A recent article in the New York Times is a disturbing harbinger of things to come. The Obama administration has given the green light to states to cut Medicaid payments to doctors and other health care providers to help contain costs. , the secretary of health and human services, approved the cuts in October 2011 after finding that beneficiaries would still have “adequate access” to the wide range of services covered by Medicaid. Okay, hang on... we want to expand Medicaid - that's a good thing, right? But then we also want to cut costs to help contain the cost of expansion. So who wins and who loses in this scenario? Kids and families, that's who.
In the Times article, Governor Jerry Brown of California is quoted as saying that the Medicaid cuts were essential to his efforts to deal with state budget deficit.
- “California has a great record of providing more benefits, expanding to more people, doing more of everything..,But I believe in balancing our budget, living within our means.”
“We like the president’s commitment to extend health care to as many Americans as possible, and we can be powerful partners,” Mr. Brown said. “But we need more authority than we now have. I want to emphasize that — more authority than we have now to manage the Affordable Care Act and the expansion of Medicaid.”
- “Two-thirds of doctors in California cannot afford to participate in Medicaid because the rates are so low. The problem will only get worse if rates are cut as we move more and more people into Medicaid.”
And therein lies the rub... What about the people who benefit from Medicaid? You know, the approximately 60 million low-income people whose numbers are soon to be increased with the new health care law. What happens to them?
Hence the slippery slope. Cut costs, cut rates, definitely cut quality for traditional services. If you doubt it, take a look at the Bickman opinion article we recently posted, which describes a study that shows what many mental health administrators already know - the quality of traditional mental health care is just not that good. The problem is that traditional mental health care is one of the key Medicaid reimbursements for providers serving children with serious emotional challenges and their families.
Cutting rates to help reign in costs is something we need to watch very closely.