Tuesday, October 03, 2017

State's Spending for Medicaid Up

....despite the fact that per-person spending for traditional Medicaid is way down. What could explain this discrepancy? Get the details here. Expanded Medicaid coverage for able-bodied adults under Obamacare, disingenuously called first "The Private Option" and then relabeled with minor tweaks as "Arkansas Works". Coverage for these folks went UP 3.4% while coverage costs per person for traditional Medicaid went down on a per person basis. Total costs are rising because about a tenth of the time when someone signs up for "Arkansas Works" they send them to traditional Medicaid instead. So our state's integration with Obamacare is swelling the ranks of both Medicaid programs to the budgetary breaking point.

It is going to get worse. Arkansas was finally forced to purge its Obamacare rolls of thousands of people who were not eligible for the program, often because they no longer lived here or already had other coverage. People in those groups did not cost us a lot of money (but insurance providers still collected payments from FEDGOV for them). Now that they are gone, expect average costs to go up. In addition, at the mid-point of this fiscal year the FEDS started asking Arkansas to take what will be an increasing share of the costs. If we don't start shedding folks from this program it will be a fiscal disaster for us. The Governor is trying, but so far he seems to be caught in a trap of his own making. He wanted to suck every dollar he could out of taxpayers when DC was collecting the taxpayers but now that they are starting to come out of his budget he is scrambling.

The Governor is pushing hard to drive down the costs of traditional Medicaid- maybe in a way which will impact services for the truly needy and disabled. But he seems to be doing it to find fiscal room to keep the other Medicaid program- the one from Obamacare for able-bodied adults. So far most of his hard choices have fallen squarely on the shoulders of traditional Medicaid because the state pays a bigger share of the tab in that program than it does in Obamacare Medicaid. But this perversely cuts services to the very ones that most people don't mind paying taxes for, such as the blind, those with autism, and other disabled people in order to keep funding for health care for able-bodied adults. At some point, we are going to have to get some kind of priority other than taking as much taxpayer money as DC is willing to hand out.


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4:05 AM, October 05, 2017  

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