Cutting to the bone

Sunday, Sept. 14, 2008 | 2:13 a.m.

At a time when bailout fever has swept Washington, the people who need help the most are least likely to get a hand, which is too bad. These are the chronically indigent and recently unemployed individuals who rely on Medicaid for their health care needs.

Medicaid is run by the states but receives supplemental funding from the federal government. During periods of economic upswings, the programs seem to manage well. But when there is a sharp downturn, as there is now, the participants are often forced to go without adequate care.

The Associated Press reported Wednesday that because many states are facing declining revenues coupled with increases in unemployment, which help drive Medicaid enrollment, they may be forced to turn to the federal government for more money. But the Bush administration opposes increases in the federal share of Medicaid, roughly 57 percent of the total costs nationwide.

That’s bad news for Nevada, which has the additional burden of a governor who has refused to consider a necessary overhaul of the state’s tax system so that everyone can pay his fair share and the state can have a more stable revenue stream.

The Associated Press, writing for a national audience, highlighted the Medicaid woes in Nevada before mentioning any other state. It reported program enrollment in this state has averaged 202,000 a month, nearly 30,000 more than projected. Yet Nevada’s budget cuts have resulted in a 5 percent reduction in hospital reimbursement rates. Vision care has been eliminated and money to reimburse home care providers for cooking, bathing and other personal services has been slashed.

These cuts are on top of the reductions that have affected Nevada’s Check-Up program for children.

Anyone who believes there is excess in state government ought to spend a year with children who lack adequate medical care or with senior citizens who don’t have the physical capacity to feed or bathe themselves. Otherwise, give talk of “fat” in government a rest.