Medicare Compliance & Reimbursement

Could higher Medicaid copays be on the horizon?

The National Governors Association and the National Conference of State Legislatures drafted proposals suggesting ways Congress could cut $10 billion from Medicaid, the New York Times reported.
 
The NGA proposed funding LTC with more reverse mortgages and raising copayments on Medicaid services. The NGA report also suggested Congress should allow states more leeway to offer different, population-specific benefits packages throughout the state.

Although some of the NGA's proposals are similar to President Bush's ideas, the governors didn't include his recommendations that shifted costs to the states, reported the Times.

In contrast, the NCSL wants Congress to provide states with a fixed amount of federal LTC funding, which the federal government would increase each year to reflect medical costs and demographic changes.

The NCSL's proposal would take away the Medicaid program's legal entitlement element and would change the requirement that states treat children under 21 years old for any health problem discovered during a routine examination, the Times reported. Of course, states haven't agreed to this proposal.

While one proposal shifts the brunt of the budget cuts onto beneficiaries, the other shifts it onto the states, but both proposals came under fire from health care providers, labor unions and beneficiary advocates. NGA's recommendation to establish higher emergency care copayments could discourage Medicaid recipients from seeking treatment, advocates argue. Advocates also fear the NCSL's proposal could endanger children, if Congress waived Medicaid's requirement to treat their health problems.

"We need to install a greater sense of personal responsibility so people understand that this care is not free," NCSL president and Maryland House of Delegates member John Adams Hurson (D) said May 9.

Proponents of Medicaid cuts believe the reduction in federal Medicaid dollars will inspire, and the new commission will encourage, streamlining the program, but challengers say the budget cuts will initially force states, Medicare and possibly beneficiaries to fill the federal funding gap.