[Congressional Record Volume 141, Number 197 (Tuesday, December 12, 1995)]
[Extensions of Remarks]
[Page E2342]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




VIEW FROM CALIFORNIA: THROW PEOPLE OFF MEDICAID TO MAKE THEM GO TO WORK

                                 ______


                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                       Tuesday, December 12, 1995

  Mr. STARK. Mr. Speaker, the Republican budget cuts Federal support 
for Medicaid by an unprecedented $163 billion--over 10 times anything 
ever enacted by any Republican or Democratic President. The Republican 
plan achieves these savings by capping overall spending. This means 
that spending growth per beneficiary would fall from the current 7 to 
1.6 percent annually--far below the rate of inflation. States cannot 
sustain coverage when Federal funds are increasing at only 1.6 percent 
per beneficiary. States will be forced to reduce benefits and/or 
provider payments and eliminate coverage for millions of people on 
Medicaid.
  A recent column in the November 28 edition of the Sacramento Bee 
leaves me fearful for the poor in our California. The author, Mr. Dan 
Walters, was commenting on California's plans for Medi-Cal if the 
Republican welfare bill becomes law.
  Currently, more than 5 million Californians receive their medical 
care through Medi-Cal. If the Republican welfare bill becomes law, 
California and other States will have to decide whether to maintain 
current eligibility and make up the shortfall with their own money or 
begin cutting caseloads. California may well slash Medi-Cal recipient 
rolls by hundreds of thousands.
  The column reports that Eloise Anderson, California's social services 
director, is urging the Wilson administration to adopt a policy that 
would focus Medi-Cal benefits on some subgroups and deny benefits to 
others. She advocates a program of varying benefits that depends on 
one's suitability to obtain employment. Anderson is quoted as saying:

       By denying or limiting Medi-Cal availability, families 
     could be further encouraged to exercise personal 
     responsibility and to obtain self-sufficiency through full or 
     part-time work.

  This philosophy is frightening. What will happen when a poor, non-
Medicaid person gets sick? Won't those eliminated simply turn up in 
hospital emergency rooms? Are they supposed to go to work sick?
  Ms. Anderson recommends cutting Medicaid for people on welfare or 
trying to leave welfare as a way to prod them into work. What if they 
have a minimum wage job--how much would it cost to buy a health 
insurance policy for a mother and a child? Is it realistic to expect 
that to happen? What about the extensive medical literature which shows 
that people who don't have health insurance tend to be sicker and less 
dependable workers? Are the types of jobs a welfare mom is likely to 
get the ones that offer employer-paid health insurance? Of course not.
  The reduction in Federal support under the Republican plan could 
force States to deny coverage for nearly 8 million Americans in 2002 
alone. California is considering a dramatic reduction in eligibility. 
How will other States respond? Will they also cut their program, to be 
competitive with California's reduced tax expenditures? Who knows--the 
Republicans have stripped away the Medicaid guarantee for the sick, 
elderly, poor, blind, or disabled. The States will have the choice 
whether to cover these vulnerable citizens. Statements like Ms. 
Anderson's point to a ``race to the bottom''--a race which will leave 
the most vulnerable in our society sick or dead.

                          ____________________