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medpundit |
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Sunday, May 25, 2003The negotiations are immensely important. Medicaid, the nation's largest health insurance program, pays for one-third of all births, covers one-fourth of all children and finances care for two-thirds of nursing home residents. It is also the fastest growing item in most state budgets, rising 13 percent last year, even though state revenues were virtually flat..... ...The basic concern, set forth in documents from the National Governors Association, is that the president's proposal does not protect states against unforeseen costs that might result from changes in the economy, natural disasters, outbreaks of disease or the development of drugs and treatments.... ....The governors readily embraced Bush's proposal to give states power to alter Medicaid benefits, modify eligibility rules and charge higher co- payments. But the governors said they had reached no consensus, among themselves or with the administration, on the financing of the program, which provides health insurance to 50 million low-income people. Medicaid is expected to cost $277 billion this year, of which $158 billion is the federal share and $119 billion comes from the states. .... ...Medicaid benefits are now generally all or nothing. Eligibility standards vary widely from state to state, but states have to cover children under the age of 6 whose families have incomes up to 133 percent of the poverty level. People who qualify for Medicaid usually have access to a package of benefits more extensive than those available in commercial health insurance. .... Medicaid provides more extensive benefits than Medicare, a program financed entirely with federal money. People who qualify for both programs account for 12 percent of Medicaid recipients, but more than 30 percent of state Medicaid spending, including $7 billion a year for prescription drugs and $24 billion a year for nursing homes and other long-term care. That's a lot of money. And here's the worst part - those numbers are nowhere near the actual cost of the healthcare Medicaid consumes. Throughout the country, Medicaid programs have notoriously poor reimbursement rates. Depending on the state, a $60 office visit might be reimbursed for $10 or $15. (My own practice gave $4,000 worth of immunizations to Medicaid patients last year and got paid $821) Few doctors are willing to accept Medicaid patients for this very reason. So, where does all that money go? It would be interesting to know how much of it goes to adminstering the state programs and how much of it goes to actually paying for care. posted by Sydney on 5/25/2003 02:02:00 PM 0 comments 0 Comments: |
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