Monday, August 07, 2006
Another NGA meeting full of handwringing about Medicaid
[Robert Tanner, "Governors wrestle with Medicaid changes," Associated Press, 7 August 2006.]
A number of states are tackling major Medicaid reform, but for the most part the nation's governors seem content to meet once a year and either talk big about far-off plans or simply bemoan about the growing problem:
For most governors, what's happened so far are just baby steps — but they are steps toward change.
- Massachusetts created universal health insurance by requiring everyone to carry insurance, with a combination of subsidies and penalties to make coverage more affordable and encourage people to buy it.
- Florida tried to rein in costs, starting in two large counties, by shifting many Medicaid recipients into private managed care. Medicaid recipients choose a managed care group to coordinate their care and the state pays a premium to the group. Companies will get more money for sicker patients.
- West Virginia aims to encourage Medicaid families to make healthier decisions and save money by reducing benefits if they refuse to sign contracts promising to show up for doctors' appointments and use the emergency room only for emergencies.
Most programs are not yet in place or too new to assess whether the change is for better or worse, or even if they work. Democratic Gov. John Baldacci's overhaul in Maine — which brings state and businesses together to get more people on insurance — is one of the oldest, though so far has failed to enroll the numbers of uninsured that it aimed for.
[Michael Bond, "Reforming Medicaid," Testimony before The Kansas Health Policy Authority, The Flint Hills Center, 18 July 2006.
Michael Bond, "Create a Real Kansas Medicaid Market," The Wichita Eagle, 10 February 2006.]
A number of states are tackling major Medicaid reform, but for the most part the nation's governors seem content to meet once a year and either talk big about far-off plans or simply bemoan about the growing problem:
For most governors, what's happened so far are just baby steps — but they are steps toward change.
- Massachusetts created universal health insurance by requiring everyone to carry insurance, with a combination of subsidies and penalties to make coverage more affordable and encourage people to buy it.
- Florida tried to rein in costs, starting in two large counties, by shifting many Medicaid recipients into private managed care. Medicaid recipients choose a managed care group to coordinate their care and the state pays a premium to the group. Companies will get more money for sicker patients.
- West Virginia aims to encourage Medicaid families to make healthier decisions and save money by reducing benefits if they refuse to sign contracts promising to show up for doctors' appointments and use the emergency room only for emergencies.
Most programs are not yet in place or too new to assess whether the change is for better or worse, or even if they work. Democratic Gov. John Baldacci's overhaul in Maine — which brings state and businesses together to get more people on insurance — is one of the oldest, though so far has failed to enroll the numbers of uninsured that it aimed for.
[Michael Bond, "Reforming Medicaid," Testimony before The Kansas Health Policy Authority, The Flint Hills Center, 18 July 2006.
Michael Bond, "Create a Real Kansas Medicaid Market," The Wichita Eagle, 10 February 2006.]
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