Guest Commentaries:
Protecting our most vulnerable
by
Neely C. Carlton
As a former senator from the Delta, I am well aware that the programs and services provided by the Division of Medicaid are critical to the lives of many Deltans. Often folks are surprised to learn that a family member, a friend from church, or a neighbor receives Medicaid benefits.
Recent reforms, including ones that transition certain Medicaid recipients to Medicare, have left many concerned citizens confused and scared. Whether these reforms affect you directly or indirectly, you deserve to know the facts regarding these recent reforms.
In the last several years, Medicaid expanded its services and eligibility requirements which resulted in tens of thousands of Mississippians being added to its rolls. In fact, Mississippi’s Medicaid laws have been the most expansive and beneficial in the nation. As a result, Medicaid’s spending doubled in cost over five years and, without change, threatened the state’s ability to fund necessary state services - such as support for schools, universities, and public safety. However, changes had to be made in a way that ensured access to adequate health care coverage.
The Medicaid Reform Act of 2004 included many reforms. For example, for the first time, Medicaid recipients will receive a health screening so that diseases, such as diabetes which plagues the Delta, can be detected early and lives saved. Another part of the solution of which you have heard was to move 47,000 state Medicaid recipients who are also eligible for federal Medicare (6% of all recipients - called PLADs, or Poverty Level Aged and Disabled) off of Medicaid and onto Medicare alone. What you may not know is that Medicare, by in large, will provide more comprehensive health coverage than is currently offered by Medicaid.
Still, most concerned citizens have been focused on the Medicare prescription coverage. Currently, Medicaid will only cover a maximum of seven prescriptions. Under Medicare, recipients will have no limit on the number of covered prescriptions and will receive $600 when they enroll in Medicare and another $600 in January 2005 to assist them with prescription costs and they will receive a Medicare drug discount card. Additionally, every PLADS recipient transferred to Medicare is eligible to participate in the Patient Assistance Programs.
Because beneficiaries and their families have not received this information and therefore are rightly concerned, Governor Barbour has delayed the implementation of the transition until September 15. During the next several weeks, all 47,000 affected Mississippi PLADs beneficiaries will be contacted by Medicaid and allowed an exclusive advance enrollment opportunity to enroll in the Medicare prescription drug discount cards and some of the Patient Assistance Programs, which make more than 1350 prescription drug programs available for free or low cost per month. Every PLADs beneficiary is eligible for these benefits, but I know many of them need help getting enrolled and served.
Finally, I would note that Governor Barbour asked for some of the most vulnerable PLADS recipients to stay on Medicaid through a waiver. The Division of Medicaid has had positive waiver negotiations with federal officials, and Governor Barbour is confident the waivers will be granted when the reforms go into effect on September 15.
While I have provided you with a broad overview of recent Medicaid reforms and the safety nets in place, there is certainly much more to know. I encourage you to visit Governor Barbour’s web site at www.governorbarbour.com, where you will find the details of his 4-point Medicaid Transition Plan and quickly access information on the Medicaid Reform Act of 2004, Patient Assistance Programs, and Prescription Drug Lists. I know that you feel as I do, that good public health policy should be balanced with the care and concern we each feel for our neighbors and loved ones. Deltans should know that all efforts are being made to provide for a smooth transition for the 47,000 Medicaid PLADs beneficiaries. Together, we are all moving towards a healthier Mississippi. DBJ
(Neely C. Carlton is a staff member for Gov. Haley Barbour where she holds the position of Legislative Affairs and Counselor.)
