Monday, April 4, 2011

How Medicaid Is “Useless” for Low-Income Beneficiaries

The New York Times ran a front-page story on Saturday highlighting how for many low-income patients, a Medicaid card does not lead to access to care.  Among the highlights and quotes:

  • One emergency physician noted, “Having a Medicaid card in no way assures access to care.”
  • A nurse (and Medicaid beneficiary) with three herniated disks in her back complained, “My Medicaid card is useless for me right now…It’s a useless piece of plastic.  I can’t find an orthopedic surgeon or a pain management doctor who will accept Medicaid.”
  • A family physician asked, “How can an already overtaxed Medicaid system handle such a large influx of people?”
  • One pediatrician said he devotes one afternoon a week just trying to find specialists for his patients who will actually take Medicaid.
  • A mother showed her exasperation: “I have tried for more than a year to find a child psychiatrist or psychologist to get [my son] evaluated, but the mental health professionals in this area have told me they absolutely do not take Medicaid.”
  • The Secretary of Louisiana’s Department of Health and Hospitals admitted, “We have a hard time finding specialists for Medicaid enrollees.”
  • An OB-GYN worried that thanks to the health care law, “more of his patients will be on Medicaid, and fewer will have private insurance, which helps offset the financial losses doctors sustain on their Medicaid business.  Already…many of his patients have jobs with private insurance but switch to Medicaid when they become pregnant, avoiding premiums, deductibles and co-payments.”

The Times article perfectly illustrates the shortcomings of the health care law.  As the family physician quoted in the piece noted, an “already overtaxed Medicaid system” should not be asked to handle up to 25 million new beneficiaries placed in the program under the law.  And while supporting steps to ensure Medicaid’s reimbursement levels will allow patients access to care, some may view slapping states with yet another unfunded mandate for minimum reimbursement levels – which the Administration plans to do later this year – at a time when states are facing record budget shortfalls as precisely the wrong approach.  Instead of following the health care law’s example and pouring yet more taxpayer funds into a leaky Medicaid boat, state governors need additional flexibility to manage their programs – and Medicaid needs true reform.