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| Wilson: Health Care Loses Out When States Play Games with Medicaid Dollars |
March 18, 2004 |
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Washington, DC – Congresswoman Heather Wilson, who chairs the Energy and Commerce Medicaid Task Force, today said that Medicaid should reward states for improving the health of low-income children, pregnant women, disabled and elderly who depend on the program.
Wilson, who has experience in state government, said that states work to maximize their share of federal dollars, but often the money misses its intended use. By inappropriately using Upper Payment limits and Disproportionate Share Hospital payments to draw down federal funds, some states are not using those funds for Medicaid or any other health care program.
“States are chasing pennies on the dollar rather than focusing on improving the health of people who depend on Medicaid,” Wilson said. “But these tricks are really only a symptom of the bigger problem: Medicaid’s whole financial structure is held together with bailing wire and duct tape.”
Wilson’s comments came at a hearing of the Energy and Commerce Health Subcommittee. Wilson’s task Force asked the committee to hold a hearing on the topic of these financing mechanisms, known as Intergovernmental Transfers.
“We shouldn’t be surprised that states play the game; Congress wrote the rules. And the rules need to be changed so that states win when the health of low-income children, pregnant women, the disabled and seniors improves,” Wilson said.
Medicaid has surpassed Medicare as the largest public health insurance program in the United States with 48 million beneficiaries and expenditures of $280 billion each year. The program is 7 percent of the federal budget and between 15 and 20 percent of state budgets.
Some states have been able to use schemes to increase their federal matching rate by as much as 4 percent, penalizing states that do not follow the same tactics and undermining the intention of the formula based on per capita income.
“The time is coming to fundamentally change the program so that states don’t need a waiver to establish programs that improve the health or empower the patients who depend on Medicaid,” Wilson continued. “We must make sure the money goes to the low-income children, mothers, elderly and disabled people who depend on it.”
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