| Reform may ease Medicaid's budget woes AIKEN - Medicaid helps hundreds of thousands of poor South Carolinians pay for health care every year, but many of the doctor visits could be avoided if recipients were better educated. Teaching people to take better care of themselves and treat potentially costly ailments before they become exaggerated is one tactic reformers say could save the program money in light of its budget shortfall of almost $200 million next year. Legislators say they won't give the program any new funding unless reform happens. They say Medicaid's list of recipients in South Carolina has become fat with people who are abusing the program or shouldn't qualify at all. Almost 900,000 people received Medicaid benefits last year, about one-fourth of the state's population, although only about 20 percent of the state is considered to be living in poverty, Rep. Rick Quinn, R-Columbia, points out. "We believe Medicaid should be a safety net," Mr. Quinn said. "We've found that it's becoming health insurance, when we need to get the program down to people who have no other alternatives." Mr. Quinn wrote legislation last year calling for Medicaid reform that passed the House and is before a Senate sub-committee. He recommended a sliding scale that would charge better-off recipients higher fees to receive care. As it stands, users aren't required to pay anything for most services, he said. Few disagree that Medicaid needs reform, but some worry the Legislature might have an exaggerated estimate of how many people shouldn't be receiving care. "Many lawmakers think there's rampant abuse," said Jim Head, the vice president of the South Carolina Hospital Association. "Eligibility studies show that's not the case." If too many people are eliminated from Medicaid's list, it could create a "false savings," he said. "Those people are still going to be out there needing patient care." Possible alternatives, Mr. Head said, include paying doctors who handle more Medicaid cases more money; hiring doctors who would monitor recipients, alerting them when they need care to avoid unneeded and costly emergency room visits; or an "integrated" Medicaid health care community of medical professionals geared toward treating recipients. Medicaid's budget has been cut by roughly $90 million in the past three years, said a spokesman with the Department of Health and Human Services, which regulates the program. Medicaid was bailed out last year when the federal government handed down a last-minute gift of almost $200 million. That money won't be around next year, and a state budget shortfall of between $300 million to $500 million likely means more cuts, legislators say. Gov. Mark Sanford also aims to release a Medicaid reform plan, which will include changes to eligibility, his spokesman, Will Folks, said. The governor backed away from funding Medicaid with an increased cigarette tax, as he did last year. His proposal this year to raise the tax by 61 cents a pack would send the money into the state's general fund, which disappoints members of the Cigarette Tax for Health Care Coalition. The group is pushing a third time for legislators to fund Medicaid with a cigarette tax, arguing that smokers cost the health care system more than nonsmokers. According to their figures, every pack of cigarettes sold leads to $6.52 in health care for smokers down the road. They estimate the average South Carolina family pays $485 a year in state and federal taxes to pay health care for smokers. "The truth is, if Medicaid services are cut, we're all going to feel those impacts," coalition member Stephanie Jones said. If Medicaid doesn't get more money, it could mean less money for doctors, who already are hesitant to treat Medicaid patients, and fewer benefits for recipients. "You could potentially go bankrupt if you only saw Medicare or Medicaid patients," said Paul Velky, a doctor at Family Physicians of North Augusta. "We try not to let how someone is paying change how we treat the patient. You're obligated as a physician to do the best you can for them." "We believe Medicaid should be a safety net. We've found that it's becoming health insurance, when we need to get the program down to people who have no other alternatives." - Rep. Rick Quinn, R-Columbia Reach Josh Gelinas at (803) 279-6895 or josh.gelinas@augustachronicle.com.
|