Medicaid offers vital safety net to vulnerable
BY SHERRY KNOWLTON

As lawmakers and the Rendell administration grapple with a budget deficit that could reach $2 billion or more by this summer, it's imperative that we don't jeopardize the health care safety net that our most vulnerable citizens rely on each and every day -- the Medical Assistance (Medicaid) program.

Two recent national studies and the budget forecast from the state Capitol provide an ominous look ahead.

In the next 20 years, state Medicaid programs will spend $3.7 trillion, according to a new report issued by the trade group America's Health Insurance Plans. AHIP's report is echoed by the Kaiser Family Foundation, which issued a report showing overall Medicaid enrollment nationwide grew 2.1 percent in fiscal 2008, and states saw spending growth of 5.3 percent during the fiscal year -- higher than the previous two years.

What does this mean for the upcoming budget debate here in Pennsylvania? The numbers dictate that Medicaid is an obvious target for budget cuts. Medicaid is a taxpayer-funded public health insurance program that finances essential health care and long-term care for roughly two million Pennsylvanians at an annual cost of $14.6 billion.

Given these daunting numbers, ideas will no doubt be put forward in the coming months in Harrisburg to cut Medicaid benefits or change the way services are delivered. Given the budget situation, it is appropriate to re-examine Medicaid and all other state programs. A well-funded and well-managed Medicaid program guarantees access to affordable health care for our most vulnerable residents. At the same time, a well-managed Medicaid program will save our taxpayers hundreds of millions of dollars annually.

There are two key points legislators need to remember as they look at Medicaid in Pennsylvania. First, the people who rely on this system for health care truly have nowhere else to turn. Consider that 46 percent of Medicaid recipients are children under 18; 10 percent are seniors 65 or older; and another 17 percent are disabled citizens.

And, it's not just a big city issue. Two-thirds of Medicaid recipients in Pennsylvania live outside of Philadelphia and Allegheny counties, and 27 percent live in rural counties. Here in south-central Pennsylvania, more than 121,000 of our neighbors in Cumberland, Dauphin, Lebanon, Perry and York counties rely on Medicaid for health care.

The second point for lawmakers to consider is the job Medicaid Managed Care Organizations are doing in delivering health care to more than 60 percent of the people on Medicaid in Pennsylvania.

Each of the seven plans in the state has been ranked among the best in the nation and combined have saved the commonwealth more than $2.7 billion during a recent five-year period, according to a study by the health care consulting firm (The Lewin Group). The MCOs do this by coordinating the care their clients receive, emphasizing lower-cost preventive care, and avoiding unnecessary hospital stays. MCOs also use more generic drugs than government managed health care.

Of course, MCO Medicaid clients lead better, healthier lives, which is the purpose for Medicaid's existence. Pennsylvania's MCOs look forward to working with the Rendell administration and the next session of the General Assembly to strengthen this vital safety net for our most vulnerable citizens while working to deliver significant savings for taxpayers. SHERRY KNOWLTON is Senior Vice President and General Manager for AmeriHealth Mercy Health Plan.

From PennLive.com