Medicaid under the ax in New York

NEW YORK'S "liberal" Democratic Gov. Andrew Cuomo has engineered a drastic $2 billion cutback in the state's Medicaid program. Medicaid provides health coverage for people who cannot afford commercial insurance. The overwhelming majority of Medicaid recipients are elderly and most are low-income.

Cuomo's cuts will mean that the state will lose $2 billion in matching federal funds. So Cuomo will actually be cutting $4 billion from New York's health care budget.

Virtually all of the state's 4.7 million Medicaid patients will be forced into managed care programs that place insurance companies, not patients and their doctors, in charge of medical decisions. Insurance companies are able to cut costs and make profits from managed care by denying treatments and medications.

People with chronic diseases such as lupus, kidney transplants, mental health disease and HIV or AIDS are saying that the Medicaid cuts will deprive them of the necessary medications. Kathe LeBeau, who is awaiting a kidney transplant, told a Gannett reporter that she won't be able to get the drugs she needs for the transplant because the state will only pay for generics.

In the same article, Julie Mersereau, a lupus patient and board chairwoman of the Lupus Foundation of Genesee Valley N.Y., said that her medications are tailored to her specific needs, and decisions about which ones she takes have to be between her and her treatment team. "To have my doctor not be able to make the determination about a particular drug is just impossible to even consider," said Mersereau, who got the disease 37 years ago, when she was 14.

Cuomo's Medicaid cuts will also mean that hospitals will be forced to close, poor people will lose home health care, and many low income people will have no access to dental care.

New York City is projected to lose 10 to 12 hospitals because of the cuts in Medicaid reimbursement. Most of these hospitals are located in poor neighborhoods with large numbers of Medicaid patients. Already, St. Vincent's Hospital in Greenwich Village as well as North General Hospital in Harlem closed when neither Cuomo nor New York City Mayor Michael Bloomberg would come up with the funds to save them.

Some medical "experts" say New York has too many hospital beds. That will be no comfort to the hospital workers who lose their jobs or people in communities left without a hospital.

HOME HEALTH aides provide vital housekeeping services to frail and elderly people who cannot care for themselves. They do everything from shopping and cooking meals to helping people dress and care for themselves. But now, if you live in New York City, you will only get eight hours a week of housekeeping services a week. This will drive old and disabled people out of their homes and into nursing homes.

People who need physical, occupational or speech therapy currently have no limits on the amount of care they can receive. Cuomo will limit them to 20 visits in a 12-month period. Anyone who needs more therapy to recover from an injury or illness will be out of luck.

Cuomo's plan will also slash state reimbursement for dentists who treat low-income patients. This will make it very difficult for poor people to find a dentist who will treat them.

For all practical purposes, only dental clinics will be able to treat Medicaid patients. Housing Works, which advocates for people with HIV and AIDS, reports that many locations have no dental clinics, and that even when the clinics exist, many don't accept new patients.

But the worst may be yet to come for New York's Medicaid patients. If the present cuts don't generate enough savings, the Cuomo administration will be able to dictate as much as $640 million in future cuts.

Incredibly, 1199SEIU, the union that represents many New York health care workers, is actively supporting Cuomo's Medicaid cuts. George Gresham, the union's president, served on the panel that recommended the cuts. He recently issued a statement saying, "We are proud that working people were able to play a role in proposing innovative solutions and thoughtful reforms that protect patient care."

1199 bases its support for Cuomo's proposal on winning guarantees of a living wage for home health aides in New York City and the surrounding suburban counties. It is entirely possible, however, that any gains will be outweighed by job losses and layoffs resulting from the cuts in home health services.

Even if the union manages to make some gains for one group of workers, that is no excuse for inflicting pain and suffering on millions of other working people.

1199 leaders like to say theirs is a progressive union and boast of its ties to Martin Luther King. But they would rather make deals with Democratic politicians like Andrew Cuomo than lead the fight for decent health care for all New Yorkers.