety net. It kicks in after nursing home bills devour a patient’s life savings - which takes only 13 weeks, on the average.

Republicans in Congress want to end the federal commitment to shoulder nursing home costs, replace that commitment with a block grant to states, and reduce projected growth in Medicaid outlays.

Why were outlays projected to grow? Two reasons, both valid: Growth in the elderly population, and inflation in health care costs.

Here in Washington state, the number of people over 75 will grow 13 percent in the next six years.

Even if inflation in the cost of medical care declines from historic levels to only twice the rate of general inflation, health care fees would rise 25 percent in the next six years.

Total increase in need: 38 percent over six years.

Yet for Washington state, Congress proposes only a 15 percent increase in Medicaid funding. The average state would get about twice that much. The inequity is in a formula that calculates block grants.

What are the human consequences?

You can’t kick out the sickest patients, so the dwindling funds would go their way. Funding would wither for marginally better-off patients who can live at home or in apartments if a visiting nurse makes sure they eat and take their medicine. Unlike many states, Washington’s Medicaid program pays for nursing to keep patients in those lower-cost settings. That saves money and improves quality of life. But due to a perverse flaw in the GOP’s block grant formula, Washington’s programs to control costs are punished, by a block grant that falls far short of need.

Meanwhile, if nursing homes lose funding to cover inflation, they’d have to cut wages and lay off nurses aides. That would worsen quality of care. Nursing home operators who insist on quality may sell out to the big corporate chains that run warehouses for the elderly.

Congress needs the honesty to face the human cost of its cuts. In coming negotiations with the president it must make the cuts fairer, for the sake of those who are at risk.

, DataTimes The following fields overflowed: CREDIT = John Webster/For the editorial board