The states can’t absorb more of Medicaid burden

opinions

October 8, 2012 - 12:00 AM

All told, the 50 states and the cities within them have unfunded pension obligations of about $1.4 trillion.
This is not news. Kansas, for instance, hasn’t set aside enough money to fund KPERS — the Kansas Public Employees Retirement System — adequately in any budget year for the last decade. Not only have states and cities underfunded their programs, they have made extravagant promises of future benefits to government workers that they can’t keep.
In Rhode Island, an Associated Press account relates, 58 percent of teachers and 48 percent of state retirees receive more in their pensions than they were paid in their final years of work, a patently ridiculous situation.
California Gov. Jerry Brown last month approved higher retirement ages and contribution rates for state workers and put a cap of $132,000 on annual pension payouts — which indicates that some state retirees were getting more. The California State Retirement System is underfunded by $165 billion.
Of necessity, other states are putting off bankruptcy by slashing benefits.
This sorry fiscal state of affairs in state and local government needs reviewing as the presidential campaign moves toward election day. One of the planks in the Republican platform is to limit the federal government’s funding obligation under the Medicaid program by paying states a set amount rather than agreeing to cover 90 percent of the state’s Medicaid bill, as is required under the Affordable Health Care Act.
If medical costs continue to rise as they have every year since records were kept, Medicaid costs will rise, meaning that a fixed grant from Washington will require states to increase their Medicaid appropriations or reduce the care given to the low-income people that program covers.
Expansion of Medicaid to cover a wider swath of the low-income population is a key feature of the Affordable Health Care Act — Obamacare. It is through this provision the law will sharply reduce the number of uninsured American families and individuals. But, as the pension picture so clearly demonstrates, the states don’t have the money to carry more than 10 percent of the additional cost.
If the money isn’t there from either Washington or the states, then millions of Americans will continue to go without good medical care.
Before Nov. 6, President Barack Obama should make clear to the voters how his health care law will provide for those Americans now without coverage — and Mitt Romney should lay out in simple declarative sentences how he would deal with that imperative need.
Both should begin by admitting that tossing the ball to the states is not the answer.


— Emerson Lynn, jr.

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