Thursday, August 18, 2005

Doctors, HHS Clash Over Need For Higher Co-Payments For Medicaid

A Bush Administration proposal to hike Medicaid co-payments for adults and introduce co-payments for children has drawn fire from doctors.

The debate came at an Aug. 17 meeting of the Medicaid Reform Commission, a federal advisory panel appointed by the administration to help rein in the growth of Medicaid, which provides health insurance to more than 50 million low-income people.

Under current law, adults pay $3 co-payments. Co-payments are not allowed for children under 18. The administration is proposing $5 co-payments for adults, and $3 co-payments for children.

Under the proposal, the Congressional Budget Office estimates, Medicaid recipients would pay $4 billion in additional charges over the next five years. But according to an Aug. 18 story in the New York Times, Dennis G. Smith, a top federal Medicaid official, reminded his fellow panel members that this was not a large amount in the context of a program expected to cost the federal government and the states $2 trillion in the next five years.


Democrats have been leery of the commission, saying it would simply ratify budget cuts proposed by President Bush. Shortly after it was created, Senate Minority Leader Harry Read (D-NV) and House Minority Leader Nancy Pelosi (D-CA) declined the invitation to appoint four non-voting members to the commission, which it said was stacked with as many as 34 voting and non-voting members appointed by Republicans.

"We fundamentally disagree with the premise that this Commission should make recommendations on how to cut Medicaid outlays by $10 billion by September 1. While we need to reduce the deficit, we should not make cuts affecting the most vulnerable Americans in order to finance more tax cuts for the wealthy," Reid and Pelosi wrote in a May 26 letter to HHS Secretary Michael Levitt.

But the panel made clear yesterday that it would not rubber-stamp the Bush Administration proposal.

"If we raise the co-payment, some people will not get the care they need. These are real people," the Times quoted commission member Dr. John C. Nelson, a former president of the American Medical Association.

A person with chronic illnesses who forgoes medicine because of the higher co-payment could end up in a hospital emergency room, which costs much more, said Dr. Nelson, an obstetrician and gynecologist from Salt Lake City.

Dr. Carol D. Berkowitz, a commission member who is president of the American Academy of Pediatrics, said that co-payments of $3 to $5 could quickly add up to substantial costs for a low-income family with four children.

Another commission member, Julie Beckett, said that a $5 co-payment for each drug and doctor's visit "is a lot if you have multiple chronic conditions and multiple needs."


The commission was established in May with the charge of saving $10 billion over five years. It will decide on the administration's proposed co-payment increase in a report to be submitted to Levitt on Sept. 1.


Blogger Chandira said...

I think it's fair to keep copay up with inflation to some degree, you know things do get more expensive, but what about a sliding scale of some sort.
1st, say, 5 visits are $5. After that they go back down to $3?
Or maybe a $1 off for each kid you have. Got 1 kid? $3. Got 4? $1 each..
Or would that be common sense? ;-)
Probably an admin nightmare, but worth a try?

5:06 PM  
Anonymous Anonymous said...

This administration would probably think that was some sort of welfar incentive to have more kids.

5:11 PM  
Blogger Chandira said...

Well, then they should ban the Pope.. ;-)

5:19 PM  
Blogger Kristopher said...

...Doesn't being against bush make you biased? A journalist is unbiased. Therefore you are a pundit not a journalist.

5:22 PM  
Anonymous alias: "cutiepie" johnson said...

I can't speak for JABBS, but he's a business journalist by profession (see upper left corner of blog for details).

In the course of running this blog, I suppose you could label him a pundit. That would make the name of the blog, PABBS, which doesn't offer the same double entendre.

5:32 PM  
Anonymous Anonymous said...

The Democrats keep trotting out this "tax cuts for the rich" theme on nearly every single issue that comes up. I have to admire their discipline at staying on message, and adhering to the party's talking points.

Do they not pay attention to the revenue numbers that show that the revenues are significantly higher, and continue to increase ?

5:38 PM  
Anonymous Anonymous said...

It's the Bush Administration that is looking to cut $10 billion over five years, not the Democrats.

All the Democrats are saying is that if revenue has to be raised, let's not raise it from the poorest among us.

Considering the size of the tax cuts, and the fact that they overwhelmingly benefit the wealthy, this doesn't seem like an outrageous opinion.

5:46 PM  
Blogger Michael said...

Mathetes, exposing propaganda and the shills in the press isn't necessarily "against Bush". It just so happens that Bush is a lying propagandist who pays off journalists to be spread lies and propaganda. See how that works?

Chandira, you are proof that liberals are not only more sensible, but way cuter than conservatives. :-)

6:21 PM  

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