Medicaid, the health care program for low-income families, including seniors and the disabled, would be cut sharply under the 2005 budget proposed last week by Governor George Pataki.

The cuts come because of dissatisfaction at all levels of government with the huge costs imposed by the program, which takes the lion’s share of budgets at all government levels.

The $1 billion in reductions Pataki proposes would eliminate some coverage; curb the nursing home program, which the governor says, is too expensive and is overly reliant on Medicaid. Alternatives, such as expanded in-home services, are proposed, as are proposals to close existing eligibility loopholes, individuals’ claims of lack of financial resources to pay for a family member’s admittance to a nursing home.

Other changes proposed by the governor would affect the popular EPIC prescription drug discount program for seniors.

The governor, on the other hand, made proposals in the budget to increase the STAR benefit for seniors in order to further increase their rebate on property taxes levied to cover education costs.

It should be remembered, however, that the governor’s proposals must undergo scrutiny by the Assembly and state senate, followed by long and hard negotiations to work out a final budget that all parties agree on.

The governor’s budget advances a comprehensive proposal to reform and improve the long-term care system so that it is efficient, affordable and better meets the needs of seniors and the disabled. The existing system, the governor’s aides said, is expensive, overly reliant on Medicaid and institutional care and is often difficult for consumers to access.

The governor’s reform proposal includes doubling the Expanded In-home Services for the Elderly Program, a new Access to Home Program that would provide financial assistance to make residences more accessible to the elderly and disabled, and Home Care Demonstration programs to support the provision of services in community-based, rather than institutional, settings.

The reform program also:

•Advances a long-term Medicaid waiver to allow the elderly and disabled to maintain independence at a lower cost and with the highest level of quality care.

•Closes existing eligibility loopholes because efforts to increase the use of private insurance to finance long-term care costs would be successful only if the state closes the existing Medicaid loopholes which allow individuals to refuse to contribute any of their assets towards the cost of health care services, and

•Restructures nursing home reimbursement to generally reduce reimbursements to nursing home owners.

The governor’s budget proposal also includes a series of measures capping several Medicaid programs to make Medicaid more affordable for the state tax programs. These include the EPIC program, which provides eligible seniors with prescription drugs at a discount, reduces state reimbursements to hospitals, eliminates several optional Medicaid programs for adults and advances other cost-saving initiatives.

Changes in the EPIC program would be part of efforts to make savings in costs for pharmaceuticals by establishing a preferred drug program for Medicaid.

Also, EPIC recipients would be provided with incentives to join the new Medicare Prescription Drug Program, which started last June, that would reduce costs for both seniors and the EPIC program, the governor believes.

Measures to control hospital and clinic costs would include reimposition of a 0.7 percent assessment on hospital revenues, requiring providers to offset inflationary cost increases.

The optional Medicaid programs for adults, which would be eliminated under the governor’s proposed budget, would include: dental, nurse, audiologist and psychologist services provided by private practitioners; and also podiatry clinic services to move Medicaid coverage closer to coverage offered by private insurers.

Other cost-saving Medicaid initiatives include freezing premium payments for various programs and achieving administrative efficiencies.

On the plus side, the proposed budget provides $82 million for state-operated nursing homes serving veterans and their dependents.

Several changes were proposed in the STAR program, which provides reductions in the portion of seniors’ property taxes which go to pay for education costs.

The executive budget also creates a Co-STAR program which would provide New York City residents with a six-year, phased-in increase of 25 percent to their existing personal income tax credit, beginning in 2006.

MEETING: AARP Chapter No. 2889 will meet next Wednesday, February 2 at 12:30 p.m. at the First Presbyterian Church of Newtown, 54-05 Seabury St., Elmhurst. There will be a talk on predatory mortgage lending and credit reports.