Some States Find Partial Solution to Medicaid Crisis

Michigan legislators enacted a 75-cent increase in the tax on a pack of cigarettes and directed that the revenue raised be devoted to the Medicaid program for 2004 and 2005.

Gov. Jennifer Granholm (D) had told the legislators that she would cut payments to Medicaid providers by 22 percent if they did not enact the tax, according to the June 18 Detroit News.

A spokesperson for the Michigan State Medical Society said that Medicaid currently reimburses doctors for only 61 percent of costs.

More than 1 in 7 state residents is enrolled in Medicaid, and the program has grown by 40 percent in the last four years, according to the Detroit News.

In Kentucky state officials agreed to a settlement of a lawsuit brought by Kentucky Legal Services that alleged that some people with mental illness had been unfairly excluded from in-home or nursing-home services under Medicaid because they had been ruled ineligible.

According to<www.kaisernetwork.org> on June 28, officials agreed to re-evaluate the “statuses of hundreds of people with mental disabilities who lost Medicaid coverage because of changes in eligibility requirements.”

Kentucky Legal Services attorney Anne Marie Regan said, “We got pretty much everything we wanted in the lawsuit. These new standards that they agreed to use are actually more liberal than what were in place prior to April last year.”

In Mississippi mental health advocates and others succeeded in delaying implementation to September 15 of the plan of Gov. Haley Barbour (R) to cut 65,000 Medicaid beneficiaries from the rolls. The cuts originally were scheduled to take place July 1.

In May the Mississippi House voted 1080 to pass a resolution requesting that Barbour let legislators revisit the bill.

As reported on June 24, Rep. Mark Formby (R) told reporter Jason Niblett of the Picayune Item, “There needs to be an extension. This is the biggest mess I've seen in the 13 years I've been in the legislature.”

Sen. Sid Albritton (R) said, “It's turned out to not be what they explained to us. We were told [beneficiaries] would have better care and coverage.”

Angela Ladner, executive director of the Mississippi Psychiatric Society (MPS), said that it appeared that the estimated 6,000 people with chronic mental illness who were originally scheduled to be cut would be protected by a federal waiver.

She said that advocacy efforts had been enhanced by the fact that MPS shares offices with state chapters of the National Alliance for the Mentally Ill and the National Mental Health Association.

“From day one, we've been on the same page and have presented a unified front on behalf of people with mental illness.”

Results of a poll reported in the Delta Democrat Times of Greenville, Miss., indicated that only 1 percent of the state's residents favored cuts to the Medicaid program as a means to balance the budget.

On June 14 New York Times columnist Bob Herbert editorialized against the cuts.

Herbert wrote that in signing the law, Barbour had said that Mississippi taxpayers have to “pay for free health care for people who can work and take care of themselves and just choose not to.”

Herbert continued by writing that the governor is “free to characterize the victims of the cuts as deadbeats if he wants to,” but that some have “incomes so low they effectively have no money to pay for health care.”

Herbert also noted that Barbour's idea that many of those cut from the rolls could get prescription drug benefits and other health care through Medicare is flawed because “in most cases [it] will not come close to meeting their overall requirements” (see box on Original article: page 5). ▪