EDITORIAL: Medicaid Reform Needs More Study
By The Kansas City Star, Mo.
May 13–An ill-conceived plan to dramatically overhaul Medicaid should not be rushed through the Missouri General Assembly before adjournment next Friday. It is too complex an issue to decide in a week and ought to be put off until next year.
Neither the Senate’s bill, nor the 107-page House version debated Friday, reflects careful consideration of the effects the changes will have on the poor, children, elderly and persons with disabilities. The proposals would create layers of new bureaucracy that threaten the ability of sick people to see a doctor and could dampen doctors’ participation. They create additional costs for taxpayers and other health-care consumers.
Ten reasons for lawmakers to come up with a better plan:
1. The proposals won’t restore the 2005 Medicaid cuts affecting 400,000 people that cost the state $700 million over two years in federal matching funds. Loss of federal money cost the state at least $1.4 billion in economic activity, including 20,000 new health-care jobs, one economist says.
2. New rules would severely limit access to aid. A family of three could earn no more than $300 a month to qualify for the state’s health insurance. That’s lower than most states and far below the federal poverty level.
3. Other states are adopting more progressive plans worthy of study. Massachusetts’ new law and California Gov. Arnold Schwarzenegger’s plan would cover all the uninsured. Missouri’s plan would leave thousands of low-income workers unable to see doctors regularly.
4. The Missouri plan contains hidden costs for taxpayers and insured consumers. Hospital costs to treat the uninsured would be passed on to those with insurance. A recent Missouri Hospital Association report says Kansas City area hospitals provided $139 million in uncompensated care in 2005.
Lack of a tough anti-fraud provision costs taxpayers, too. The state could recoup an estimated $575 million annually from providers’ fraudulent billings if lawmakers would include sufficient incentives for whistleblowers to report cheating.
5. Injured or sick people could be fined for emergency room visits if they aren’t hospitalized. That could discourage people from seeking treatment.
6. Doctors may face a conflict if financial rewards for saving money result in denial of treatment for chronic illness.
7. Recipients could lose health benefits if they miss a doctor’s appointment, even for a legitimate reason.
8. Persons who don’t meet certain health goals, such as stopping smoking, could be denied benefits such as dental care.
9. Only a few thousand of the 17,000 workers with disabilities cut from the program in 2005 would have benefits restored. Yet these workers depend on the state’s help to hold a job.
10. The General Assembly would decide annually whether to pay for dental, podiatry, optometry and physical, speech and occupational therapy and other services, creating uncertainty for patients and doctors.
While tightening Medicaid eligibility and benefits, lawmakers have passed at least $250 million in tax cuts for businesses, the wealthiest elderly and others this session. Limiting medical care for children, poor elderly and working families is no way to accommodate tax cuts, and could end up costing all taxpayers a lot more.
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Copyright (c) 2007, The Kansas City Star, Mo.
Distributed by McClatchy-Tribune Information Services.
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