Long recognized for its dedication to social justice and outreach to Americans in need, the Jewish community has consistently displayed the Jewish value of Menschlekeit in its efforts to strengthen this country’s social safety net.  Current congressional efforts to cut federal Medicaid spending, however, threaten to fray that safety net and leave our most vulnerable populations without access to much-needed health care.

            For the past forty years, Medicaid has served as the health insurer of last resort for America’s low-income, elderly and disabled populations.  More than 50 million Americans rely on Medicaid for their health and long-term care coverage, an entitlement that pays for nearly 20 percent of all health care dollars and half of all nursing home dollars each year. 

            An overview of the Medicaid population reinforces the program’s importance to the health of our nation.  Sixty percent of our nation’s nursing home residents are Medicaid beneficiaries, while half of all low-income children rely on Medicaid for their health care.   Forty-four percent of individuals living with HIV/AIDS depend on Medicaid for the health care critical to the management of this chronic disease.  Nearly forty percent of all pregnant women in this country utilize Medicaid benefits to ensure that their children have a healthy start at life. 

            Without the access to health care that Medicaid provides, it is clear that beneficiaries would go without care at all.  While nearly a quarter of uninsured children have no regular source of health care, Medicaid provides 94 percent of young beneficiaries with a regular source of care.  Among uninsured adults, thirty percent report not receiving needed care, whereas only thirteen percent of adult Medicaid beneficiaries forgo needed care.

            Between 2000 and 2004, enrollment in the Medicaid program increased by 23 percent – a jump that can be attributed to an economic recession and many employees’ loss of employer-sponsored health care.  As a result of increased Medicaid enrollment and increased costs throughout the health care sector, Congress adopted a budget that called for $10 billion in Medicaid cuts over the next five years.

            Medicaid, however, is not the source of this country’s budget problems.  The Medicaid program also is not to blame for rising health care costs in this country.  Between 2000 and 2004, private health insurance costs grew 12.6 percent, with Medicare’s costs rising 7.1 percent.  Despite absorbing additional beneficiaries during this time, Medicaid held its cost growth to 4.5 percent, suggesting that it is one of the most efficient players in our health care system.   

            Efforts to balance the budget on the backs of America’s most vulnerable are unconscionable and fly in the face of the cherished Jewish value of Menschlekeit.  Instead of helping Medicaid beneficiaries gain access to needed health care, the nation’s governors have proposed targeted benefits and an increase in co-pays that will only serve as a disincentive to seeking needed care.  The governors’ plan also calls for the Medicaid program to scrutinize of five years’ worth of gifts that low-income seniors give to family members or synagogues, after which the program would penalize seniors’ for their generosity at the very time they begin to need long-term care under Medicaid.

            A strong voice from the Jewish community is needed to fight these misguided Medicaid cuts that will undoubtedly block access to health care for our most fragile population.  Together, in the spirit of Menschlekeit, we can speak for the Medicaid beneficiaries who, to date, have been disregarded and reduced to a mere budget number by the proponents of Medicaid reform.  The voice of the beneficiaries must be heard; after all, it is the Medicaid beneficiaries who have the most to lose.

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