Governor Huckabee's News Column: Medicaid

Governor Huckabee's News Column: Medicaid

There's a crisis in every state Capitol in the country. It concerns the increasing cost of Medicaid, the federal-state partnership that ensures medical treatment for the poor and disabled. On Jan. 10, Gov. Phil Bredesen of Tennessee announced he's eliminating Medicaid services for 323,000 of that state's low-income working poor while limiting services for an additional 400,000 Tennessee residents. Medicaid represents almost 33 percent of the Tennessee budget. Next door in Mississippi, meanwhile, a state not much bigger than Arkansas is faced with a Medicaid deficit that could reach $290 million. Even if there's level funding in all other areas of state government, Mississippi is expected to experience a deficit of between $350 million and $400 million in fiscal year 2006.

At least 39 of the 50 states have budget problems due to Medicaid growth. Sixteen states in addition to Tennessee are cutting recipients from the Medicaid rolls. Last year, there were 20,000 people cut in Connecticut; 10,000 in Massachusetts; 27,000 in Minnesota; and 24,000 in Oregon. As you can see, this isn't a problem confined to one part of the country. It's not that states aren't trying to control costs. More than half of the states have caps on the number of outpatient visits. Five states refuse to cover dental services, 26 states prohibit chiropractic services and 13 states refuse to pay for podiatry services. Due to the superb management of Kurt Knickrehm and his staff at the Arkansas Department of Human Services, we don't face problems in Arkansas as severe as those in Tennessee and Mississippi. But as is the case in other states, the cost of the Medicaid program in Arkansas continues to soar. We must take steps to limit that rate of growth.

As vice chairman of the National Governors Association, I've been going to Washington on a regular basis to meet with Bush administration officials, members of Congress and other governors to address the Medicaid monster. Here in Arkansas, a state with fewer than 3 million residents, more than 700,000 people are served by Medicaid. I'm hopeful governors and members of Congress from both parties will work with the administration in a non-partisan manner to enact reforms that will create savings. Medicaid costs are growing at an annual rate of 12 percent and eating up 22 percent of state budgets on average. That's up from just 10 percent of state budgets in 1987. The causes for this growth are a 33 percent increase in caseloads during the past four years and rapidly increasing long-term care costs. Medicaid finances about 70 percent of all care for nursing home residents nationwide. The program now costs the states and the federal government more than $300 billion annually. Medicaid is now a larger component of total state spending nationally than elementary and secondary education combined.

One of the problems we face at the state level is that 42 percent of all Medicaid benefits paid by states are delivered to Medicare beneficiaries. That's despite the fact that Medicare, which unlike Medicaid is totally funded by the federal government, already fully insures these people who are in what's known as the dual-eligible population. Maintaining the status quo isn't acceptable. Yet it's equally unacceptable in any federal deficit reduction strategy to simply shift federal costs to the already overburdened states. Unlike the federal government, states must balance their budgets. The more money we spend on Medicaid, the less money we'll have to spend on education, highways, public safety and other essential parts of state government. I understand the need to reduce the federal deficit. After all, I'm a fiscal conservative. But I'm also a compassionate conservative and consider it unacceptable to balance the budget on the backs of the poorest people in this country. You don't take wheelchairs from children and feeding tubes from the elderly to balance the budget.

The baby boomers are aging, and Americans are living longer. Health care costs are thus spiraling out of control. One of the fastest growing segments of the population is chronically ill adults who have little or no income. No one believes we should cut off care for these people. But consider the fact that the cost of health care for a mother and a child on public assistance is $2,400 a year. The cost of nursing home care for an elderly resident is $23,000 a year. A recent headline in The Wall Street Journal put it this way: "Critical Condition: Surging Costs For Medicaid Ravage State, Federal Budgets." This isn't an issue just for Democrats. It isn't an issue just for Republicans. We must work together to deal with the rising costs and shrinking federal support.

http://www.state.ar.us/governor/media/columns/text/c03052005.html