DN Editorial: Medicaid: The cruelest cuts

THEY DIDN'T peddle worthless stock derivatives that crashed the stock market, killing more than eight million jobs.

They didn't wage two unnecessary, budget-busting wars. And they surely won't benefit from trillions in tax cuts for the wealthiest Americans.

So why should the children of America's poorest families bear the brunt of the newfound, and phony, passion to cut the budget deficit - especially when the "banksters" who got us into this mess are pocketing record profits?

Yet it appears that cuts in Medicaid coverage to 68 million poor and disabled Americans, half of them children, are about to become the sacrificial lamb in the budget talks being led by Vice President Joe Biden.

Republican are pushing hard for huge reductions in government services in exchange for maybe, possibly, voting to raise the debt ceiling and not blow up the world economy. Democrats have pushed back hard to save Medicare and Social Security. Pledges to oppose any benefit cuts to either of those beloved programs have become guaranteed applause lines, as well they should be.

Medicaid? Not so much.

It's easy to see why. Medicaid's recipients are, by definition, poor or disabled and therefore, by definition, they lack political power - except, perhaps, the 64 percent of seniors in nursing homes who rely on Medicaid to pay for their long-term care, not to mention their children, who otherwise would be hard-pressed to provide for them.

That in turn has raised fears that Democrats will fight harder to protect seniors on Medicaid while subjecting low-income families to more of the cuts. This is not only morally wrong, but it makes no sense financially. Slashing Medicaid would cost more money than it saves - and all of us would be stuck with the bill.

Like Medicare, Medicaid's rising costs pose a threat to the nation's economic future by adding to the long-term deficit. But the cost of private health insurance is rising even higher, faster. Medicaid pays much less than most private health insurance - 27 percent less for low-income children and 20 percent less for adults.

(The program's lower cost is proving to be a problem in itself. A University of Pennsylvania study published last week confirmed what most health-care professionals already know: Lower payouts translate into less care for sick kids. When researchers tried to schedule nonemergency appointments with pediatric specialists, two-thirds of the Medicaid kids were turned away, compared with only 11 percent of those with private insurance.)

As we ought to know by now, reducing access to health care actually raises costs. People who don't get preventive care get sicker and eventually need more expensive care. Many who can't get care in a doctor's office often go to high-cost emergency rooms. The costs inevitably show up in increased premiums for those who still have insurance.

IN CONTRAST, increasing access to health care reduces costs and the deficit, which is the underlying rationale of the Affordable Care Act.

Half of the coverage extension contained in the law comes from expanding Medicaid eligibility. So cutting Medicaid has the potential to undermine even the modest benefits promised by the flawed health-care-reform law passed last year. (Of course, this would suit opponents of health-care reform just fine - but not the 35 million Americans who are without insurance and who would be covered once the law is fully in effect.)

Members of Congress need to hear that the "shared sacrifice" we're always hearing about should not mean that the poorest and most vulnerable get stuck with the bill. Besides, the health-insurance premium you save could be your own.