Hitting bottom on Medicaid: South Carolina gives Arizona some competition

Here’s an entertaining fact for you: My brother-in-law Vincent receives toe and toenail care at the podiatrist. No he doesn’t wear toenail polish like Frank Burns did on M*A*S*H. A combination of skin issues, chronic obesity, and intellectual disability create mundane but important foot problems for Vincent that require serious attention.

He’s unlucky enough to require Medicaid. Luckily for him, though, he doesn’t live in South Carolina (h/t Diane Meier’s valuable tweets), since that state will no longer cover these mundane but important services. As today’s WYFF4 news puts it:

Starting in February 2011, Medicaid will no longer cover podiatry services, routine eye exams or dental services for anyone older than 21. Routine circumcisions for newborns, diabetic equipment and services and some wheelchair accessories are on the list. Hospice care services will also be eliminated.

You read that last one correctly. The state will no longer provide Medicaid coverage for hospice care.

Like an anxious investor watching a crashing stock market, I’m seeing what’s happening with Medicaid and wondering when states will finally hit bottom. One might think Arizona’s transplant policy provides a credible floor (listen here if you haven’t been following this). But maybe not. Here’s what is coming later to South Carolina:

In April, Medicaid will eliminate services under the state’s Community Long-term Care Program, which provides services to people at their home. That includes chore and appliance services, nutritional supplements, adult day health care nursing services and respite service. There will also be a reduction in the number of meals delivered to the home each week.

That’s a new one. Meals on wheels will apparently reduce its weekly meal deliveries from fourteen to ten.

I don’t quite know what to say, except to hope that this is some budgetary game of chicken, and these cuts don’t actually happen. Given what is happening around the country, there’s little reason to be hopeful.

We’re becoming sadly accustomed to states which deny Medicaid recipients dental care and eye exams, not to mention the circumcision thing. But what kind of state withholds hospice care and cuts meal deliveries to disabled seniors? I liked South Carolina better when we were joking about the Appalachian trail.

Postscript: South Carolina provides a sad example of the trend noted in this terrific Monica Potts piece posted at TAP yesterday on southern cuts in anti-poverty programs. Hard times.