Kaiser Family Foundation Asks Serious Questions About Cutting Entitlement Programs for the Poor

Well before we have any clarity on the impact of the election on health reform, the pundits are handicapping the prospects of efforts to make a serious dent in the national debt and deficit. Three national commissions are hammering out recommendations for reducing the debt and reining in entitlement spending, putting two giant health programs that serve the elderly, disabled and low-income Americans, Medicaid and Medicare, as well as Social Security, in the crosshairs of a new policy debate...

Nearly half (47%) of all elderly and disabled people on Medicare have incomes below twice the federal poverty level (less than $20,800 for an individual and $28,000 for a couple in 2008). Poverty rates are even higher among women, African American and Latino Medicare beneficiaries. And two-thirds of the 8 million disabled people on Medicare who are under age 65 have incomes below twice the poverty rate; beneficiaries with disabilities face more serious access problems than others on the medicare program...

If new policies are proposed to rein in entitlement spending and reduce the deficit, it seems only reasonable to include the following criterion among others for evaluating proposals: do no harm to the financial security or access to care for elderly and disabled beneficiaries living on low and modest incomes. Indeed, given the high out-of-pocket costs these groups have, and the large share of their incomes they already pay for health care, a comprehensive approach might well seek to improve circumstances for these most vulnerable groups, while also advancing "hard choices" for entitlement programs to reduce the deficit.

www.kff.org/pullingittogether/People-Behind-The-Entitlement-Debate.cfm