Fitzsimon File

For your reading pleasure during the holidays, we are republishing some of the best Fitzsimon File commentaries written earlier this year. This commentary was orginally published on Monday, February 5th, 2007

You would think that state lawmakers would be celebrating a program that provides vital services to 1.6 million people, most of them among the state’s most vulnerable–children, the aged, and people with disabilities.  Especially since the services are provided with much lower administrative costs than the private market provides.

You might think it, but you’d be wrong. The program is Medicaid of course and it’s far more likely to be characterized as a burden than a success story, even though it is literally a lifeline for thousands of children and adults with special needs.

As Adam Searing of the NC Justice Center has pointed out, a recent legislative overview of the program was filled with missing information and misleading or even blatantly incorrect assertions.

No on mentioned that that Medicaid costs actually came in $350 million less than projected last year or that despite the fact that the cost of Medicaid is increasing, it continues to grow far less than private health insurance.  It is now a much greater share of the state’s budget because health care costs overall are rising significantly and more people, particularly children, need coverage.

Of the 1.6 million people in North Carolina covered by Medicaid in 2006, 941,000 of them were children. Most of the money spent on Medicaid goes to care for the blind, the aged, and the disabled, who make up 29 percent of the recipients but account for 69 percent of the Medicaid dollars.

Legislators were told those figures during the recent briefings, but they didn’t seem to have much of an impact. They were also told that North Carolina covers 28 of 34 services that the federal government does not mandate that states provide, meaning they are considered optional services.

That several lawmakers did seem interested in and wondered if the state should offer fewer services to save money. Some of the optional services include eye care, prosthetics, prescription drugs, speech therapy, and ambulance service, making them hardly optional. No one has yet proposed ending coverage for people who need artificial limbs.

Lawmakers also wondered about people coming to North Carolina from other states to receive services and a legislative staff member told them that it was possible for someone to simply check into a North Carolina motel and be eligible for Medicaid. Searing points out that is simply not true.

The proof of residency requirements were significantly tightened several years ago, but the allegation went unanswered, adding to the conventional, but flawed wisdom that Medicaid is out of control and rife with waste and fraud.

Medicaid is also notable for what it is not. It is not a government program for everyone who is uninsured. Most uninsured adults do not qualify for Medicaid regardless of their income levels. It is a program targeted at specific groups of people.

The bottom line is that Medicaid works. It efficiently provides desperately needed services to the most vulnerable people in our state who can’t afford them. That is a reason to celebrate, not complain.

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This entry was posted on Monday, December 24th, 2007 at 8:16 am and is filed under Fitzsimon File. You can follow any responses to this entry through the RSS 2.0 feed.