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  • Shocking Study Results Reveal Moral Imperative to Fix Medicaid

    This week, The New York Times highlighted a study on Medicaid, the federal–state partnership to provide health care to the poor and disabled, and its failure to offer enrolled children access to care. The researchers used a “secret shopper” technique to see how many specialists in Cook County, Illinois, turned away children with Medicaid compared to private insurance.

    The results were jaw-dropping. While specialists turned away 11 percent of privately insured children, 66 percent of children with Medicaid were unable to get an appointment. For those who did, the waiting time was 22 days longer than for other patients.

    Shocking as these results may be, they aren’t a surprise—and they aren’t unique to Cook County. One physician’s response: “It’s interesting to think you even need a study to prove that. It’s pretty much common knowledge.” Though Medicaid provides adequate coverage on paper, nationwide, beneficiaries experience low access and poor quality care. The reason is decreasing provider reimbursement, which is a symptom of a large issue: States can’t afford the current Medicaid program, and thanks to the new health care law, it is only going to get worse.

    Senator Orrin Hatch (R–UT) recently visited The Heritage Foundation to bring attention to this issue. He pointed to Medicaid’s “mission creep” as one of the largest problems:

    Though Medicaid was intended to serve the most vulnerable members of society, it now covers almost one-fourth of the entire population. And that number will grow under Obamacare, which extends the program to upward of 20 million additional individuals.… An ever-expanding Medicaid program is devastating for our nation and our states’ finances, and by spreading itself so thin, fails to provide adequate care for those who need it.

    Meanwhile, states’ hands are further tied by so-called maintenance of eligibility restrictions in the stimulus and Obamacare that limit their ability to review or restructure who is eligible for the program. This leaves states with fewer tools to manage the program and forces them to reduce spending by further cutting benefits or reimbursements for providers. This has led to the severe access problems outlined above.

    Governors from 29 states recently sent a letter to Senator Hatch outlining the principles to guide Medicaid reform. They write that Congress “should provide states and territories a general healthcare framework where we can make necessary adjustments without constantly seeking permission from the federal government for changes that we already know work.”

    The first step is repeal of Obamacare, which exacerbates the Medicaid crisis through a huge expansion in eligibility. Then, Washington should change the federal financing of the program to encourage financially responsible behavior from the states and the federal government. Meanwhile, the role of Medicaid should be reorganized. Under the Heritage plan, Medicaid would assist healthy moms and kids mainstream into private health insurance. For the truly vulnerable poor, disabled, and elderly, states should be given greater authority to develop innovative models that promote patient-centered reforms. To read more about the right direction for Medicaid reform, read Heritage’s plan at http://savingthedream.org.

    Posted in Ongoing Priorities [slideshow_deploy]

    8 Responses to Shocking Study Results Reveal Moral Imperative to Fix Medicaid

    1. Karl, Huntsville AL says:

      I agree with the physician's response. It's a "no duh" study for anyone who has had to deal with medicaid. We had foster children on medicaid the same ages as our permanent children under private insurance, and experienced the difference first hand, apples to apples.

      You can't create more supply by creating more demand and lowering the price.

    2. OhioHistorian says:

      Medicaid has this problem? Why don't they just mandate 5 year prison terms with Bubba as a roommate for all doctors who turn down Medicaid payment? That will fix the market!

      Medicaid is not something I am opposed to. However, I have worked in emergency rooms where the Medicaid crowd pours in after the free clinic the hospital offered had closed because they didn't like the "wait". The problem is not Medicaid, it is the "free ride" mentality of the recipients. If you could reduce usage to what it should be, then you might actually be able to pay the doctors free-market payments.

    3. Michelle. FL says:

      This type of philosophy of doctors trying to chage clients for the right to get cured is rediculous. How do they look at themselves in the mirror everyday knowing they' were the only cure for them and they denied the right to see the child, elderly or disabled person or whomever may be ill. When will the USA put thier trust in God with action.

    4. Bill Stanley says:

      Doctors not taking appointments for 66% of Medicaid patients is not surprising. The government's primary way of containing costs is to pay doctors only portions of their standard fees. When Obamacare adds 20 million more to Medicaid, the situation will get worse. http://www.newandopinions.net

    5. Patriot Rodney says:

      Why is there is no button or link to enable me to e-mail this excellent article?

    6. George Colgrove, VA says:

      I posted an idea for healthcare reform a while back on heritage. Medicaid – does not work. Medicare – does not work. Government Healthcare in general – never has worked wherever it is tried. The general problem that has been defined over time has been to provide some level of healthcare to poor people. I think this has largely been done at the state level. VT has created a state level coverage for all [ http://hcr.vermont.gov/ ]. I am not a fan of this, but it shows that states can take care of this themselves. What I was advocating with a summit is to get lots of ideas on how to solve this one problem in the arena of competing ideas and not from a single place in the most ineffective, inefficient, and the most costly place in the entire universe. If we have 50 states with 50 different programs, then ideas can compete for ever-increasing achievement in solving the core problem. This problem will be better solved the closer to the private sector it is. If one can profit at the same time assist people in need, we know every dollar was used wisely. See my summit idea at: http://www.foundry.org/2011/01/20/new-jersey-pr

    7. Bobbie says:

      sounds like the government is making quite a monetary bundle by deliberately depriving medical care discriminatingly. Actions speak louder than words and the actions of this government is deceptive and corrupt. Hold accountable and REPEAL!

    8. Expertia says:

      Worse than Medicaid — try getting an appointment as a "self-pay" customer ! Virtually impossible! Even when you fully intend and are able to pay out of pocket, they don't believe you and won't serve you.

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