Kathleen Vinehout: Examine fast-growing Medicaid program

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Jan 15, 2010 No Comments ›› admin

By Sen. Kathleen Vinehout / Alma (District 31) | Posted: Friday, January 15, 2010 12:15 am Wis. state Sen. Kathleen Vinehout

Last summer, John told me BadgerCare saved his wife’s life. John is a dairy farmer and could not afford insurance. He thanks God and the state of Wisconsin for a program that brought his wife back home.

BadgerCare is a Wisconsin success story. In the past two years, Wisconsin has provided coverage to more than 150,000 people who did not have or could not afford health insurance. BadgerCare now covers 700,000 people. More than one in five Wisconsin citizens are helped through Medicaid.

This health care comes at a cost. From nursing home care and services for the disabled to BadgerCare for low income families, taxpayers spent nearly $6 billion last fiscal year for health care.

Medicaid is a program that is growing. Nationwide, Medicaid has grown 8 percent over the past year. Wisconsin expenses have grown almost a billion dollars or 20 percent in just the last year.

As the program grows much faster than state revenue, Medicaid is taking up a larger proportion of the state budget. In 2009, Medicaid accounted nationwide for an average of21 percent of total state spending.

People ask me, “Will Medicaid disappear” with federal health care reform. The answer is no. In fact, the federal government will rely even more on this program to provide health care to those with the least.

Historically Medicaid has served special populations – low-income children, parents of these children, pregnant women and low-income elderly. Just last summer, the poorest without children became eligible for the Medicaid program.

The effect of those who are poor and without health care coverage is staggering. In 2007, more than 45 percent of the poor, non-elderly were uninsured and only 15 percent had coverage through their job .

Federal health care reform will bring us a Medicaid program with fewer holes in the safety net. A new insurance exchange will be the answer to the self-employed and small business person. But for the poor, health care reform will be provided nationally through an expansion of Medi-caid. The Congressional Budget Office estimates nearly one-third of those newly insured will gain coverage under Medicaid.

One reason is because the federal cost of providing care is less to enroll someone in the Medicaid program than to enroll the person in the new Health Exchange. The Congressional Budget Office estimated the per capita federal cost of covering a patient through the Exchange in 2019 would be $5,926 and covering the same person through Medicaid would be $1,826

The state cost for an adult under family Medicaid was a little over $2,000 a year. Medicaid has lower administrative costs, contains no profit and pays providers less than commercial insurance.

Wisconsin’s Medicaid program faces a deficit of more than $600 million. The Legislative Fiscal Bureau recently estimated unanticipated increases in enrollment may cause overruns of an additional $120 million to

$150 million. On Wednesday, the Joint Legislative Audit Committee, on my recommendation, considered a comprehensive audit of the state’s Medicaid program. The audit can help us be better informed on how we can most efficiently provide health care to some of our most needy individuals and families.

With federal and state efforts to expand the program and one out of every five budget dollars going to Medicaid, it is critical we make the most informed decisions. With federal dollars likely to be in short supply in the next budget cycle, an audit can lay out a blueprint for the incoming governor and the Legislature to craft policies in 2011 that provide care for those with great need at a cost taxpayers can afford.

La Crosse Tribune  – Posted in Opinion, Columnists on Friday, January 15, 2010


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