Friday, July 16, 2010

150,000 coming into already troubled Medicaid program

Finally attention is being paid to probably the largest impact of national reform – an estimated 150,000 people in CT will become eligible for Medicaid/HUSKY; an increase of 38% over current levels. Any reader of this blog knows how HUSKY has struggled since its inception. A secret shopper survey found only one in four listed providers would make an appointment, very low provider participation compared to other states, inability to implement PCCM (successfully implemented in 21 other states), and overpayments to HMOs estimated at $50 million/year to name just a few of the challenges. Today’s CT Mirror is reporting on the coming tsunami of applicants when Medicaid eligibility rises to 133% of the federal poverty level regardless of family situation on January 1, 2014. Currently Medicaid eligibility is mainly limited to low-income families with children, pregnant women, seniors and people with disabilities. This increased demand in CT’s largest health care purchasing pool (yes, HUSKY is the biggest pool – 394,114 as of July 1st) happens as the entire state is facing a growing primary care capacity shortage. This is everyone’s problem and we need to begin planning now.
Ellen Andrews