Palm Beach Post

As President Bush gives tax cuts that favor the wealthiest, he is trying to cut
medical coverage for the poorest. His plan would limit for the next 10 years the
amount of money the federal government spends on Medicaid, the $280
billion-a-year federal-state program that pays for health care for 50 million
uninsured, poor residents.

In fact, states need more money, not less. Medicaid generally consumes 20
percent of state spending -- second only to education, according to the National
Governors Association, and has reached "crisis proportions" in many states
struggling to serve growing numbers of residents. Florida spends about 15
percent of its $52 billion budget to serve 2.1 million Medicaid recipients. Of
Medicaid's $8 billion budget, $1.87 billion -- almost a fourth -- goes toward
prescription-drug costs. That amount alone would have covered Florida's entire
Medicaid budget just four years ago.

A 10-state task force, including Gov. Jeb Bush, is right to reject the
president's financing proposal for Medicaid. Instead, states instead want the
federal government to pay the full cost of providing care to 6 million poor
seniors who qualify for both Medicaid and Medicare. Eligibility for Medicare is
not based on income. Transferring the responsibility of "dual eligibles" to the
federal government would free 30 percent of state Medicaid money, including $7
billion a year for prescription drugs and $24 billion a year for nursing homes
and long-term care. For those same patients, states also want the power to
change eligibility rules for Medicaid prescription-drug benefits, control
co-payments and offer more long-term-care options.

President Bush's proposal fails to protect states against unforeseen costs that
could arise from natural disasters, new drugs and treatments, disease outbreaks,
changes in the economy or unexpected catastrophic events. New York's Medicaid
rolls grew by 300,000 immediately after the Sept. 11, 2001, terrorist attacks.
Governors praised Congress' approval last month of $20 billion over the next two
years to state and local governments, half of it to reimburse states for
increasing Medicaid costs. The one-time federal aid will loosen a short-term
squeeze as the nation's largest health-insurance program is expected to cost
states $120 billion this year. A long-term federal commitment to pay its fair
share is the kind of help states need.
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