Reform to grow Medicaid rolls, for costs it’s unclear

By Marion Davis
Contributing Writer
In Rhode Island today, more than 1 in 4 children are enrolled in RIte Care or another Medicaid program. And of the more than 18,000 who are uninsured, almost three-quarters are eligible for RIte Care. Thousands of uninsured, low-income parents are eligible as well. More

To continue reading this article, please do one of the following.



HEALTH CARE

Reform to grow Medicaid rolls, for costs it’s unclear

By Marion Davis
Contributing Writer
Posted 5/10/10

In Rhode Island today, more than 1 in 4 children are enrolled in RIte Care or another Medicaid program. And of the more than 18,000 who are uninsured, almost three-quarters are eligible for RIte Care. Thousands of uninsured, low-income parents are eligible as well.

Under health care reform, childless adults up to 133 percent of the federal poverty line will be newly eligible for Medicaid. If Rhode Island wanted to – a state official said it’s “highly unlikely” given the budget crisis – it could enroll them tomorrow, three years ahead of when it will be mandatory.

Depending on your perspective, health care reform’s Medicaid provisions are a godsend or a nightmare. By requiring states to cover more people, and ensure that everyone who is eligible is actually enrolled, reform dramatically strengthens the Medicaid safety net.

It also pumps hundreds of billions of dollars into the states, covering 100 percent of new Medicaid enrollees’ costs for three years, then gradually dropping to 90 percent for 2020 and beyond. For Rhode Island, one study estimates that will yield $1 billion in the first five years.

For providers, it means far fewer patients who can’t pay for care, even though for hospitals especially, Medicaid rates still fall far short of cost.

But the expansion of the Medicaid rolls will pose significant challenges. Along with about 25,000 adults who will be newly eligible, there are 30,000 to 50,000 adults and children who already qualify for Medicaid but are not enrolled, said David J. Burnett, associate director of the R.I. Executive Office of Health and Human Services, although some may have insurance and not need Medicaid. For most of those who do need the government program, however, the state could only get its standard federal matching rate (52 percent before the stimulus bill).

So when you ask officials how health care reform will affect the state budget, they can only guess at the answer, although they do tend to sound anxious. And as if the cost issue weren’t enough of a challenge, there are the logistics: How do you find all these people, enroll them and keep them enrolled?

The latter is a longstanding challenge for RIte Care. So-called “churn” is endemic, especially among people who are required to pay a monthly premium. It’s common for enrollees to forget to get recertified for the program, as they must do periodically.

Next Page
Calendar
PBN Hosted
Events

Two Great Programs...One Great Event. PBN's Annual Celebration of Growth and Innovation is now underway. 2014 applications are now available. Deadline August 1st.
  • Healthiest Employers
    Celebrate with the Healthiest Employers in RI on August 14th at the Providence M ...
  • 40 Under Forty
    Thank you to our sponsors and to all those who attended the 10th Anniversary of ...
Advertisement
Purchase Data
Book of Lists
Lists
Book of Lists cover
PBN's annual Book of Lists has been an essential resource for the local business community for almost 30 years. The Book of Lists features a wealth of company rankings from a variety of fields and industries, including banking, health care, real estate, law, hospitality, education, not-for-profits, technology and many more.
Data icons
Data can be purchased as single lists, in either Excel or PDF format; the entire database of the published book, in Excel format; or a printed copy of the Book of Lists.
  • Purchase an e-File of a single list
  •  
  • Purchase an e-File of the entire Book of Lists database
  •  
  • Purchase a printed copy of the Book of Lists
  •  
    National
    Local
    Latest News
    Advertisement