States face rising Medicaid rolls under health reform

As part of the ongoing "Are You Covered?" series done in conjunction with Kaiser Health News, NPR profiles a 94-year-old Medicaid recipient in Colorado, who lives in a nursing home largely paid for by her Medicaid coverage. Gracie Scarrow and her daughter, Lela Petersen, both "say they are very satisfied with the program."

"Petersen says her mom couldn't afford the nursing home on her own. Her Social Security income is $600 a month and after selling her house she cleared only $3,500. A doctor suggested signing up for Medicaid to pay the $80,000 a year bill for her long-term care. Scarrow is left with about $50 of her Social Security check each month for spending money." The number of Medicaid recipients in Colorado, as in most states, has grown significantly this year amidst rising unemployment. In the past year, it's climbed 10 percent to nearly a half-million people. "Typically states and the federal government split the cost of Medicaid, though with the recent stimulus money the federal government is picking up a larger share now. Even with that help, Colorado has difficulty paying its share. Recently the governor trimmed payments to doctors and hospitals to help balance the state's budget" (Brady, 10/5).

In an interview with NPR, KHN's Mary Agnes Carey explained the proposed Medicaid expansions pending in Congress, and how states might react to the increased cost. "They can't cut the benefits. That's against the law. But they could reduce payments to their providers," Carey explained. "T]he concern is if you expand Medicaid enrollment, those providers who may already feel squeezed will be squeezed further. There's also a concern for several -- for many Medicaid beneficiaries. There's problems with access to care, especially access to specialty care because of the low reimbursement. And if you put more people into the program, they're concerned that those problems could worsen" (10/5).

KHN also has an explainer on Medicaid and how health reform might change the program: The pending congressional bills would all "extend Medicaid coverage to a new category of individuals -- childless adults who fall below the income thresholds. Twenty-four states have some childless adult coverage now. And, although details again vary, all of the proposals would provide more federal funds to states to help pay for this new coverage category" (Villegas, 10/5).

The Associated Press/Mercury News reports on how the proposed expansion might affect Nevada: "The number of Nevada residents receiving care through Medicaid would nearly double by 2015 under provisions of a health care bill being developed in the U.S. Senate Finance Committee, according to the state Health Care Financing and Policy Division. Just over 222,000 residents now get care through Medicaid. The total would increase by 217,000 under the national health care bill" (10/5).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.