Wall Street Journal Examines HHS Secretary Nominee Leavitt's Experience with Medicaid Reform

Wall Street Journal Examines HHS Secretary Nominee Leavitt's Experience with Medicaid Reform

Kaiser Daily Health Policy Report December 17, 2004

The Wall Street Journal on Friday looked at recently nominated HHS Secretary and former Utah Gov. Michael Leavitt's (R) experience with Medicaid reform, noting that if confirmed, Leavitt would be the "point man for the White House agenda" on various health reform efforts. While Leavitt served as governor, Utah restructured its Medicaid program to help expand limited health care coverage to low-income residents who did not qualify for Medicaid. In particular, the effort aimed to reach low-income adults who do not have children -- people who generally are not eligible for Medicaid. The state in February 2002 received a federal waiver to allow Medicaid funds to be used to establish the limited-benefit insurance package. To help fund the new program, the state limited Medicaid mental health and substance abuse treatment coverage, created higher charges for physician visits and prescription drugs for some Medicaid beneficiaries, ended Medicaid coverage for nonemergency transportation and eliminated a program for low-income adults with serious health problems. According to the Journal, the effort marked the "first time a state was permitted to reduce some benefits for Medicaid-eligible people to pay for coverage for others not in the program."

Primary Care Network

In July 2002, enrollment in the Primary Care Network began for uninsured residents between ages 19 and 64 with annual incomes lower than $13,965. The program covers physician visits, basic dental care and up to four prescriptions monthly. In addition, hospitals in the state agreed to provide $10 million a year in no-cost care for PCN patients, and some specialist physicians also offered their services for no cost. The state anticipated that the new program would allow 25,000 people to obtain coverage for preventive medical care, the Journal reports.

'Mixed' Results

The program has so far had "mixed" results, with critics calling the new levels of coverage "so basic as to be inadequate," and supporters pointing to early data that suggest a drop in the number of people requiring hospital stays and emergency department visits, the Journal reports. Early last year, Leavitt said, "During a difficult time, it's better to have everyone have basic health care than a few to have all the health care." Cindy Mann, a health policy researcher at Georgetown University, said, "This approach just gave people a lot less than they needed and made other low-income people pay for it." Judi Hilman, research director at the advocacy group Utah Issues, said, "In the final accounting, the PCN is a mistake. It's been an interesting experiment, but nobody should be calling this coverage." Rod Betit, who was head of Utah's Department of Health under Leavitt, said, "He wants to see that people get covered, but he wants to make sure he doesn't break the bank in the process." Betit added, "When he does things like the PCN, he's not doing it to punish anybody. He's doing it to move policy forward and reach people that have been left out" (Lueck, Wall Street Journal, 12/17).

Source: Kaiser Daily Health Policy Report

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