Well-managed Medicaid vital for Utah
It is easy to confuse Medicaid with Medicare, our national government's health insurance program for the elderly. Both are big ticket items (together totaling $650 billion in 2005), but Medicaid is now the focus of both national and state scrutiny because in 2004 it nearly surpassed Medicare in overall costs ($291 billion).
U.S. Health and Human Services Secretary Michael Leavitt has established a Medicaid Commission to study the issue and to make recommendations by the end of this year. The commission's report is expected to warn of the increasing costs of Medicaid due to aging low-income baby boomers and to encourage greater state flexibility in managing their Medicaid programs.
Here at home, the Utah Legislature last year established a Medicaid Interim Committee that has been wrestling with similar concerns. The committee should be complimented on its sincere efforts to learn more about the complexities of Medicaid and its consideration of all options available for cost containment. However, it should come as no surprise that no easy solutions have yet been identified.
— Medicaid enrollment has been declining over the past year, not only in Utah but across the nation. This is likely due to improved state economies and increased personal income. Declining enrollment will provide some temporary relief in expenditures.
— Utah Medicaid has been fairly prudent in its use of state funds. Utah has limited eligibility in most categories to the lowest levels allowed by the federal government. As a result, in 2004 only 6 percent of our state's revenues went to Medicaid. Tennessee and Connecticut were at 20 percent.
— Medicaid is an important safety net for 275,000 Utahns who are poor and particularly vulnerable. More than 60 percent of Utah nursing home residents receive Medicaid assistance.
— Medicaid has implemented creative pilot projects using federal "waivers" to provide health care to those who otherwise would not be served or who would be served in a more costly manner. These include the Primary Care Network, home and community-based care (as an alternative to nursing homes) and "capitated" or managed mental-health care through local mental-health centers.
— Medicaid pays for the majority of care to the mentally ill and disabled in the State Hospital in Provo and the Utah State Developmental Center in American Fork.
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