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Debt deal for states: whither Medicaid?

Debt deal for states

As we reach the end game in Washington, states still have no idea how a reduction in federal spending will trickle down to their budgets. Stateline.org drills down to the number one concern of governors and state legislators — Medicaid (emphasis mine):

Among the biggest concerns for states was — and remains — the fate of Medicaid, the joint state-federal health insurance program serving more than 60 million poor Americans. That’s because Medicaid is generally the biggest item in state budgets. In the short term, the debt deal appears to spare Medicaid from immediate cuts in federal support. What’s more, Medicaid was specifically exempted from a “trigger” mechanism that would reduce spending automatically if the special congressional committee does not achieve its deficit-reduction goals.

Further:

NYT: States and Cities Brace for Far Less Money From Washington

Reuters: Three reasons conservatives should oppose a balanced budget amendment

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Medicaid moguls

As a nice bookend to state officials’ concerns about Medicaid, the New York Times has an outstanding piece today on the excessive pay for executives who provide care to the developmentally disabled. Medicaid funds these programs with federal and state dollars. All is not well in the public, non-profit sector. From the NYT:

Mr. Castellani, the former Office of Mental Retardation and Developmental Disabilities official, calls them “Medicaid moguls” — the nonprofit executives who have prospered while providing services to 135,000 developmentally disabled people in New York.

At the top of the class are the executives at the Young Adult Institute. No organization in the field in New York has paid its executives as well. Four of its executives received compensation in excess of $500,000 in 2009; none of its competitors had more than one executive at that level, according to a review by The Times of tax returns of the 100 largest providers.

JumboAmerica

Are we JumboAmerica?  That is to say, has America succumbed to gluttony and sloth?

These questions, though rhetorical, are important since we have impossibly high obesity rates in this country and spend 17% of our GDP on health care. A new national system, Obamacare, will expand access to health care, but it does nothing to address the obesity epidemic among the poor.

Yesterday Phil Izzo of the Wall Street Journal reported on an important study that addressed poverty and obesity (emphasis mine):

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