Some of the speakers rolled up to the podium in wheelchairs. A few stopped in midsentence to stifle sobs. They were among hundreds of persons who journeyed to four hearings, held across Virginia this week, to speak overwhelmingly against proposed reductions in Medicaid payments.
"Did you ever wish someone happy birthday and many more -- and have them respond, 'I hope there are not many more'?" asked Frank Curhan of Annandale, one of about 50 speakers in an audience of 200 who packed the Fairfax County Board of Supervisors meeting room on Monday. "Are we now, in our civilized society in Virginia, advocating abortion of the aged?"
The state Board of Health sent representatives to public hearings in Fairfax, Norfolk, Salem and Richmond to give Virginians a chance to comment on the Health Department's proposed dropping of about 55,000 patients from the state's financially troubled Medicaid program (a cut of roughly 20 percent) by raising eligibility minimums. Another 12,000 children from low-income families would no longer receive free hospital care or other vital medical services.
State officials say the cuts are needed because of an anticipated $103 million Medicaid deficit over the next two years. Part of that deficit is the result of reduced federal aid, but a larger part is the result of inflation and rapidly increasing health-care costs.
"We can't spend money we don't have," said Dr. Leonard Weyl, an Arlington surgeon and vice-chairman of the Board of Health, who chaired the hearing in Fairfax. Weyl said that only action by the state legislature, probably in the form of a tax increase, could stall the reductions. "I think this problem has to go straight to the legislature."
Weyl began the 3 1/2-hour hearing by trying to deflect the audience's animosity. "The Board of Health is acutely aware of the severe nature of the proposed amendments and the impact they would have," he said. ". . . Any action to cut the program would be taken with extreme reluctance and regret."
But Weyl made it clear the cuts would have to be made unless some other revenue source could be found to supplement Medicaid. During a recess in the hearing, Weyl offered his own solution to the problem to Fairfax delegate-elect Vivian Watts.
"If we put a penny tax on every soft drink sold in the state, every Coke, Pepsi and Mountain Dew, it would pay for everything and it wouldn't hurt anybody," said Weyl. "It's a matter of making the legislature aware that we need some more funds."
There was no need to emphasize that message to the audience at the hearing. One by one the speakers came to the podium with sad tales of relatives or friends in danger of being evicted from nursing homes or cut off from medical care.
Arthur P. Amesse, who works in Fairfax for the Navy, told Weyl of his 81-year-old mother, who has had a stroke and a brain tumor and must be fed through a stomach tube. She is in danger of losing medical benefits and her bed in a Fairfax nursing home because her income exceeds the $500-a-month maximum the proposed new rules will allow.
"My mother's income is $504.96. The state of Virginia is now proposing that my mother is no longer needy by the total of $4.96," said Amesse.
Pat Tatum of the Reston Community Association suggested that Medicaid be rescued by levying a new tax on tobacco. "Since the use of tobacco products causes higher medical costs, it would be appropriate for the tax to be increased," she said.
Joan Bishop, administrator of the Leewood Nursing Home in Annandale, said she feared the public may not understand where the budget cuts are coming from and "nursing homes may emerge as the culprit." Bishop proposed a number of alternatives she said could save more than $20 million each year. She suggested, for example, that the state stop spending 20 cents a month to mail Medicaid cards to each of the program's 286,000 clients -- and thereby save more than $57,000 a month.
After the hearing, Weyl said he would try to relay what he had heard to the General Assembly in Richmond.
"If I were a politician . . . and I heard the messages I heard this morning, I think I'd find the money in the budget," said Weyl. "Those folks are all up for reelection next year."