<!doctype html public "-//W3C//DTD W3 HTML//EN"> <html><head><style type="text/css"></style><title>Re: Medicaid (was RE: Walzer on the Left)</title></head><body> <div>Maybe it is on solid foundation politically but look at what is happening. Most are aware of the cutbacks in Medicare payments to docs - and the physicians now saying they will no longer take Medicare.  Well many have not for years.</div> <div><br></div> <div><font face="Times" color="#000000">Medicaid is facing even worse doctor non participation.  Nearly half of docs surveyed for a study conducted by the Medi-Cal Policy Institute in California reported that they did not acdept Medi-Cal patients in 1998. The ratio of docs available to Medi-Cal patients (38 per 100,000) was well below the workforce standards established by the Health Resources Services Administration (which recommends 60 to 80 prmary care docs per 100,000 population).</font></div> <div><font face="Times" color="#000000"><br> There are further violations pending due to Medicaid cutbacks on the horizon.  State health care costs are growing while states face budget shortfalls that total about $15 billion for 2002.  As a result some states are just outright slashing health care funding, while other states are looking for more flexibility to make tradeoffs in benefits and overage. What they mean is RATIONING health care to those already on the program.  While some states are expanding the numbers of people who can qualify for Medicaid they are also planning to cut services and benefits to make room for the additional people to be added on.<br> <br> Some states are considering cutting back on prescription drug coverage for Medicaid recipients. They can do that!  There is no law that says they have to cover prescriptions. Another state plan brewing is to cut back on what drugstores get paid per Medicaid prescription.  This has drugstores threatening to end Medicaid services.</font><br> <font face="Times" color="#000000"></font></div> <div><font face="Times" color="#000000">Some governors want the federal government to chip in some extra funding for Medicaid in these times of budget shortfalls but George W. Bush is against any temporary increase in federal Medicaid funding for states so the GOP governors have opted not to pursue that course.</font></div> <div><font face="Times" size="-1" color="#000000"><br></font></div> <div><font face="Times" color="#000000">Marta</font></div> <div><br></div> <div><br></div> <blockquote type="cite" cite>I think the reason Medicaid is on more solid foundation politically has a lot to do with its state-administration and its funding.  Even while serious deficits in this fiscal year, the cuts in Medicaid are not as pronounced as in other areas.  Because of federal matching 50%-75% on basic health care and even more in some other budget areas, a state needs to cut $1 million in programs to save around $500 thousand in the state budget.  Also, that is a loss of $1 in revenue for industries (hospitals, doctors, nursing homes, etc.) that usually is pretty well connected.  I have heard several Medicaid directors and researchers of all political stripes that mention this.<br> <br> This, of course, does not explain why the Feds do not complain but again they are just doling out part of the money and no administration.  They do not like to be cheated by the states and raise a stink when certain funding streams get out of wack (hospital share stuff and uncompensated care pools) but have left a lot alone.<br> <br> There is also the argument that Medicaid essentially subsidizes all people's health care.  That is, to the extent that Medicaid actually pays for care received by the poor (instead of given away for free) then that reduces the need to share the costs of people who cannot pay.  I do think some people intuit this in their support of Medicaid.<br> </blockquote> <blockquote type="cite" cite>Jim<br> </blockquote> <div><br></div> <x-sigsep><pre>-- </pre></x-sigsep> <div>Marta Russell<br> Los Angeles, CA<br> www.disweb.org</div> </body> </html>