JFC Looking at Medicaid Options
The Republican congress is scattershot. The Republican president is temperamental. This is what the Joint Finance Committee has to deal with when looking a repeal of the Affordable Care Act and its repercussions in the state.
Projected growth in Medicaid spending is modest compared to years past, at $13.3 million for fiscal year 2018. In the current year, Delaware will pay about $760 million for its share of the program.
In an effort to reduce future costs, his fellow co-chair, Rep. Melanie George Smith (D-Bear), said Delaware could look into requiring adults on Medicaid to take steps toward better long-term health in exchange for added benefits.
Such a change would need approval from the Centers for Medicare and Medicaid Services.
Define said steps towards “better long term health, the statement of itself sounds Republican in nature and makes me think the little twit wants to drug test the poor.
“Delaware could look into requiring adults on Medicaid to take steps toward better long-term health in exchange for added benefits.”
There are some requirements that could be reasonable, like showing up for an annual physical, or following up on tests indicating chronic conditions like diabetes or high blood pressure.
Apply the kind of prohibition we have on cannabis to sodas.
Realistic step (that I admit I don’t know exactly how to implement): require Medicaid recipients to use urgent care and primary care physician services for non-emergency medical treatment instead of Emergency Rooms. This would, by itself, save millions each year. Urgent care and PCP providers do the same services for about 25-30% of what Medicaid is billed by hospitals.
But it would also require ERs to be able to triage and turn away inappropriate visits, which would require some tinkering with Federal statutes and medical liability law. Still, we could start by implementing “non-Emergency co-pays” for ER visits for Medicaid patients.
FYI I have a daughter and grandson on Medicaid, so I do realize exactly what I’m advocating, and I do not believe it would constitute any actual hardship. Going to the ER is often a convenience choice.
The interdependence between and among effects of benefit cuts, health outcomes and social/economic outcomes are never being considered in these discussions around budgetary austerity. Take Michigan’s example: Economic Effects of Medicaid Expansion from: John Z. Ayanian, M.D., M.P.P., Gabriel M. Ehrlich, Ph.D., Donald R. Grimes, M.A., and Helen Levy, Ph.D. N Engl J Med 2017; 376:407-410February 2, 2017DOI: 10.1056/NEJMp1613981
“During this period, estimated additional employment associated with increased Medicaid spending peaked at over 39,000 jobs in 2016 and is projected to decline to approximately 30,000 jobs in 2021. About two thirds of these jobs are outside the health care sector, because of two factors. First, about one third of Healthy Michigan Plan spending represents preexisting spending by the state, employers, and individuals for which the federal government is assuming responsibility, thus freeing state and private resources to be spent in other ways. Second, about half the jobs created by the macroeconomic stimulus arise from the multiplier effect as new spending spreads through the economy. During these years, the increased personal income associated with new employment is expected to be relatively stable, at $2.2 billion to $2.4 billion per year. The added economic activity is projected to yield approximately $145 million to $153 million annually in new state tax revenue.
This additional state tax revenue offsets nearly all of the state’s projected new spending for Medicaid expansion in 2017 and about 37% of these costs in 2021. After further accounting for the projected $235 million in annual state budget savings for mental health and other programs arising from Medicaid expansion and up to $200 million annually in state taxes and contributions from health plans and hospitals,3 we found that the state costs of Medicaid expansion will be fully covered through 2021 (see table) and are very likely to be so in subsequent years as well.”
I wonder if they have cannabis infused soda dispensers anywhere
Steve, I don’t know why anyone would choose to send their child to the e.r. for something mild in nature, compared to a true emergency. I agree, take them to Urgent Care if their own physician isn’t available.