States get creative to curb Medicaid costs

Taunya English’s story is part of a project on health care in the states–a partnership of WHYY, NPR and Kaiser Health News.

The recession is ebbing, but states say they are still struggling to cover the cost of Medicaid, the program that helps pay for health care for the needy, aged, and low-income families with children.

New Jersey is negotiating with the federal government to change the way the Garden State manages Medicaid.

Pennsylvania officials say the state has to be a little less generous with prescription drug and dental benefits.

Delaware hasn’t raised doctor or hospital rates since 2008.

Medicaid Director Rosanne Mahaney says providers in the First State are growing frustrated.

“We haven’t seen them drop out of the program, they are really committed to serving the Medicaid population in Delaware, but they’ve expressed that it’s becoming fiscally difficult for them,” she said.

In rocky economic times, people lose jobs–family incomes shrink–and more people become eligible for Medicaid.

From the summer of 2008 to the summer of 2011, New Jersey’s Medicaid enrollment rose by 22 percent and spending increased 18 percent.

At the beginning of the recession, the federal government offered states extra funding to pay for swelling Medicaid rolls, but that extra help ran out this summer. In New Jersey, that meant about a billion dollars less in the budget.

New Jersey’s Medicaid Director Valerie Harr wants to expand the kind of care provided through managed care companies.

“So we pay them a per-member, per-month rate and they are responsible for all of the services required for their members that we assign to them, and the delivery of all their care regardless of the cost,” Harr said.

She says residents newly eligible for the Medicaid program often come to the program with “pent up” health care needs. Harr wants to move those new enrollees into a managed care plan sooner to hold down spending.

Some states have added co-payments for prescription drugs or emergency room visits to shift more costs to beneficiaries. Officials in Delaware and Pennsylvania say they’re considering those moves too.

Kaiser 50-state Medicaid Budget Survey is available here.