Members Review Medicaid’s “Flawed Structure,” Examine Proposals to Protect the Vulnerable and Offer Patient-Centered Care
WASHINGTON, DC – As part of the Energy and Commerce Committee’s continuing efforts to reform the Medicaid program, the Subcommittee on Health, chaired by Rep. Joe Pitts (R-PA), today held a hearing on “The Need for Medicaid Reform: A State Perspective.” The hearing coincides with the release of an IDEA LAB entitled Making Medicaid Work by committee Chairman Fred Upton (R-MI) that further highlights recently proposed reforms. The IDEA LAB, which builds off a joint blueprint “Making Medicaid Work” released last month by Upton and Sen. Orrin Hatch (R-UT), offers sensible solutions to fix Medicaid’s troubling fiscal state and offer states opportunities for patient-centered reforms and flexibility.
“Medicaid is in trouble,” said Pitts. “We don’t have to settle for sub-par care, limited access, and exploding costs. Many states have embarked on innovative Medicaid reforms to improve the quality of care and modernize their programs, ranging from payment incentives, to coordinated care, to consumer driven options, to added services for their beneficiaries and more.”
Seema Verma, President of SVC, Inc, testified that the current structure of Medicaid does not guarantee quality care for those who need it most. “Despite growing outlays of public funds, a Medicaid card does not guarantee access or quality of care. In a survey of primary care providers, only 31 percent indicated willingness to accept new Medicaid patients. In 2012, 45 states froze or reduced provider reimbursement rates, Medicaid access issues are tied to under compensation of providers; on average Medicaid payments are 66 percent of Medicare rates and many providers lose money seeing Medicaid patients”, said Verma. “Medicaid beneficiaries struggle to schedule appointments, face longer wait times, and have difficulty obtaining specialty care.”
Anothy Keck, Director of the South Carolina Health and Human Services Department, noted the work states are already doing on Medicaid and asked for increased flexibility. Keck told the subcommittee, “I believe there is a developing bi-partisan interest among states for flexibility to manage programs locally in exchange for more accountability for improved health and more predictability in expenditures at the state and federal level.”
As of 2012, 72 million Americans, or nearly 25 percent of the population, were enrolled in the Medicaid program at some point in the year − more recipients than any other government health care program, including Medicare. Moreover, the implementation of the Patient Protection and Affordable Care Act (PPACA), unless repealed, could grow enrollment by nearly 26 million – resulting in the largest expansion of the program in history.
“Energy and Commerce Committee Republicans remain committed to modernizing the Medicaid program so that it is protected for our poorest and sickest citizens. We will continue to fight for those citizens because they are currently subjected to a broken system,” said Upton. “The program needs true reform, and we can no longer tinker around the edges with policies that add on to the bureaucratic layers that decrease access, prohibit innovation, and fail to provide better health care for the poor.”