To get a sense for how desperate states are to cut Medicaid costs, think about this: Several of them are seeking federal permission to impose short, inflexible annual limits on hospital stays, no matter how sick or severely injured the patient is. While the states face severe budget squeezes, imposing unaffordable burdens on some of their sickest and most vulnerable residents is hardly a responsible answer, or one that will be felt by the poor alone. Hospitals will feel pressured to cut stays short, but they also say they'll continue to provide essential care, so the costs will be recovered by pushing up the price of care for bill-paying patients.
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Medicaid patients generally lack the political clout of the elderly on Medicare, who tend to be vocal and vote. But that might be changing. Because of the recession and the rapidly rising cost of health insurance, Medicaid is projected to serve 69 million people this year, or about 22% of the population. Many are seniors who can't afford the steep costs of nursing-home care, which is covered by Medicaid, not Medicare. More than one-fourth of Medicaid spending goes toward long-term care.
States have to make ends meet, but extracting savings from those who can least afford health care is a callous way to balance budgets.
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