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Medicaid Reform for Virginians a Mirage By : Nancy Piotter

Did you know that you paid nearly $1,000 for Medicaid in 2014? What’s more, you probably did not receive any Medicaid benefits. Virginia’s General Assembly reported[1] that the per capita cost of Medicaid in 2014 was $914. Medicaid is the largest program in Virginia’s budget, and appropriations for Medicaid Program Services increase year over year.

The Commonwealth’s new budget increases Medicaid appropriations—again—to $9.1B (FY 2017) and $9.3B (FY 2018), compared to $7.6B (FY 2014). These figures would have been even higher if Medicaid Expansion had been adopted in Virginia. Absent drastic changes that would reduce and control Medicaid spending by Virginia and the federal government, your share of the cost will rise year after year, accelerating the country toward insolvency.[2]

Nationwide, 22% of the U.S. population is now dependent on Medicaid.[3] “Increases in enrollment have been the primary driver of spending increases,” according to the official summary 2016 Virginia Medicaid at a Glance.[4] In 2013 ten percent of Virginians were enrolled in Medicaid; by 2015 the enrollment percentage had increased to 15%. In spite of this trend, Governor McAuliffe wants to make even more Virginians dependent on government. In signing Virginia’s $100 billion biennial budget this month, McAuliffe vetoed language that would have prohibited Medicaid Expansion through June 2018.[5] However, Virginians have the opportunity to thwart adoption of this un-affordable open-ended program, which offers no incentives to promote self-reliance or fiscal responsibility of states.

Doctor providing medical advice to a patient (Wikipedia Photo)

Doctor providing medical advice to a patient (Wikipedia Photo)

Medicaid reform measures underway in Virginia since 2013 have promised to:

transform the Virginia Medicaid program into a cutting-edge payment and delivery system where quality is rewarded and efficiency and cost-effectiveness are paramount.[6]

Yet these reforms have not reduced costs in any meaningful way, since annual appropriations have been steadily increasing. Medicaid audits in recent years have found wasteful or fraudulent spending on the order of tens of millions of taxpayer dollars:  alarming enough, until you realize that these amounts are really a very small fraction of total expenditures.

Detailed research on Virginia’s Medicaid program reveals both the complexity and opacity of government-run healthcare. A good example is a letter from Cynthia B. Jones, Director of Virginia’s Department of Medical Assistance Services (DMAS) published last month to update “DMAS Stakeholders” on Managed Care initiatives.[7] Stakeholders need navigation tools to follow the myriad of sub-programs and initiatives mentioned in the two-page letter! The goal of ever achieving significant “savings” through these reforms is probably unattainable.

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