Blog#236- 3/10/25
DEATH BY MEDICAID CUTS
By
Richard Davis
Cutting social support programs that help the most vulnerable in our society has always been a Republican blood sport. Most of those rich old white men have contempt for “those people” who live on handouts because they deem them too lazy to help themselves. It is an old trope. But now things have gotten worse.
The current Republican budget plan which looks likely to pass includes massive cuts to the Medicaid program.
Here is some context from the Center for American Progress. “Last week, House Republicans passed a budget resolution directing Congress to make cuts that would slash Medicaid funding and threaten health care access for millions in order to pay for tax cuts for the wealthy. Medicaid is the largest single health insurance program in the United States and covers 72 million Americans, including low-income kids and adults, pregnant women, seniors, and people with disabilities.”
They go on to explain that, “The Republican budget plan intends at least $880 billion in cuts to Medicaid, which would likely be achieved by shrinking the amount the federal government chips in for the program, putting annual limits on Medicaid benefits, or applying wasteful red tape to spend millions of dollars making working people on Medicaid prove they have jobs.”
Looking at Vermont shows that our state will be in a position to almost eliminate the entire Medicaid program unless we come up with $1.3 billion or more to offset the federal match. Vermont receives $1.44 in federal Medicaid support for every dollar the state spends. If the budget bill holds at the $880 billion Medicaid cut level, Vermont will lose $1.8 billion out of the roughly $2 billion Medicaid budget.
There are currently 143,657 Medicaid enrollees in Vermont and if the cuts happen at least 17,000 people will lose all Medicaid coverage. Whatever coverage remains won’t be enough to forestall the morbidity and mortality that will certainly ensure.
I have worked with many Medicaid recipients over the years. Many are in circumstances that they had no control over. It might surprise the fat cats in Washington to know that these Medicaid recipients never thought they would need government help. Many felt self-sustaining throughout their lives, working two or three jobs to get by.
I will give you a composite scenario to make this personal. Imagine Gerry is a 55 year old man with Type 1 diabetes who has managed his disease most of his life while working. He has his own cordwood business. One day he has an accident and cuts his leg on a chainsaw. He never made a lot of money and could not afford health insurance so he tried to tough it out. Two weeks later it is clear he needs a doctor because it is obvious to him that his wound is infected.
Gerry ends up spending a month in the hospital. He has no income and most of his formerly loyal customers have found wood somewhere else. In other words, his business dies. The doctors do their best but eventually they have to amputate Gerry’s leg above the knee.
While he is in the hospital the social worker helps him to apply for Medicaid, something he never thought he would ever need. Just applying makes this fourth generation Vermonter lose his dignity and sense of self-worth.
Gerry adjusts to his new life and comes to appreciate the support of the Vermont Medicaid program. Without it he would not be able afford insulin and the other medications he takes, The day that Gerry gets a letter telling him Vermont can no longer provide Medicaid services just might be the day he looks at the 30-06 in the corner and decides it is the solution to all his problems.
