Image by Anna Cervova

Medicaid Is Worse Than No Coverage at All

By SCOTT GOTTLIEB, published online with The Wall Street Journal

medicaidAcross the country, cash-strapped states are leveling blanket cuts on Medicaid providers that are turning the health program into an increasingly hollow benefit. Governors that made politically expedient promises to expand coverage during flush times are being forced to renege given their imperiled budgets. In some states, they’ve cut the reimbursement to providers so low that beneficiaries can’t find doctors willing to accept Medicaid.

Washington contributes to this mess by leaving states no option other than across-the-board cuts. Patients would be better off if states were able to tailor the benefits that Medicaid covers—targeting resources to sicker people and giving healthy adults cheaper, basic coverage. But federal rules say that everyone has to get the same package of benefits, regardless of health status, needs or personal desires.

These rules reflect the ambition of liberal lawmakers who cling to the dogma that Medicaid should be a “comprehensive” benefit. In their view, any tailoring is an affront to egalitarianism. Because states are forced to offer everyone everything, the actual payment rates are driven so low that beneficiaries often end up with nothing in practice.

Dozens of recent medical studies show that Medicaid patients suffer for it. In some cases, they’d do just as well without health insurance.

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