Patients, care givers concerned about proposed Medicaid changes

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(Host) Low-income people and health care providers are worried about Governor Jim Douglas’ proposal to overhaul Medicaid. Those on fixed incomes say they can’t afford to pay the higher premiums the governor has proposed. And hospitals and doctors are concerned that they’d be paid less if the reforms were enacted.

VPR’s John Dillon reports.

(Dillon) Right after the governor spoke, lawmakers and lobbyists surged toward a table piled high with copies of next year’s budget. They thumbed through the spiral-bound papers to see how their favorite program fared in the governor’s proposal.

Sitting to the side in a wheelchair was Edna Fairbanks-Williams. She’s the president of the Vermont Low Income Advocacy Council, which represents those on the bottom rung of the economic ladder. Fairbanks-Williams says she didn’t hear much in the governor’s budget for her constituents.

(Fairbanks-Williams) “Well, it leaves us paying more, as far as I could make out. It didn’t seem like there was going to be much help in there for the poor.”

(Dillon) The administration’s proposal to overhaul Medicaid focuses primarily on two groups: the low income people who use the program to pay for health care, and those who provide the care, including doctors, hospitals and nursing homes.

For Medcaid recipients, the proposed changes means they would pay more out of pocket for premiums. The administration wants to squeeze $9 million in premiums from those enrolled in Medicaid and a state-funded pharmacy program. That includes elderly people on fixed incomes, like Fairbanks-Williams. Under the administration’s plan, she’d pay seven dollars more in monthly premiums.

(Fairbanks-Williams) “Well, I would have to give up certain things from my diet. I’m doing chemo right now, and I have to live on a strict diet. If I have to take too much money to pay for something else, I’d have to take something out of my diet.”

(Dillon) Officials from the Douglas administration say their Medicaid plan spreads the burden. So they want to cut the amount paid to hospitals, doctors and nursing homes by $21 million. Bea Grause, director of the Vermont Association of Hospitals and Health Systems, got a briefing on the plan on Wednesday afternoon. Grause described the mood when hospital executives learned about the cuts.

(Grause) “It was grim. It was grim.”

(Dillon) The administration wants to make sure that hospitals don’t simply shift costs to insurance companies and patients who can pay. The state wants to block the cost shift by imposing tighter budget controls on hospitals. But Grause says there’s no way the cuts can be made without aggravating the cost shift.

(Grause) “I don’t see how that can possibly happen in the short term. I think there has to be some effect in terms of increasing the cost shift.”

(Dillon) Grause says that even before the $21 million in cuts, Medicaid underpays hospitals by about 30 percent.

Vermont physicians are also worried. The Vermont Medical Society predicts that the governor’s plan will cut payments so much that doctors may choose to no longer treat Medicaid patients.

For Vermont Public Radio, I’m John Dillon in Montpelier.

Related link:
Governor’s Budget Address audio and text

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