You can help Improve Utah Medicaid!

With ever-increasing costs and concerns about quality and efficiency within Medicaid, Senate President Michael Waddoups and House Speaker David Clark, have asked the community for input on how Utah’s Medicaid program can be improved. Please note: Input will be collected through a survey tool through July 31. The Utah Health Policy Project has prepared a report, Improving Medicaid in Utah, Controlling Costs while Improving Health Outcomes  to help answer the legislature’s concerns and guide the community in their response.    

Utah Medicaid is in desperate need of ideas to control costs and improve health outcomes.  Currently, the program is severely underfunded.  Enrollment has grown by over 70,000, to 225,000 over the last two years.  All of this growth has been funded using one-time resources, and no ongoing tax revenue has been identified to pay for these enrollees in future years.  Compounding Medicaid’s funding challenges is federal health reform’s requirement that Medicaid provide coverage to everyone with household income less than 133% of federal poverty starting in 2014. This is a major change for Utah Medicaid, which has to this point primarily served children and people with disabilities.  Given the generous federal match rates set aside for the coming Medicaid expansions (the feds will pay 100% of Utah’s costs in 2014, decreasing to a perpetual base of 90% in 2019), it will never been more cost effective for the state to extend health coverage to its uninsured low-income adults; however, this expansion still comes at a significant cost.  Beginning in 2014, when the Medicaid eligibility expansion begins, Utah Medicaid is expected to grow by 110,000.  In addition to the expansion to new populations, this growth is driven by the ‘woodwork effect.’ Due to the individual mandate and the culture of coverage the reform creates, states like Utah, who have relatively low participation in their current programs, will see many of their currently eligible, but not enrolled residents’ who sign up for coverage. Utah will have to cover its usual portion of the cost (about 30¢ on every $1) for these, the estimated 60,000 “currently eligible” Utahns, who enroll due to reform. Regardless of the sudden pressure on the state budget, we view this is a worthwhile and necessary expense: these individuals should have been covered all along and it’s about time we got them into the system. The Utah Department of Health estimates the state’s share of the enrollment growth will be $37 million in 2014, increasing to $125 million by 2020. This growth in enrollment and costs demands that we do things differently. Fortunately, there are many things the state can do that will both help control costs and improve health outcomes of Medicaid clients.

State leaders should consider payment methods known to bring down costs while improving the quality of care. The Medicaid benefit package should include all medically necessary care along with services like dental and vision care that will maximize integration in the workforce and independent living. The point we should drive home in the survey is that he state has myriad options to make Utah Medicaid work better for both clients and taxpayers. 

We need your help to help make the legislature aware of what these options are! The President and Speaker’s survey is open and waiting for you to share your input.  Please read our report and provide the legislature your ideas here by July 31, 2010.