In Storm’s Wake, Groups Fight Medicaid Cuts

WASHINGTON — America’s vast network of Jewish social service providers is seizing on the opportunity to use Hurricane Katrina to fight Republican efforts to slash Medicaid, the nation’s chief public health program for the poor.

In the immediate aftermath of the hurricane, GOP lawmakers have put off their plan to cut $10 billion from Medicaid and $25 billion from other aid programs. But officials at United Jewish Communities, the national coalition of local Jewish charitable federations, are hoping that the post-Katrina surge in demand for Medicaid will convince Republicans to expand, rather than cut, the program in the long run.

UJC and local federations are heavily dependent on Medicaid, a state-run plan that is funded jointly by the federal government and the states. The anti-poverty program accounts for more than half of the $2.5 billion to $3.5 billion of public funding that the federations and their constituent social service agencies receive each year. It is the principal source of funding for almost 200 Jewish nursing homes and hospitals — providing as much as 80% of revenues in some cases — and a significant source of funding for 150 Jewish family and children’s services, according to UJC data.

In recent months, UJC has intensified its lobbying efforts to fend off Medicaid cuts, while participating in the government’s efforts to reform them. Several moderate Republicans, including two key members of the Senate Finance Committee, Gordon Smith of Oregon and Olympia Snowe of Maine, are trying aggressively to block the proposed cuts to Medicaid.

Federation leaders say that the hurricane is causing lawmakers on Capitol Hill to reconsider Medicaid cuts.

“It looks like Katrina has demonstrated the value of the Medicaid program — as well as other programs such as food stamps — and as a result, Congress has taken another look at whether the decision to cut these programs is a valid one. And that’s good,” said Ron Soloway, managing director of government and external relations for UJA-Federation of New York.

Officials at UJC are supporting efforts led by other groups to make sure that the federal government and state governments simplify Medicaid registration for Katrina evacuees and that the federal government guarantees 100% of Medicaid funding for eligible evacuees. The hurricane added hundreds of thousands of eligible recipients to the 54 million uninsured low-income Americans who receive Medicaid benefits. In Louisiana alone, more than 125,000 people have applied for Medicaid since the storm hit, according to the state’s Medicaid deputy director, Ruth Kennedy. This figure hardly represents the expected increase in demand for benefits, considering that many of the storm’s survivors have crossed state borders and many have not had a chance to apply.

For now, the hurricane has derailed the process that congressional Republicans initiated for cutting mandatory spending programs, including Medicaid, by $35 billion over the next five years. As a result of GOP-backed legislation, congressional committees were required to find ways to make the cuts. They also needed to initiate at least $70 billion in tax cuts during the same period. The congressional committees were supposed to submit their recommendations this week and next week. However, the deadline was deferred after the hurricane.

This week, several key congressional staffers said that because of the extent to which Katrina has scrambled the legislative process on Capitol Hill, Congress may not even be able to complete the budget cutting before adjourning in early or mid-December. But UJC and federation officials are also attempting to use the hurricane as leverage in lobbying for long-term federal support for Medicaid and for Jewish social service agencies — nursing homes and assisted living facilities in particular.

UJC is hoping to thwart future congressional attempts to enact reforms that would produce federal cuts to Medicaid benefits. Of particular concern is a proposal to adopt block grants in place of the current “federal match” system, under which the federal government reimburses the states for a portion — typically between half and 70% — of its Medicaid costs. Under the proposed change, the federal government would give states a fixed amount of funds, in advance, for Medicaid. The states are all required by law to balance their budgets, and so they would have to find the money to make up the difference if their costs exceeded federal projections.

Some lobbyists are suggesting that the hurricane has switched the momentum in favor of advocates for a stronger federal safety net.

“The hurricane put a human face on poverty for many in our nation,” said Joyce Garver Keller, executive director of Ohio Jewish Communities. Keller is also chair of UJC’s committee on Medicaid.

“The poor are becoming very visible to us — we see them,” she said. “They are in need for health care, short term and long term. And many in Washington are wondering whether we need a national, federal system of health care for the poor, rather than one that is run state by state.”

Still, Keller and other UJC officials agreed, the shift is likely to be short lived.

Jewish agencies, UJC lobbyists said, are well advised to look beyond Katrina and prepare for what may be drastic long-term cuts to Medicaid that could come after the immediate impact of the storm subsides.

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In Storm’s Wake, Groups Fight Medicaid Cuts

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