As rising unemployment swells Medicaid rolls, the Bush administration issues a new federal rule that would allow states to “deny care or coverage to Medicaid beneficiaries who do not pay their premiums or their share of the cost for a particular item or service.”
In what the New York Times describes as a “sea change” in Medicaid, states will now “charge premiums and higher co-payments for doctors’ services, hospital care and prescription drugs provided to low-income people under Medicaid“:
The administration acknowledged that ‘some individuals may choose to delay or forgo care rather than pay their cost-sharing obligations’…The Congressional Budget Office has estimated that 13 million low-income people, about a fifth of Medicaid recipients, will face new or higher co-payments. Most of the savings result from “decreased use of services,” it said.
Rather than the Bush administration’s approach of forcing poor Americans to pay more for health care during an economic crisis, the federal government should increase FMAP — the percentage the federal government reimburses states for Medicaid — and expand the program to allow more Americans to buy affordable health coverage.
Growing health costs are now “the primary driver of the fiscal challenges facing the state and local sector over the long term.” At least 27 states are facing budget gaps and most are simultaneously experiencing an increase in Medicaid enrollment. A survey by the Kaiser Foundation concluded that “Medicaid enrollment across the country grew 2.1 percent in fiscal year 2008″ and “states expect to see even larger increases in Medicaid enrollment and spending” in fiscal year 2009.
But as more Americans are relying on government safety net programs for health care — or forgoing care altogether — the Bush administration is banking on “reduced use of services” and co-payments to help recipients become “more educated and efficient health care consumers.”