October 22, 2005

Another sneaky policy change from Dubya's administration.

This one involves Medicaid, the program that provides health care for low income families and individuals. And, interestingly, the change is happening in Florida, the state where Duba's brother Jeb is the governor. [Purely a coincidence, we're sure.]

Dubya's administration has given Florida permission to put a new restrictive Medicaid program into effect. Under that plan, the old rules under which Medicaid recipients received 'defined benefits' — in other words, there was a list of medical services that Medicaid would pay for — have been put aside. Instead, Florida's 2.2 million Medicaid recipients will be covered under a 'defined contribution' plan. What this means is that the state will allot a specific number of dollars that it will pay per year for the medical care of an individual. Once that limit has been reached, the person may be on their own — even if they still require medical care.

Another change under the new 'defined contribution' rules is that Medicaid assistance will be provided via private health plans. These plans will be free to limit the 'amount, duration, and scope' of medical care in ways that would not be allowed under current federal Medicaid rules. And says Joan Alker of the Health Policy Institute of Georgetown University, 'Many of those decisions will be made by private health plans, out of public view.'

Florida officials, of course, minimize the effects that the Medicaid changes will have on people who depend on the program for their health care. Florida Agency for Health Care Administration head Alan Levine says few recipients would reach their annual limits — maybe 5 percent. But, as The Gadflyer's David Seldin points out, 'The reason people will reach those caps is because they will be really sick. Florida is going to cut people off when they need help most, and the federal government says that's just fine with them.'

So, basically, the shift in the Florida Medicaid rules is another of the Dubya administration's retreats from the notion that the federal government has definite responsibilities to help the poorest people in the country. And, as usual, the administration is doing this under the guise of giving states more control over joint state-federal programs, and of making the administration of an those programs more financially 'responsible.' Dubya has made no secret tht he'd like to see programs like Florida's in effect for the whole country. Hopefully, he won't get the chance to make that desire a reality.

Via NY Times.

Posted by Magpie at October 22, 2005 01:18 PM | US News | Technorati links |

This Florida change is nothing other than legalized murder, and it's a damn shame that Democrats and liberals don't know how to explain this clearly and make it just as important as being 'pro-life'.

And how, pray tell, is the patient supposed to budget their resources to make them last? Can they get a firm estimate from their doctor, just as the law requires from a car mechanic, as to the costs of a proposed course of action?

I happen to be an R.N., and I know in my own case I frequently choose not to see a doctor for something that a lay person would want to talk to a doctor about. Very few people have the ability to do this- I'm not even claiming to have the ability, just saying I choose this course over the costs fo the "treatment".

This legalized murder is compounded by being directed at the most vulnerable. If the left could understand these issues, we could demand equal treatment that would either put a stop to the pro-life talk, or put some teeth in it.

Posted by: serial catowner at October 22, 2005 03:50 PM

In Florida?!!

Why don't they just start making Solylent Green instead?

Seriously, I can't think of anything that would make most of the elderly of that state vote in greater droves against the Republicans in response.

People are already getting bit by limits on what private plans will pay, and those bites add up to a serious chunk of change over time. Imagine that, plus a limit on what the elderly can spend on their health care of this magnitude, most of whom live on fixed incomes, and you have a recipe for an explosion of rage.

I'm surprised that the AARP isn't all over this like white on rice already. And Flordian Democrats should be making with the righteous anger yesterday-ish, and fast.

Posted by: palamedes at October 23, 2005 05:53 PM

Palamedes, though I agree, I do feel the need to point out that this is for Medicaid, not Medicare.

The elderly get Medicare. As far as I know, they're still covered, albeit poorly as well.

The changes they're talking about now are with MedicAID, which is medical assistance for the low income...poor families and single parents, such as myself.

So, this is going to affect mostly children under the age of 19. The income guidelines for someone without children are ridiculous. You basically can't have a job and get Medicaid. If you make more than about $300/month and don't have insurance, you're screwed. I'm inclined to believe there are more children on Medicaid than adults; therefore, I fear for those poor kids in Florida. My son was one of them at one time.

My ex lives in Florida, and I thank God every day that our son is up here in Idaho with me (Yes, I'm Christian...but I'm also Liberal). My ex's insurance premiums are so high, he wouldn't have him on his insurance. He'd be on this LIMITED Medicaid down there. Up here with me, I have him on Idaho Medicaid as well as my insurance, and since he qualifies for Medicaid, I get the insurance premium reimbursed to me. It's a good program that gives people incentive to keep Medicaid costs down if insurance is available to them.

Until just a couple of months ago, Bush had never been to Idaho. He probably never knew we existed. I wish he'd never come, 'cause now we're on his radar. Please leave us alone, Bushie...leave us alone.

Posted by: Bonnie at October 24, 2005 07:48 AM

Ahh, my bad...I just read the article more closely, and it states that pregnant women and children under 21 will be exempt from the changes.

That's good news for some, at least...but not those that are disabled.

Posted by: Bonnie at October 24, 2005 11:40 AM