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Medicare Compliance & Reimbursement

MEDICAID:

Revenue Downturns Lead To Recruiting Woes

Published on Fri Sep 02, 2005

Many potential benes caught in economic 'Catch-22.'

When it comes to healthcare coverage, many low-wage workers are between that proverbial rock and hard place. An economic downturn and fewer companies offering coverage have led many to seek state or federal programs to help cover their families, while tight budgets mean legislators want to slow this very growth.

So say two reports released by the Kaiser Commission on Medicaid and the Uninsured. The first report studied enrollment in State Children's Health Insurance Programs through 2004. The other focused on Medicaid enrollment through June 2004.

Throughout 2004, national enrollment in SCHIP held at approximately 3.9 million children. In the first half of the year, however, the number dropped from 3,924,000 in December 2003 to 3,887,000 children in June 2004. This decrease made for the second six months of continued decline. Meanwhile, the 12-month decline that began in June 2003 was the first drop in enrollment in the program's history. The last half of 2004 saw enrollment jump to 3,950,000 by December. Previously, the number of children enrolled peaked in June 2003 at 3.95 million.

Another factor for 2004 was the effect of an economic downturn on SCHIPs across the country. Because revenues were down, most states had difficulty allocating money to fund the program, which contributed to the end of many outreach and enrollment simplification initiatives that had helped previously to enroll large numbers of low-income, uninsured children, the SCHIP report showed. Meanwhile, employer-sponsored health plans continued to erode. This was especially true among employers that offered low-wage jobs, therefore making SCHIP an important source of health coverage for many families in this population.

The report on Medicaid enrollment found that 41.3 million people nationwide had either full or partial coverage under the program as of June 2004. That means that during the previous year, the number of beneficiaries increased by 1.6 million or 4.1 percent--which, thanks in part to state government measures, was a slower rate of increase than in years past. This jump continued the national trend of Medicaid rolls growing every six months since December 1998, however. The report authors also found that:

• between June 2000 and June 2001, program growth accelerated to 8.1 percent.

• a drop to a 5.7-percent rate of growth occurred between June 2002 and June 2003--and the rate continued to slow in the following year to 4.1 percent.

The study attributed this reduction in part to economic hard times. In fact, the growth rate might have been higher, save for budget-driven polices many states instituted in 2002 and 2003 that slowed enrollment, the report noted.

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