Medicaid Target of Recent Budget Cuts

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Gov. Patton recently announced $250-million in cuts to the state's Medicaid program. It couldn't come at a worse time, as an estimated 41,000 more people than projected will depend on the service.

So what's the answer?

Brenda Waltz, CEO of Greenview Regional Hospital, says she knows of a good place to start: Medicaid reform. She says the benefits of the current Medicaid system are better than any private provider can offer. She says those on the plan pay $0 out-of-pocket expense and often come to the emergency room for simple things like headaches. In addition, she says pharmaceutical costs are out of control, all which threaten to break the system for those who really need the help.

The state agrees on many fronts, and Senator Rob Wilkey (D) says to expect a "co-pay" system for some services by July 1st.

Some of the specifics of the state's plan include:

  • Eliminating the low intensity level of care for people seeking to qualify for nursing home care of the Home and Community Based Waiver services. This means Kentucky, like most other states, will have one level of care. Estimated savings= $45 million.

  • Equalizing Medicaid payments for people who are dually eligible for both Medicare and Medicaid. Medicaid currently pays any deductible or co-pay for these recipients for outpatient services. With the change, Medicaid will not pay deductibles or co-pays if it exceeds the Medicaid rate. This will not affect services to the approximately 86,000 people dually eligible by both programs. All other state in the Southeast have implemented this change. Estimated savings = $53- $57 million.

  • Requiring $3 co-payments for optional services including adult users of dental, chiropractic, optometry, podiatry and audiology services. Children, pregnant women and those living in institutional settings are exempt from co-pays. Estimated savings = $1.7 million.

  • Restructuring of the Home and Community Based Services Waiver by placing limits on homemaker services. Estimated Savings = $8 million.

  • Imposing a Certificate of needs moratorium on health care facilities.

  • Placing limits on what Medicaid pays for generic drugs. Estimated Savings = $19 million.

    Source: KY Cabinet For Health Services contributed to this report.