Pay now or pay later

 Pay now or pay later

Medicaid pays for a lot more than your neighbor’s visit to the ER or your visit for a well-baby check.  In the next several years, the bills passed by the House of Representatives will cut 687 billion dollars from the plan.  What does that mean, on the ground?

That’s a great deal of waste, fraud and abuse.  This is one of the biggest cuts to Medicaid in history.  Community based services for people with disabilities are not federally mandated.  But these are the services that allow people with disabilities to remain in their communities and to thrive.  Over 700,000 people are currently on waiting lists for these services.  With cuts this list can only grow.  Sixty-nine percent of the agencies providing these services are already declining new clients.  A third of the agencies are considering closing.  Without these community based services, people with disabilities will need to be served in more costly residential placements.

The new regulations are more complicated and require frequent eligibility checks.  Those will create administrative costs that will be subtracted from funds that can be used to care for people.  And more complications mean slower processing and more opportunity for error.

What will people do if they can’t get medical services from their local provider?  First of all, many will probably wait until they are a lot sicker.  Then they will seek medical care in their local ER.  The ER can not turn them away if they can’t pay.  But the service must be paid for somehow, some way.   And it’s the rate payer who will ultimately bear the burden as their health insurance goes up to cover the hospital costs for all of those unfunded ER visits.  And managing short term virus in a physician’s office is a great deal cheaper than the same service in the ER.  ER facilities are already overwhelmed meaning long waits.

The question isn’t so much will these services be paid for, it’s more who will do the paying and how much more will they cost depending on the provider.  So when you think the cuts in Medicaid don't impact you because you have private insurance, think again.  The piper must be paid and you could be the payer.