What editorial writers are saying about state proposals to cut or reform Medicaid

Many states are considering reducing their Medicaid spending, or changing how the plan operates, as way to balance their budgets.

Posted March 28, 2011.

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Newspaper editorials reflect an understanding that states must find ways to get Medicaid costs under control. But many caution that today's cost cuts and reforms could have unintentional, negative consequences.

Holes in the safety net

The cuts being proposed in key safety-net programs have ugly implications for all state residents, not just the poor and disadvantaged. There may be no practical alternative to the cuts, but that doesn't mean they should be made lightly. ... In the short term, the reductions in Medi-Cal [California's Medicaid program] -- including reduced payments to health care providers and potentially unaffordable co-pays for medical care -- would cause doctors and hospitals to pass on more of their costs to patients with private insurance, leading to higher premiums that fewer people can afford. In the long run, an inadequate safety net is likely to lead to higher dropout rates, more incarcerations and less productivity by those who can't obtain needed services. Los Angeles Times, March 9

The big bully

As [Virginia] struggles to balance Medicaid with other priorities, it's handcuffed by the constraints imposed by Congress. In the health reform bill, it severely limits states' ability to control their Medicaid programs or the drain on their taxpayers. Medicaid is a bully: It backs states into the corner, it demands that they do painful things, and it ignores or punishes them if they try to push back. ... Instead of dictating how states address their citizens' health care needs, the program should be redrawn to assist, to encourage. It should say to states, "We want to help you provide health care to your low-income residents. Design a system that works for your state, and we will help by providing matching money. The more you do, the more we'll do, but you decide how much you can afford and want to spend." The Daily Press (Newport News, Va.), March 9

Bureaucrat shouldn't OK Medicaid changes

Under the budget repair bill that [Wisconsin Gov. Scott] Walker signed ... the secretary of the Dept. of Human Services -- a Walker appointee -- could use "emergency rules" to change provisions in [Medicaid and other state health programs]. These changes include the setting of premiums and co-pays for participants, eligibility requirements and modifying benefits. These changes could all take place without approval from the Legislature, which passed laws governing these programs in the first place. ... There is no arguing that the Medicaid program needs revisions. It faces a deficit of about $1.8 billion in the 2011-13 state budget and represents about half of the total $3.6 billion deficit. ... But Walker snuck these changes through in his budget repair bill, even though they do nothing to fix the budget the state is currently living under. Sheboygan (Wis.) Press, March 14

Human costs an important part of much-needed Medicaid reform

[New York] Gov. Andrew Cuomo, charged with erasing a multibillion-dollar budget deficit, would find it nearly impossible to do without tackling Medicaid, the health care program for the poor; it serves one in four New Yorkers and costs more than $1 billion a week. The panel he charged with finding solutions -- the Medicaid Redesign Team -- produced 79 recommendations designed to create long- and short-term savings. Their ideas are stirring the political pot in Albany, with significant implications for taxpayers and powerful interest groups. ... The question is, how much reform can be accomplished in New York, as politicians weigh the often conflicting demands of various stakeholders -- patients, hospitals, unions and taxpayers among them? Legislators and the governor must have more than just the political will to make changes; it will require wisdom to discern the human costs as well. The Journal News (White Plains, N.Y.), March 13

Legislature must avoid Medicaid cuts

If there's any rational way for the state government to save money in the Medicaid program, it should obviously be done. But the program is barely keeping its head above water now, and proposals for a 10% cut in Medicaid payments to doctors and hospitals could be devastating. Health care providers are complaining now that Medicaid reimbursements are too low. The numbers are clear, and grim. Ten years ago, only 60% of Texas doctors accepted new Medicaid patients. Today that figure has plunged to 43%. If payments are cut 10%, in many communities it will become virtually impossible to find a physician who will take on new Medicaid patients. Those patients will either do without care or end up in emergency rooms. Beaumont (Texas) Enterprise, March 1

Idaho's Medicaid crisis is years in the making

At some point, a cost-benefit analysis has to enter into the equation. Since every state dollar cut from Medicaid sacrifices federal matching dollars, is this the one place where it makes the most sense for lawmakers to ease up on their no-new-tax dogma? ... It isn't enough to simply patch up this year's budget with gut-wrenching cuts or a politically unpopular tax increase. Lawmakers must examine the sustainability of Medicaid. ... Lawmakers have long known this day would come. In the interest of taxpayers, and 229,000 Medicaid recipients, lawmakers need to step up to the moment. Idaho Statesman (Boise), March 13

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