Congressional Republicans are hoping to give states more discretion over their Medicaid programs and ideally push beneficiaries into private sources of insurance coverage. They argue that the program’s costs are growing at an unsustainable rate and that Medicaid’s structure and lower provider reimbursement rates undermine patients’ access to quality care. The party has gone so far as to suggest that people are better off uninsured than insured under Medicaid and has described the program as a “medical ghetto.”
But a new report from First Focus highlights the importance of Medicaid in providing cost efficient coverage to lower income patients who “face elevated health risks.” Medicaid typically offers “a broader range of services, including preventive care and special services needed by those with disabilities or other chronic conditions” at access levels that are actually “comparable to access provided under private health insurance and far better than access available to the uninsured.” Despite the GOP’s claims, “almost all children covered by Medicaid or CHIP children have a usual source of care” and “about nine out of ten publicly- and privately-insured adults had a usual source of care, compared to less than half of uninsured adults”:
Moreover, “after controlling for health status, age, gender, income, and other factors, the average per person annual cost of serving an adult on Medicaid was 20 percent less than under private insurance and the annual cost of serving a child on Medicaid or CHIP was 27 percent less than under private insurance”:
The report also notes that Medicaid’s cost sharing limits — “low out-of-pocket copayments, deductibles or premiums – compared to private insurance” play an important role in preserving access to coverage and keeping lower income families from being pushed out of insurance by escalating health care costs.
Rep. Paul Ryan’s budget reduces Medicaid funding by $1.4 trillion over the next decade and transforms the existing financing mechanism into a block grant that does not keep up with projected health care costs. As a result, a recent Kaiser Family Foundation report estimated that up to 44 million Medicaid beneficiaries could be pushed out of the program.