Tenn.'s Retreat On Medicaid Points to Struggle
Planned Cuts May Signal National Trend
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From The Washington Post click on headline below for link.
Tenn.'s Retreat On Medicaid Points to Struggle
Planned Cuts May Signal National Trend
By Ceci Connolly
Washington Post Staff Writer
Tuesday, January 18, 2005; Page A03
NASHVILLE -- They staged a die-in here Wednesday night -- to mourn the demise of one of the nation's most innovative health insurance programs for the working poor and to dramatize what advocates say will be the human toll of a bitter government decision.
On Jan. 10, Tennessee Gov. Phil Bredesen, a Democrat elected in 2002 on a promise to rescue TennCare, announced he is cutting 323,000 low-income adults from the program and limiting services for 400,000 others. Like many other governors, Bredesen said that Tennessee's expanded Medicaid program is devouring the state budget and that he cannot afford what had been hailed as one of the most generous government health plans in the nation.
"It might not be the level of care we want to provide, but it's the level of care we can afford without bankrupting our state," said Bredesen, a former mayor who made millions as a managed-care executive.
The announcement sent shivers through health care advocates nationwide who see in TennCare's retreat the start of a bleak trend to scale back government-paid care at the same time the private sector is trimming benefits. A day later, Florida Gov. Jeb Bush (R) proposed giving Medicaid clients vouchers for private health coverage, making Florida the first state to let insurers set benefits for poor clients. And this week, New York Gov. George E. Pataki (R) is scheduled to slash $1 billion from his state's Medicaid program.
As President Bush attempts to cut the federal deficit in half within five years, governors are girding for battle. Though eager to restructure Medicaid, the joint state-federal health program for low-income Americans, the National Governors Association warned last month it would oppose "any deficit reduction strategy to simply shift federal costs to the states."
The TennCare saga -- from its historic creation a decade ago to its precipitous collapse today -- illustrates the nation's struggle to provide medical care for millions of Americans who are not poor enough to qualify for Medicaid but not wealthy enough to afford private insurance. In a move hailed as a national model, Tennessee leveraged additional federal money to offer a more modest package of managed-care benefits to traditional Medicaid clients as well as the working poor who were uninsured.
But years of mismanagement and court battles, an aversion to higher taxes and managed care, and runaway prescription drug spending have created a system that threatens to swamp other state programs, such as education. The result is a severe retrenchment in Tennessee, from one of the broadest, most creative programs to one that will now barely exceed the minimal coverage guaranteed under federal law.
... more at linked article
The last highlighted copy probably says it all... From one of the broadest, to barely...
I guess it never occured to the people that set up the program that eventually bills would come due. People get older, they use more and more health care services as they are made available and are pre-paid, though most people of course don't pay attention to their own obligations in the equation - that of (and I'm as guilty as the next person here) of trying to keep in shape, eat a healthy diet, exercise and generally try to take good care of one's self.
It really is a unwinnable situation. Citizens of Tenn., like the rest of the country, want the best health care they can get, with the best benefits they can get, but like many things, they may not want or may not be able to pay for it.
Tenn.'s Retreat On Medicaid Points to Struggle
Planned Cuts May Signal National Trend
By Ceci Connolly
Washington Post Staff Writer
Tuesday, January 18, 2005; Page A03
NASHVILLE -- They staged a die-in here Wednesday night -- to mourn the demise of one of the nation's most innovative health insurance programs for the working poor and to dramatize what advocates say will be the human toll of a bitter government decision.
On Jan. 10, Tennessee Gov. Phil Bredesen, a Democrat elected in 2002 on a promise to rescue TennCare, announced he is cutting 323,000 low-income adults from the program and limiting services for 400,000 others. Like many other governors, Bredesen said that Tennessee's expanded Medicaid program is devouring the state budget and that he cannot afford what had been hailed as one of the most generous government health plans in the nation.
"It might not be the level of care we want to provide, but it's the level of care we can afford without bankrupting our state," said Bredesen, a former mayor who made millions as a managed-care executive.
The announcement sent shivers through health care advocates nationwide who see in TennCare's retreat the start of a bleak trend to scale back government-paid care at the same time the private sector is trimming benefits. A day later, Florida Gov. Jeb Bush (R) proposed giving Medicaid clients vouchers for private health coverage, making Florida the first state to let insurers set benefits for poor clients. And this week, New York Gov. George E. Pataki (R) is scheduled to slash $1 billion from his state's Medicaid program.
As President Bush attempts to cut the federal deficit in half within five years, governors are girding for battle. Though eager to restructure Medicaid, the joint state-federal health program for low-income Americans, the National Governors Association warned last month it would oppose "any deficit reduction strategy to simply shift federal costs to the states."
The TennCare saga -- from its historic creation a decade ago to its precipitous collapse today -- illustrates the nation's struggle to provide medical care for millions of Americans who are not poor enough to qualify for Medicaid but not wealthy enough to afford private insurance. In a move hailed as a national model, Tennessee leveraged additional federal money to offer a more modest package of managed-care benefits to traditional Medicaid clients as well as the working poor who were uninsured.
But years of mismanagement and court battles, an aversion to higher taxes and managed care, and runaway prescription drug spending have created a system that threatens to swamp other state programs, such as education. The result is a severe retrenchment in Tennessee, from one of the broadest, most creative programs to one that will now barely exceed the minimal coverage guaranteed under federal law.
... more at linked article
The last highlighted copy probably says it all... From one of the broadest, to barely...
I guess it never occured to the people that set up the program that eventually bills would come due. People get older, they use more and more health care services as they are made available and are pre-paid, though most people of course don't pay attention to their own obligations in the equation - that of (and I'm as guilty as the next person here) of trying to keep in shape, eat a healthy diet, exercise and generally try to take good care of one's self.
It really is a unwinnable situation. Citizens of Tenn., like the rest of the country, want the best health care they can get, with the best benefits they can get, but like many things, they may not want or may not be able to pay for it.