Kansas Health

No need for "terrible" solutions to Medicaid spending

[Phillip Brownlee, "Beast: Medicaid gobbling budget," The Wichita Eagle, 28 February 2005.]

The Wichita Eagle's Phillip Brownlee is correct to point out the need for reform in the state's Medicaid program:

Lawmakers have been appropriately focused this session on school finance. But there is an even bigger financial challenge facing the state -- and one that may be even more difficult to solve than adequately funding schools.

The state's share of Medicaid costs have been increasing an average of 12 percent a year -- and they are expected to keep climbing. As a result, the state is having to use most of its revenue growth to cover these increasing costs, rather than spend the extra money on education or other state needs.

[T]he bottom line is that one way or the other, lawmakers have to tame this budget beast.

Unfortunately, he sees no way out:

The policy dilemma is that the options for controlling costs are all terrible. For example, lawmakers could raise some eligibility requirements, but do they have the stomach to kick away vulnerable Kansans who really do need help? They could also reduce reimbursement rates to hospitals and physicians, but the state's rates are already among the lowest, and dropping them more could cause physicians to stop treating Medicaid patients.

In reality, legislators do have the ability to craft a program that is more effective at meeting the needs of beneficiaries while also containing costs. Florida is doing just that. So is South Carolina. There needs to be a genuine discussion of the growth in costs to motivate action, but just as importantly we must not lose sight of the fact that reform does not have to mean "kick[ing] away vulnerable Kansans who really do need help." Those Kansans are the same ones who are being underserved under the current program. Both they and the taxpayers paying for Medicaid deserve better.

[John McClaughry, "Patient Power: A Health Care Reform Agenda for Kansas," The Flint Hills Center, May 2004.]