The State of California has already slashed $1.7 bil. from California's Medicaid Budget (called Medi-Cal here). More cuts will be on the way if our State legislators can't get a two-third majority to put forth a special election to extend temporary taxes which are only in place until June 30. But one of the strangest moves I have seen yet to shore up Medicaid came from Arizona. Governor Jan Brewer on 3/31 proposed what the Wall Street Journal called a Medicaid Fat Fee.
Those who are obese or smoke and do not have children would have to follow a Doctor-supervised program to lose weight or pay a $50 fee to the State. Smokers would also be required to pay the $50 fee. The surcharge is part of a broader plan to raise money that would allow the state to offset recent cuts Republican Governor Brewer made to the state Medicaid program. If ratified, the measure would reinstate organ transplants, which the state stopped paying for last year in order to save money. It would also put 135K of the 250K cut from the Medicaid program back into the program. In Arizona, 25.5% of residents were obese in 2009, according to the Centers for Disease Control and Prevention, and about 46% of Arizona's Medicaid enrollees smoke daily, according to a survey by the state's Medicaid program.
Like her plan to cut organ transplants from the budget, this surcharge also attracted criticism. "If someone is obese because they're severely disabled or can't exercise, we shouldn't be punishing them, I mean, it's not their fault," State Sen. Kyrsten Sinema told the WSJ. She said she would vote against the plan and believed such a charge would need to be approved by voters. It might also need authorization from the Centers for Medicare and Medicaid Services in Washington, D.C.
I went to a panel entitled "Health Care Reform: How Will It Affect You and Your Business" on April 1 in Monterey, and many issues were discussed including the massive cuts to social service programs like Medi-Cal. Jim Griffith, VP of Strategic Management and Planning at Salinas Valley Memorial Healthcare System spoke and said currently, payments from Medicare only cover 40% of the cost of services and for Medi-Cal it's a scant 13%. This is why insurance premiums are so high, they are essentially subsidizing Medicare and Medi-Cal patients. Clearly something has got to change, but this surcharge seems very bizarre. I have private duty caregiving Clients who are in various degrees of health. Often times, as Sen. Sinema pointed out, people become obese simply because it's difficult for them to move about due to age or various ailments. So an across the board penalty for all people that are obese would seem discriminatory.

http://online.wsj.com/article/SB10001424052748704530204576235151262336300.html

http://www.familyinhomecaregiving.com/blog/index.html?entry=social-services-big-losers-in