As people have lost jobs and health care benefits, the state has come to rely more and more on Medicaid: 1.7 million people or 1 in six are now enrolled in the program. As reimbursement rates decline, the number of doctors accepting Medicaid has also decreased, making access to health care more difficult for some Medicaid recipients.
Medicaid funding is a confusing and complex subject. As budget proposals are offered by the Governor and the legislature, I hope there will be some wise people who know a lot more than I do, who will help us understand the comparative wisdom of the choices our legislators will have to make.
Medicaid is a shared state and federal program where the federal government matches state money according to a formula that varies from state-to-state and year-to-year, depending on the state's economic condition and need. Michigan is a very needy state indeed. For every dollar that the state spends on Medicaid, the state gets three dollars from the federal government. While this is not free money, in many respects, Medicaid services are a real bargain. I assume that by maintaining or increasing Medicaid spending, the money could go a long way toward maintaining and increasing jobs in health care and specialty services in the community mental health system and would have a positive effect on the economy.
That the Senate Majority Leader is considering dropping optional Medicaid services, could be a scary proposition. Don't let the word "optional" fool you. These services are lifelines for people with developmental disabilities and their families, as well as for the other populations that Medicaid serves. Here is partial list of optional Medicaid services that people with developmental disabilities have come to rely on:
- Prescribed drugs
- Medical care or remedial care furnished by licensed practitioners under state law
- Diagnostic, screening, preventative, and rehabilitative services
- Clinic services
- Dental services
- Prosthetic devices
- Physical therapy and related services
- Intermediate care facility for the MR
- Home health care
- Case management
- Respiratory care services for ventilator-dependent individuals
- Personal care services
- Private duty nursing services
- Hospice care
- Home and community-based waiver services
Reducing spending on Medicaid and the services covered, looks more like folly than fiscal responsibility to me.
For more information on Medicaid services, including a more complete chart of mandated and optional services, see the VOR Website.