Control Health Care Spending

By The Intelligener
Gov. Ted Strickland and state legislators — along with an estimated 700,000 low-income Ohioans — have fallen victims to one of the biggest pitfalls involved in government health care programs: unpredictability.

Earlier this year, lawmakers and Strickland agreed to enhancements in the state’s Medicaid program. Health care providers were to receive modest increases in amounts they are reimbursed for handling Medicaid patients. In addition, dental benefits eliminated in 2005 were to be restored for about 700,000 Medicaid recipients. Funding for the two plans was included in the two-year budget that went into effect July 1.

But this week, Strickland announced that the dental benefits will not be restored and that reimbursement rates will not be increased. “Higher than expected caseloads” for Medicaid were blamed.

In other words, the program is costing Ohio much more than the governor and lawmakers had expected just a few months ago.

Strickland’s announcement upset some in the health care community. They pointed out that many health care providers have not had an increase in Medicaid reimbursement rates for seven years. They added that failure to restore dental care benefits may send some low-income Ohioans to hospital emergency rooms for costly treatment of dental problems that could have been prevented. David J. Owsiany, of the Ohio Dental Association, referred to the decision as “penny-wise and pound-foolish.”

He may well be correct about that. At some point, health care providers may simply decide that seven years without a reimbursement increase is too long. They may refuse to accept Medicaid patients. It has happened in other states.

Lawmakers and Strickland clearly thought they had their budget ducks in a row earlier this year. They anticipated having enough Medicaid funding to restore the dental benefits and increase reimbursements to providers. That plan had to be delayed because of higher than expected spending in Medicaid. It was not the first time — and it will not be the last — that government officials have been stymied by skyrocketing usage of and costs for programs such as Medicaid and Medicare.

We hope the reimbursements/dental care plans can be implemented later this year. In the meantime, the failure is one more reminder that the key task facing governors and state legislators is finding ways to get health care program costs under control.