Monday, August 01, 2005

Dual Eligibles: Medicaid’s Role for Low-Income Medicare Beneficiaries Fact sheet (in PDF format) from the Kaiser Family Foundation - "This fact sheet describes the over 7.5 million 'dual eligibles,' the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid, why this population needs Medicaid, what services they receive from Medicaid, and the current policy challenges related to dual eligibles, including the new Medicare prescription drug benefit."  
  

Premiums for the Poor Washington Post editorial - "The notion of asking Medicaid recipients to pay more toward their health care has a lot of intuitive appeal. Rapidly growing costs for the health care program for the poor are straining state budgets across the country, as well as the federal government's. In private insurance programs, co-payments, deductibles and other cost-sharing mechanisms have helped make patients more informed and cost-conscious consumers. It's not surprising, then, that the nation's governors are pressing for more flexibility to require Medicaid recipients to pay more for their care as well. But the evidence from states that have adopted such cost-cutting measures suggests that any changes should be made only with extreme caution. Those considering changes in the program must make certain that the payments -- even if they don't appear burdensome -- don't prevent recipients from getting needed services and don't backfire by resulting in more expensive emergency room and hospital care."  
  

Ruling leaves fate of sickest TennCare enrollees uncertain (Tennessee) Story in The Tennessean - "A federal judge's ruling yesterday afternoon leaves unclear what will happen to about 97,000 of the sickest TennCare enrollees who are due to lose access to state-paid prescription-drug coverage come Monday. Saying he was ruling as quickly as possible before those changes are to take effect, U.S. District Judge John Nixon gave the go-ahead to part of the state's plans to enact cost-saving drug-management tools. State officials have said those tools are key to overhauling TennCare — and sparing 97,000 people from cuts. However, Finance Commissioner Dave Goetz said last night that he was unsure whether yesterday's partial ruling will help avert the changes to come for the "medically needy" — a special category of TennCare enrollees whom Gov. Phil Bredesen has said are the sickest people on the program."