New Medicaid Rules Will Hurt States During Economic Downturn, Critics Say

Main Category: Medicare / Medicaid / SCHIP
Article Date: 21 Feb 2008 - 11:00 PDT

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Critics of Medicaid regulations that will begin to take effect on March 3 contend that implementing the rules during an economic downturn "will only worsen the fiscal situation for already strapped state budgets," CQ HealthBeat reports. Speaking at a forum sponsored by the Alliance for Health Reform and the Kaiser Family Foundation's Commission on Medicaid and the Uninsured, Barbara Edwards of the National Association of State Medicaid Directors said that as the economy weakens, more workers are becoming unemployed and some are enrolling in Medicaid because they have no alternatives for coverage. At the same time, state revenues are declining, and states are faced with more demands for Medicaid services and fewer resources, Edwards said, adding that the timing "almost couldn't be worse for states for many reasons."

However, Dennis Smith, director of CMS' Center for Medicaid and State Operations, at the forum said that timing is not the only consideration. "In good times people say, 'Don't rock the boat.' In tougher times they say, 'Oh no, not now,'" adding, "We think that these are good regulations that help preserve the integrity of the program" (Johnson, CQ HealthBeat, 2/19).

A webcast of the forum is available online at kaisernetwork.org.

Dental Coverage
In other Medicaid news, the House Oversight and Government Reform Subcommittee on Domestic Policy on Thursday held a hearing on improving access to dental services for Medicaid beneficiaries, one year after a 12-year-old Medicaid beneficiary died when an infection from an abscessed tooth spread to his brain, CQ HealthBeat reports.

Witnesses told the subcommittee that CMS has done little to improve access to dental services. Jim Crall, director of the National Oral Health Policy Center at the University of California-Los Angeles, said that Medicaid dental reimbursements are lower than the "usual, customary and reasonable" fees that private health insurers charge for dental services. In addition, many states have no mechanism to provide regular updates to reimbursements.

Smith acknowledged that reimbursement rates are low and that the rates are "major barriers of access" for beneficiaries attempting to access dental services. He said that Medicaid spends $2,900 per child each year and that one in three children enrolled in SCHIP or Medicaid received dental services in the past year -- a 10% increase from 2003 (Straus, CQ HealthBeat, 2/19).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.