In Medicaid “optional” service does not mean “unnecessary”

In a good conversation with Becki Gray yesterday on News 14 we discussed the different visions for Medicaid reform proposed in the respective budgets of the Governor, House, and Senate. In particular, Gray, who works for the John Locke Foundation, noted that the state has a “rich” benefits package in Medicaid because we offer many optional services, that is, services that are not required to be covered by the federal government. The Senate, she correctly pointed out, wants to whittle away these optional services.

Ending optional services in Medicaid is a popular policy among conservative think tanks in the state. Apparently the Senate is listening.

As this debate progresses it is important that we know what services we are talking about when we talk about optional services. Let’s review a few: transplants, prescription drugs, dentures, hospice, prosthetics. None of these treatments are frivolous or lavish.

And that’s the trouble with optional services. If you want to get at some of the more expensive options then you are limiting life-saving care. Former Locke Foundation analyst Joe Colletti even praised Arizona for cutting optional services like transplants in a report on Medicaid reform. But these cuts inflicted so much pain in Arizona that the state made a volte-face on its decision.

That brings us to the Senate budget. Among other things the Senate wants to end the optional Medically Needy program in Medicaid. This program allows people who have enormous medical expenses, but earn too much to qualify for Medicaid, to apply these medical bills to their income to access Medicaid. This makes sense. If, for example, you earn $30,000 per year but need expensive drugs or nursing home care then these costs will quickly eat through your monthly income. Although you may have some money your medical needs erase it all. It’s not fair to tell this person that he or she is too wealthy for Medicaid when they effectively have nothing.

But this is exactly what the Senate aims to do.

As we have said many times before, “optional” refers to a regulatory requirement and does not mean anything about the necessity or quality of specific Medicaid services. You may call it foolish for the state to cover optional services. I call it basic human decency.

 

7 Comments

  1. LayintheSmakDown

    June 19, 2014 at 1:48 pm

    Well that tagline applies to almost every situation out there. Duh…

  2. ML

    June 19, 2014 at 2:29 pm

    Not a big of that type of rhetoric either. It boils down to anything applying to government assistance, the price tag is always determined by what kind of consensus can be made in what is deemed mandatory. that’s the way it’s always been and will always be.

  3. decencyisntoptional

    June 19, 2014 at 4:50 pm

    Beckie Gray’s a dilettante and that’s being nice about it. The Lockers are heartless and that’s being nice about it, too.

  4. LayintheSmakDown

    June 19, 2014 at 10:15 pm

    Alan, good to see you back. You forgot to add that with the government the price tag is always exponentially higher, you get sub par service, and you have a lot less of the product. See the VA system as an example.

  5. Alan

    June 19, 2014 at 10:29 pm

    Yet more anti-guv’mint nonsense from the right wing extremists.

  6. Jim Wiseman

    June 20, 2014 at 2:33 pm

    Alan, lately you just make ad hominem attacks. Starting to realize the fallacy of your positions?

  7. LayintheSmakDown

    June 20, 2014 at 5:57 pm

    Thanks for the support Jim, I am glad others see Alan/ML for the troll he is. I rarely see an actual argument, just name calling such as above.