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Huge Medicaid Cuts Weighed in Washington

By John S. James

April 4, 2003

In March 2003 the U.S. House of Representatives voted to cut $92 billion dollars from Medicaid over the next 10 years, mainly to finance tax cuts for the richest Americans (the war on Iraq and its followup had not yet been accounted for, and could result in further massive cuts). The Senate voted for no Medicaid cuts, and possibly an increase in some funding. Now a House/Senate conference committee will decide between the two budget plans, probably but not necessarily coming to some compromise between them. Medicaid pays for much of the HIV treatment in this country, in addition to other programs including long-term care for the elderly.

Meanwhile, the Bush Administration has proposed what has been estimated at a $600 billion tax cut -- when many states already face their worst financial crisis in decades. The Bush proposal for Medicaid is not known in detail, but it appears that states that agree to give up entitlement to Federal matching funds for Medicaid will be able to split two large block grants, one for long-term care and one for all other care. But the grants would have to be budget neutral -- and to meet this requirement, states could cut prescription drug coverage, home health services, primary care case management, physical therapy, dental care, and other services. (For more information, including a list of who is most likely to lose benefits, see the Pennsylvania Health Law Project:

For More Information on Medicaid and HIV

For background on Medicaid policy, see the Kaiser Family Foundation, -- especially the section "Kaiser Commission on Medicaid and the Uninsured."

For state profiles on HIV and Medicaid, see (published by the Infectious Diseases Society of America), especially Most, but not all, states have a profile available on this site.

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Copyright 2003 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used.

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