Monday, July 2, 2012

Howard Dean’s Dirty Little Secret on Medicaid

Appearing on Meet the Press yesterday, former Vermont Governor Howard Dean was asked about the possibility that, given the Supreme Court’s ruling on Obamacare last Thursday, states could choose to opt out of the law’s new Medicaid expansion.  He gave an interesting response: “I think this stuff about not accepting Medicaid and not accepting Exchanges is crazy.”

Which is ironic, because a May 1998 front-page article from the Rutland Herald profiled how Judith Steinberg, a physician based in Shelburne, had written to her patients that she was no longer accepting individuals insured by the state’s largest Medicaid managed care organization:

Dr. Judith Steinberg told her patients in a letter that Community Health Plan/Kaiser Permanente has cut payments to her practice while raising rates to its insured.  The decision by Steinberg’s group means several hundred patients in CHP’s commercial and its “Access Plus” Medicaid plan will be obliged to either switch doctors or switch insurers.  The practice is the only CHP primary care provider in Shelburne….CHP serves about 30,000 of the 51,000 Medicaid clients who are in HMOs in Vermont.

Why is all of this relevant?  Because Dr. Judith Steinberg just so happens to be Howard Dean’s wife.

Put it another way: Howard Dean’s wife dropped out of that state’s largest Medicaid plan – while Dean was governor – due to low reimbursement rates and onerous bureaucratic regulations the Governor himself imposed.  So if Dean wants to go and publicly argue that “not accepting Medicaid…is crazy” – either for individual physicians, or for states looking to avoid Obamacare’s new unfunded mandates – he might want to chat with Mrs. Dean first.