Earlier today, President Obama presented his vision for deficit reduction, as well defending Medicaid and Medicare from proposals to fundamentally replace them. Some initial thoughts.
President Obama was right to say our current budget debate is about the kind of future we want and the country we want. The framing pushed back against the “you are on your own” narrative so prevalent in DC these days, reminding us that our country has a long history and tradition of investing and working together for common goals and purposes. Finally, President Obama was absolutely right to vigorously defend Medicaid and Medicare as key commitments we have made to ensure that we all have some basic security, especially when confronting the issues and costs and risk of health care.
A good portion of the speech was a point-by-point rebuttal to Paul Ryan’s House GOP plan. As tough as he was, President Obama’s strong critique of the House GOP proposal, to basically end Medicare and Medicaid as we know it, was not as harsh as how that proposal would be felt by our state, our seniors, and our families. The Ryan proposal does nothing to control the main issue of medical inflation but simply shifts major costs of care from the federal government to states, seniors, and families–all to pay for trillions of dollars in tax cuts.
The President’s deficit reduction plan was serious and centrist–and we have some concerns with specific elements, both about the need for a more balanced approach that includes additional revenues, and about the specifics of the cuts and targets for both discretionary and entitlement programs. While also appreciating the overall direction, the Center on Budget and Policy Priorities has a good, detailed critique of the specifics. But it was good that the President push back against a pessimistic plan that would forceour country to abandon not just seniors, children, or families, but the very notion that we should provide basic security to our citizens, and support to the health system on which we all rely.”
We are pleased that California leaders have already weighed in against the destructive proposal to block grant Medicaid, shifting billions of dollars of cost onto on already beleaguered state.
* Governor Jerry Brown co-signed an April 4th letter from 16 Governors to Congressional leaders, warning against a “transformation of the Medicaid program’s finances that significantly shifts the costs and risks to states” and that would “severly undercut our ability to provide health care to our residents and adequately pay providers.”
* Senator Barbara Boxer co-signed an April 12th letter with other Senators to President Obama, opposed to a Medicaid block grant or other spending cap, stating that “complying with a spending cap would thus require unprecedented draconian cuts to Medicaid over time.”
* Senator Dianne Feinstein wrote her own letter on April 12th, warning that “Converting Medicaid to a block grant would harm the 7.2 million Californians who currently receive basic health care from the state program, Medi-Cal, and would shift costs to the state, counties, beneificiaries, and health care providers. Through such proposals, California stands to lose an estimated $147.8 billion–$878.7 billion in federal investment in Medi-Cal, and an additional $60.1 billion from the Medicaid expansion included in the Affordable Care Act.”
Given the dramatic and draconian impact to our state and our health system, every member of Congress from California should vote against the Ryan proposal when it comes up before the House of Representatives in the next few days. We will be actively educating Californians about these proposals, and the ready and realistic alternatives that are pending.