It’s Not Just Covering the Uninsured That Matters, It’s How You Do It

Previously in this space, I’ve mentioned the flaws in using expansion of the Medicaid program – a key provision in pending health reform legislation – as a prominent tool for reducing the uninsured rolls.  Many physicians don’t see Medicaid patients because of the program’s low reimbursement rates.  Thus, moving 15 million more Americans into Medicaid can only exacerbate healthcare access problems.

But there’s another issue with Medicaid expansion, and it’s brought to the fore by Tennessee Governor Phil Bredesen (D).  In a letter to Senator Bob Corker (R-TN) and Congressman Bart Gordon (D-TN), Governor Bredesen points out the havoc that Medicaid expansion will raise with the state’s financial future.

He wrote:

“In this environment, for the Congress to also send along a mandatory bill for three quarters of a billion dollars for the health reform they’ve designed is very difficult.  These are hard dollars – we can’t borrow them – and make the management of our finances post-recession even more daunting than it already is.”

It’s critical that health reform be sustainable for the long term.  Encumbering fiscally-challenged state governments with more long-term financial obligations doesn’t meet that goal.  A better idea is to focus on providing assistance to help families and individuals better afford private coverage, and take steps to bring all Americans into the system in order to keep costs affordable.

Governor Bredesen makes an important point that Capitol Hill should be hearing.