Medicaid Cuts Likely: Lansing State Journal

One of the biggest budget challenges facing Gov. Rick Snyder is reining in the skyrocketing costs of serving nearly 2 million people now on Medicaid in the state.

And though that's not exactly a new issue in Michigan, Snyder's task may be harder this year because - among other things - a provision of the federal health care reform act prohibits states from using one budget-cutting tool that has been used before: This year, states can't cut people from the program.

In fact, the number of people on Medicaid - the public health plan for primarily low-income, elderly and disabled people - is expected to rise.

"It's a huge budget challenge," said Marianne Udow-Phillips, who heads the Center for Healthcare Research and Transformation, an Ann Arbor think tank.

"We're looking at a $1.6 billion deficit, and Medicaid is the single largest item in that budget."

The state's recession has led to a 54 percent spike in Medicaid enrollment since 2002 as more and more people have lost their jobs and health insurance.

Between 1999 and 2010, the number of Medicaid recipients rose from just over 1 million to 1.9 million...

Though Medicaid cuts alone won't come close to solving the state's budget crisis, there are some targets that Snyder's team may consider based on history:

• Cuts to optional services, such as dental care for adults.

• Mental health services not currently protected under Medicaid.

• Reimbursement rates to doctors and hospitals that serve Medicaid patients...

"We're hopeful that Gov. Snyder will maintain ... his recognition that provider rates of reimbursement should be not cut but increased in order to preserve access to care for the citizens of Michigan," said David Finkbeiner, senior vice president of advocacy for the Michigan Health and Hospital Association.

"The important sidebar to that is when a service is reduced or limited as a result of government underfunding, that service goes away not only for those covered by Medicaid but those covered by other forms of insurance as well."

Human impact

Medicaid advocates say they know cuts are inevitable but hope Snyder and his team will keep one thing in mind.

"At the end of the day, what is the real human impact?" said Gilda Jacobs of the Michigan League for Human Services.

"We're not just talking about numbers."

www.lansingstatejournal.com/article/20110123/NEWS04/101230471/Health-care-cuts-likely-as-Michigan-struggles-with-budget