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Medicaid Block Grant Program is Not The Answer

Gayathri Suresh Kumar, M.D
Georgia State Director, Doctors for America


The House’s proposed budget plan to reduce federal support for Medicaid by converting it into a block grant program is the most absurd idea.  As a physician at Grady Memorial Hospital in Atlanta, I provide care for many patients who are dependent upon Medicaid for their well-being. Without Medicaid, what would happen to my patients? Would they stop coming to their appointments or picking up their medications knowing they no longer can afford health care? What if their medical conditions spiral out of control and they seek help at a stage where it may be too late for me to provide meaningful care?


As I think about all the patients who could be impacted by the snoring help proposal, I am reminded of one of my patients – an African-American man who was recently diagnosed with obstructive sleep apnea, a condition which results in momentary pauses in breathing during sleeping because of brief closure of the airway. With this condition, he was constantly fatigued throughout the day which limited his functional capacity while working at a nearby factory, where the income he earned was just enough to provide for himself and his mother. However, as soon as his diagnosis was established, my patient was fired and told that he was not fit to continue working. Without a source of income to maintain his eligibility, Medicaid dropped his coverage.

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This story is playing out all over the country to countless Americans, and it’s hard to ignore here in Georgia.  Shouldn’t we help ensure that this is the exception rather than the rule?


Without a job and health care coverage, he was at a loss. Without treatment, his condition could deteriorate to even more severe medical complications and possibly even death. It was just too expensive. Medicaid would have helped defray those costs, but now he must scavenge for financial support and without a job, he struggles to get by. He continues to struggle with his sleep apnea and worries about how he will support both himself and his mother, read more at MyEtizolam blog. How will he ever get better without an income and health insurance? How can we expect our economy to improve if people can’t earn a living and provide for their families?


With the Patient Protection Affordable Care Act (PPACA), I was ecstatic to know that by 2014, Medicaid would expand its eligibility level to 133% of the federal poverty level (up from 50% of the federal poverty level in Georgia), with full financial support for the first three years by the federal government. This means that with health reform, between 600,000 to 900,000 Georgians will gain health insurance coverage. Finally, here is a chance for my patients to access critical health care services without fear of being denied coverage or bankrupted.


Recently, my optimism has begun to wane. If passed, the House budget plan would repeal health reform and convert Medicaid into a block grant program which would place a federal cap on Medicaid spending. With this proposed reduction in federal Medicaid spending, the states would lose critical federal dollars that they rely on each year to cover our low-income Americans and economic recovery will slow even further.


Georgia is projected to lose close to $1.9 billion in federal support for Medicaid. This places 38,420 jobs and $4.4 billion in business activity at risk, as Medicaid dollars are used to reimburse health care providers, medical suppliers, and pharmaceutical agencies. Further, given the constraints on funding, it is estimated that by 2012, Medicaid enrollment nationally will be 44 million people fewer than what it is projected under the current law.


This proposal is flawed on multiple levels. Morally, we are depriving our patients of quality health care. Economically, these cuts will cost jobs for our health care providers and suppliers and slow economic recovery.  Moreover, with more uninsured patients, our sick patients will continue to seek ER care which will lead to a rise in uncompensated care costs and an increased strain on tax-payers and society. Eventually, this may lead to cutbacks in availability of ER care which can compromise readiness for large-scale emergencies.


This doesn’t make any sense.


Why are we spending our time contemplating methods to further deny health care access for our patients? As our politicians continue to bicker, our patients will continue to struggle for access to care and our health care costs will continue to soar to unsustainable levels.

The Medicaid block grant program is not the answer, while the PPACA is a significant step in the right direction.


Gayathri Suresh Kumar, M.D
Georgia State Director, Doctors for America



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