ALLENTOWN, Pa. — Lehigh County Controller Mark Pinsley on Tuesday gave what he called "a snow warning alert" to prepare residents for how federal budget cuts could affect area social safety net programs.
Dozens of people were at Lehigh County Government Center as Pinsley kicked off an event to provide a look at how programs such as Medicaid and SNAP are funded and administered in Lehigh, and the possible impact.
Pennsylvania Policy Center’s Dwayne Heisler stepped in to helm a brief town hall for attendees.
The discussion came in the wake of a directive from U.S. House Republicans to fund President Donald Trump’s budget priorities by demanding the House Energy and Commerce Committee cut spending by $880 billion.
"That is what he has said. You guys can choose whether to believe it or not. What my goal is, really, this is kind of like, you know, a snow warning alert, right?"Lehigh County Controller Mark Pinsley
“So my disclaimer is, you know, President Trump has said that he is not going to cut Medicaid unless it's for fraud, waste and abuse," Pinsley said.
"That is what he has said. You guys can choose whether to believe it or not. What my goal is, really, this is kind of like, you know, a snow warning alert, right?
“I wanted to say the Congressional Budget Office has basically said if he really wants to cut $880 billion it's not possible to do it without Medicaid.
"Like all of the other things that that particular association, which is called the House Energy and Commerce Committee, don't equal up to enough.
"So we're going to [plan that] Medicaid would be the one to be cut.”
'Just be prepared'
Pinsley said cuts to Medicare would be unlikely because of its connection to other federal entities.
“What I am suggesting is, you know, if you thought you were going to have three feet of snow, you would go out and you would buy your milk and your eggs and your toiletries?" Pinsley said.
"And that's what I'm suggesting you do now. We don't know what's going to happen, just be prepared.”
In a brief review of how money flows into the county, Pinsley explained residents pay taxes to the federal, state and county government.
The federal government takes in $4.918 trillion dollars, funnels $72.8 billion of that to the state, with $415 million of that ending up supporting the county.
About $119 million comes into the coffers directly from taxpayers, though ultimately, 77% is derived from the allocated state funding.
For Medicaid support in Pennsylvania, the federal government covers 55 cents on the dollar, with the state covering the remaining 45 cents, Pinsley said.
For Medicaid expansion, the federal government covers 90 cents per dollar. Pinsley pointed out that's why Medicaid is a potential target for federal cuts.
About 24,000 people ages 19 to 65 are on Medicaid expansion in Lehigh County, Pinsley said.
'What are we going to do?'
As another example of how Medicaid impacts even those not on it, Pinsley said a man in 2012 was billed $93,000 for his mother’s stay in a skilled nursing home.
Though the man had nothing to do with her being in that home, filial responsibility laws placed that debt on him.
The same thing could happen with parents who have adult children, Pinsley said. He encouraged the crowd to reach out to their politicians and speak out on the law.
“And I will tell you that probably none of them know about it,” Pinsley said. “This law is very rarely used, however, if Medicaid gets taken down, away or reduced, I am going to be you that that law is used more and more.”
An audience member with experience in care homes said Medicaid reimbursement for services does not fully cover the cost of care, leaving many in a negative position to start.
Medicaid cuts would make the issue even worse, the person said.
Pinsley provided an example of the impact a 10% cut to Medicaid would do.
Normally, the cost of a bed in a care facility runs about $12,700 a month, with $8,300 coming from Medicaid and $4,400 from state and federal grants.
A 10% cut to Medicaid would create an additional $830 gap, assuming there are no new grants and no additional cuts.
“So what are we going to do?" Pinsley said. "Nobody knows. This is where it comes down to taxes, cutting services, you know, or little bit of both, or leave it to the family."
To accommodate that 10% cut, there would need to be an 18% tax increase, Pinsley said.
'Nothing about cuts'
Lehigh County Republican Committee member Joe Vichot responded that in the bill Republicans are passing, "there is nothing about cuts to Medicaid or Social Security."
Vichot accused Pinsley of using his office to promote a personal agenda.
Heisler fielded more of the town hall, explaining the necessity for state funding to provide social safety net programming.
"So you are literally looking at taking money from Medicaid, our safety net, and funneling that to a tax cut. Let's remind everyone what that tax cut looks like."Pennsylvania Policy Center’s Dwayne Heisler
But with a $2 billion deficit, Heisler said, “the money’s just not there” to bridge such a gap, especially in light of tax cuts for upper income levels.
“So let's talk about why this is happening, and why this is happening is because this year, the 2017 Trump tax cuts are up, and they need to pay for it," Heisler said.
"So you are literally looking at taking money from Medicaid, our safety net, and funneling that to a tax cut. Let's remind everyone what that tax cut looks like.
"And they're talking about expanding it, but just the way it is, the bottom 20 percent got about $80 in the year, middle class, somewhere around $800.
"The top point 1 percent got $250,000 — a quarter-million dollars.”
'Really important'
As it stands, Heisler said, if the budget passes in its current form, 750,000 to 1 million Pennsylvanians may lose health coverage provided by Medicaid.
Locally, that could affect 168,000 in the congressional district, he said.
For-profit and nonprofit hospitals also could suffer and perhaps even face closures, Heisler said, as they draw some funding from the federal government.
“His stunt, which he titled ‘Medicaid Cuts and Tax Cuts for the Rich’ is an obvious and deeply inappropriate attempt to inject national politics into our county government."Republican Lehigh County Executive candidate Mike Walsh
Heisler encouraged the crowd to reach out to their politicians and motivate friends and family to do the same.
“You can send a letter to your congressperson, no matter where they are in the state, and that includes your two senators as well,” he said.
He said they could simply scan a QR code on a handout and follow the link to do so.
“This is really important that you do that,” he said.
'Really important'
Shortly after the town hall, Republican Lehigh County Executive candidate Mike Walsh issued a statement denouncing Pinsley’s event.
“It was disappointing to see the Lehigh County Government Center — paid for by local taxpayers — used to finance Mr. Pinsley’s politically motivated fear-mongering,” Welsh said.
“His stunt, which he titled ‘Medicaid Cuts and Tax Cuts for the Rich’ is an obvious and deeply inappropriate attempt to inject national politics into our county government.
"Unfortunately, behavior like this shouldn’t come as a surprise to the voters of Lehigh County, who are used to seeing this kind of craven politicking from Pinsley and his former staffer-turned-state-Rep. Josh Siegel.”
Welsh said there was room to discuss concerns related to national topics that could affect Lehigh County, but “political stunts like this only serve to scare residents and create divisions.”
