Medicaid as a state/federal cost-shared program that provides medical assistance for certain individuals and families with low income and limited assets was implemented in Michigan in 1966. There are some requirements to join this program, such as families, aged, blind, and disabled who receiving cash assistance through Temporary Assistance for Needy Families (TANF); infants, children, and pregnant women in lower-income families; low-income elderly and disabled persons; individuals eligible for transitional Medicaid (provided for 12 months to beneficiaries who get a job or a better job and, because of the income increase, become ineligible for Medicaid); and certain low-income Medicare beneficiaries. The services which is given by Medicaid includes inpatient and outpatient hospital services; services provided at rural health clinic and federally qualified health centers; laboratory and x-ray services, nursing home services; physicians' services, including medical and surgical services provided by a dentist; home health services; EPSDT for youth under age 21; family planning services and supplies; necessary medical transportation, and services provided by a nurse midwife, certified pediatric nurse, and certified family nurse practitioner.

In the national case, the Medicaid programs cost has grown substantially from year to year and this condition has not balance with the United States financial resources. Many people that are getting elderly (aged 65 and over) give contribution to the increasing of Medicaid cost, even though they are the small proportion in the United States population. Their cost of care is the most expensive. This demographic condition becomes problem in cost of Medicaid. Michigan has the same demographic problem with the United States. As the number of elderly who qualify for the program grows, the cost of Medicaid will also grows. In Michigan, Medicaid services cost about only about $790 per child but $9,400 per elderly adult.

Currently, Michigan and other states get the impact from the condition. The problems become complicated because of the Federal government's failure to approve an expected six-month extension of the Medicaid program, instead of the Michigan budget problem. The impact from this policy, it will add $514 million to the $1.7 billion Michigan budget problem. Besides that, it will make more cuts to Medicaid provider reimbursement or reductions in Medicaid eligibility or optional services that could decrease Medicaid patients' access to primary care physicians and send them to emergency rooms.

To address the problem of Medicaid's financial future, policymakers are debating changes in the way to solve the problem through managed care and considering changes to eligibility standards and requiring recipients to pay more for the care. Managed care is an approach to health care that coordinates patient care so as to ensure that services are appropriately utilized; and routinely monitors and measures provider performance so as to control cost and maintain or improve the quality of care. Michigan is one of the states that considering a decision on narrowing Medicaid eligibility limits or requiring additional patient out-of-pocket contributions.

The other alternatives that can be discussed to solve the increasing of health care budget, especially in Medicaid, are through extending Michigan's sales tax. This tax can gives funding for the rapidly spending growth in health care. Bob Emerson as the State Budget Director in Michigan suggests the 3% of physician tax will increase state reimbursement rates to Medicaid physicians by 80%.

Sources:
http://www.detnews.com/article/20100613/OPINION01/6130305/1008/Editorial--End-to-federal-Medicaid-help-would-hurt-Mich.
http://www.crainsdetroit.com/article/20100228/SUB01/302289959#
http://www.michiganinbrief.org/edition06/text/issues/issue-45.htm

TrackBack URI for this entry

Comments (0)

Subscribe to this comment's feed

Name

Title

Comment

smaller | bigger

Subscribe via email (Registered users only)

I have read and agree to the Terms of Usage.

Write the displayed characters

Add Comment