- The Washington Times - Thursday, April 19, 2007

Medicaid programs are failing to deliver adequate medical services to the low-income populations they were designed to serve, a new report contends.

The non-profit consumer advocacy organization Public Citizen this week issued a report ranking Medicaid programs by how they met and surpassed federal mandates in four categories: eligibility, scope of services, quality of care and provider reimbursement.

Massachusetts had the top-ranked Medicaid program in the country, followed by Nebraska, Vermont, Alaska and Wisconsin. But Massachusetts has no reason to gloat, says Annette Ramirez de Arellano of the Health Research Group at Public Citizen.

“Massachusetts received less than 65 percent of the possible maximum points,” she said. “No one state Medicaid program can be considered ‘excellent’ across all categories.”

Fifty-five million, mostly low-income Americans get their health care coverage through their state Medicaid program.

The worst Medicaid programs in the country, according to Public Citizen, are those in Alabama, Colorado, Idaho, Indiana, Mississippi, Missouri, Oklahoma, South Carolina, South Dakota and Texas.

“As it enters its fifth decade, the Medicaid program is going through a midlife crisis,” said Sidney Wolfe, director of the Health Research Group at Public Citizen.

States are revamping their Medicaid programs in reaction to health care costs increasing at double the rate of inflation while the number of uninsured Americans, at last count 43 million, is forcing states to find ways to cover more people.

In states like Kentucky and West Virginia, Medicaid programs are being modified to cover more people, such as pregnant women and children, but eligibility requirements and costs, such as higher copayments, are being implemented to offset the expansions.

Kentucky and West Virginia are using a new law to change their programs, while other states are finding that the Bush administration is allowing states to maneuver their programs more than ever before.

“Never in the history of Medicaid has an administration been so open to states’ ideas on how to reform their Medicaid programs,” said Joy Wilson, health policy director at the National Conference of State Legislatures. Health and Human Services “Secretary [Michael O.] Leavitt has told states to come to him with their plans, that hasn’t ever happened.”

When it comes to Medicaid, where you live makes all the difference. Public Citizen ranked states by the optional health care services that states provide beyond legally mandated services.

People living in Illinois, Minnesota, New York, Oregon and Washington have the most health care options on Medicaid, the report found. But residents of Alabama, Georgia, Mississippi, Oklahoma and Wyoming have the least.

“Medicaid desperately needs nationwide uniform standards of quality of care and an effective means of monitoring and upholding those standards,” said Ms. Ramirez de Arellano.

In other news

Steve Case formally launched the RevolutionHealth.com, a health and medical Web site that offers health information, treatment advice and more than 125 online tools. Mr. Case sank $100 million of his own money into the venture and also got some big-name backers — Colin L. Powell and former Hewlett-Packard CEO Carly Fiorina.

As well as a repository of health information, the site provides people with a personal health representative as a guide through the health care system.

Health Care runs Fridays. Contact Gregory Lopes at 202-636-4892 or [email protected]washingtontimes.com

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