While there have been many arguments related to the
stability protections (aka the maintenance-of-effort requirements) that irk me
due a skewing of the issues (such as the lack of “flexibility” states have in
their Medicaid programs), one in particular has been driving me crazy.
We at CCF have long tried to get the data straight on state budgets and Medicaid and I’m beginning to worry that our pleas for
a “look at the facts” is falling on deaf ears.
Take for example, some of the recent statements regarding
Medicaid’s share in Arizona’s budget. In a letter asking for a waiver of the
stability protections, Governor Brewer writes, “In 2007, the Medicaid program
represented 17 percent of the State’s General Fund spending; today that figure
is nearly 30 percent. Overall Medicaid spending has increased by 65 percent
over that same time period.” This 30% figure has been repeated several times,
but it certainly doesn’t paint an accurate picture.
Once again, let’s take a look at the facts, using the
most recent figures from the National Association of State Budget Officers.
Arizona General Fund Spending (in millions)
|
|
Medicaid Spending |
Total Spending |
Medicaid Share |
|
2007 |
$1,523 |
$10,478 |
14.5% |
|
2008 |
$1,285 |
$10,368 |
12.4% |
|
2009 |
$1,239 |
$9,239 |
13.4% |
|
2010 (est.) |
$1,187 |
$9,079 |
13.1% |
Now, if you add in federal spending (which I think we can
all agree is not actually state spending), the total spending on Medicaid is
about 34%. But if you just look at state general fund spending, the actual
dollar amounts and share have gone down since 2007.
Indeed states need more resources and tools to deal with
rising health care costs, an aging population, and the increasing demand for
coverage, especially in light of their ongoing budget deficits. However,
mischaracterizations of Medicaid’s impact on state budgets do a disservice to
an honest debate of the issues.