Kaiser Daily Health Policy Report Rounds Up Recent Opinion Pieces on State Medicaid Programs

The following is a summary of opinion pieces on state's Medicaid programs:

• Billings Gazette: In an editorial, the paper tells the tells the Montana Department of Public Health and Human Services what it "needs to hear" when it considers "emergency cutbacks" to the state's Medicaid program that are expected to save the state $5.1 million this year. The editorial states that a proposed across-the-board cut in payments to Medicaid providers would reduce "any incentive [doctors have] to serve needy Montanans," adding that the current rates are already below costs. The state also is considering raising copayments for all Medicaid beneficiaries, and the editorial agrees that beneficiaries "should be paying what they can afford." But the Gazette maintains that "an across-the-board increase [in copayments] isn't designed to collect what people can pay. It hits those who can least afford to pay" (Billings Gazette, 2/6).
• Boston Globe: Medicaid is the "creature that ate [Massachusetts'] budget," Boston Globe columnist Charles Stein states in an op-ed for the paper. In fiscal year 2003, Medicaid is expected to cost the state $6 billion, or 25% of state spending, up from $4 billion and 20% of the state budget in fiscal year 1999. Acting Gov. Jane Swift (R) recently made some changes to the program -- including eliminating basic dental coverage for adults -- to save the program money. Swift "took plenty of heat" for that decision, but "she didn't have a lot of attractive options," Stein maintains. Besides cutting the program's drug costs, a "subject for another day," Swift had three ways to cut Medicaid expenses: "You can kick people out of the program, you can cut their benefits, or you can pay doctors, hospitals and nursing homes less. It's a lose, lose, lose situation," Stein writes (Stein, Boston Globe, 2/5).
• Daily Oklahoman: The Oklahoma Health Care Authority, which oversees the state's Medicaid program, "must do its part" to address the program's "problems," which include increasing enrollment, a "seemingly eternal funding shortage" and administrative problems, a Daily Oklahoman editorial states. For its part, the agency should cut "administrative overhead," reduce its work force and "attemp[t] to streamline" its operations so that physicians are not "put off" by "oppressive paperwork demands," the editorial suggests. Further, state and federal officials alike should consider eliminating some coverage mandates, which might drive up the program's costs (Daily Oklahoman, 2/1).
• Winston-Salem Journal: Over the last 20 years, North Carolina's Medicaid program has grown on average more than 15% per year and "will only get bigger" in the future, Winston-Salem Journal columnist Paul O'Connor states. According to predictions by the state's Fiscal Research Division, if Medicaid spending increases by 12% over the next eight years, Medicaid would require 36% of all new state revenues by 2010. O'Connor says that when the state Legislature resumes session, lawmakers will "have to face these numbers," and they don't have any "easy" choices. Lawmakers "won't raise taxes again, especially not in an election year," but they also will be "hard pressed not to reduce the services available to Medicaid recipients, or the fees paid to the doctors, or to raise copayments," O'Connor concludes (O'Connor, Winston-Salem Journal, 2/3).