AMA Crafts Plan to Improve Medicaid Coverage

Article excerpt

HONOLULU -- Patient access to Medicaid and physician reimbursement from the program have reached the critical point, delegates said at the interim meeting of the American Medical Association's House of Delegates.

After heated debate, 94% of the delegates voted to support a proposal to replace the low-income medical assistance portion of Medicaid with federal tax credits yet keep discussions open on the issue of combining tax credits with other financing mechanisms and insurance reforms. The proposal was the result of discussions at the AMA Council on Medical Service.

Delegates at this particular AMA meeting chose to focus on Medicaid because the situation is critical, past president Yank Coble told this newspaper. Failure to address the issue now will further jeopardize Medicaid patients' access to care, he said.

A number of states have reduced or restricted Medicaid benefits and eligibility categories and frozen or reduced payments to physicians, the council's report noted.

The tax credit option would apply to low-income adults and children in the Medicaid program, who account for 73% of current enrollees and 27% of expenses. Tax credits would not be used for long-term care or care of disabled adults enrolled in Medicaid.

The report calls for tax credits to be inversely related to income and large enough to entice beneficiaries to purchase private health insurance with little or no cost sharing.

In effect, this would split the program, completely federalizing the medical assistance portion of Medicaid, "but on a privatization model," Robert Doherty, senior vice president for governmental affairs and public policy for the American College of Physicians, told this newspaper.

Although no one opposed the idea of tax credits as an option, primary care physicians argued that the AMA shouldn't rely on tax credits alone.

"We don't think the public safety net should be disconnected," ACP president Munsey Wheby said during committee proceedings. Instead, the council should investigate how the current safety net could be improved, he said.

The report's authors claim that physician reimbursement would improve under such a proposal, yet "there's no evidence to suggest the case," Mr. Doherty said. …