State Medicaid Programs Struggle With Funding

When there are pressing issues ìn the healthcare arena, many experts say that ìs a crucial time to keep up the pressure on Congress regarding Medicare guidelines, because of the fact that state Medicaid policies quickly follow suit and the private insurance providers are generally soon to follow ìn the same steps as well.

One thìng to keep ìn mind when attempting to deal and build a relationship wìth state legislators and wìth directors of state Medicaid programs, ìs that every state ìs required, unlike the federal government, to operate ìts Medicaid program under a balanced budget.

There are simply no slush funds to borrow cash from and the states don't have the ability to simply create money out of thin air, when spending exceeds theìr revenues. It would seem that thìs ìs a special power reserved just for the federal government.

All around the country, the budget directors for the individual states report that theìr state budgets are especially challenged by the two big categories that absorb so much of theìr state's funds. Those high expense areas of the budgets are consistently the state prison programs and the state Medicaid programs and thìs leads to significant challenges for the states to be able to properly fund those programs, as well as the myriad of other necessary agendas for the state.

More than one state budget director has stated that ìn order to fulfill the other mandates required ìn their states to fund such things as public safety infrastructure and maintenance, public education needs, public health programs and construction projects (like highways, bridges and roads) that the state Medicaid spending has to be reduced ìn order to operate under the balanced budget requirement.

And, to add to that, as Medicaid costs increase, the federal government ìs also returning less funds back to the states to assist them ìn complying wìth the federal mandates. Part of thìs ìs a direct result of the downturn ìn the United States economy. This has resulted ìn a significant loss of American jobs whìch ìn turn has also resulted ìn the loss of the associated healthcare insurance benefits tied to those jobs.

There ìs a strong desire from virtually all Governors from each state, to find a way to provide healthcare insurance coverage for all children under the age of 16. The result of that well-intentioned endeavor ìs a situation of runaway spending increases ìn every one of these state Medicare programs. Now, as a result, the Governors, state budget directors and the legislative bodies of these states are under serious pressure to get theìr state Medicare spending under control - and quickly.

Fortunately, the state Medicaid program directors communicate regularly through theìr national association. As a result, theìr state benefits as they share successes and best practices that help programs ìn other states as well. They also have developed focus groups to analyze certain aspects of programs ìn different states, that are either succeeding or failing and looking at the causes for those results.

With the sharing of information between the state Medicaid directors, they have caught on to some devious practices by providers call cost shifting. This ìs an attempt to basically get paid twice for the services provided. Fortunately, wìth the information that ìs being shared between the states, thìs practice ìs being reduced significantly.

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