• Medicaid! – You can’t save much money by dropping work-eligible adults

    So you want to cut Medicaid in your state. Or maybe you have to. You know you’re already under-reimbursing doctors. So you do what lots of states try to do. You cut people from the rolls. But whom will you cut? Disabled people? The elderly? Children? No – you cut “adults”. There’s one problem; you can’t save much money that way:

    We spend about $15,000 a year on each elderly person and each blind/disabled person through Medicaid. We spend only about $2000 per child. Here’s the kicker, though – we spend only about $3000 per adult.

    So when you cut these adults from the rolls, sure you save some money. But you have to kick a whole lot more of them off to save real money.  It gets worse, though:

    Children make up almost half of all people on Medicaid. Adults comprise another 20-25%. So if you want to cut people from Medicaid, that’s who is available.

    There’s no magic solution here. If you won’t touch the elderly, nor the disabled, you have to go after children and adults. And many of those adults are pregnant women. And cutting them won’t save much money.


    • Yes, but if the adults have to pay some form of co-pay, the cost will go down by decreasing utilization.
      The issue here seems to have moved from helping the disadvantaged to a right for the disadvantaged. The line has to be drawn somewhere. But where?
      It’s the same thing on the side of revenues to pay for all of this. Where do you draw the line as far as tax percentages, income levels, deductions?

      • These people are the poorest of the poor. How much should they pay? It better be enough to make a difference in overall costs, or what’s the point?

        • I spent time volunteering in northern Haiti at a hospital clinic. The history behind this clinic included the fact that for the first month of it’s existence, care was free. The staff was working 6 AM to 10 PM taking care of patients. Then they changed it to one gourd mandatory payment. The numbers of people seen went down, the severly ill still found ways to come up with one gourd, and health care was provided without burning out the staff.
          It’s time everyone pays something. Anything.

    • I have heard of people disbursing the assets of their elderly parents to get them on medicaid to avoid paying for nursing home care. One guy told me that he hired a lawyer how helped him do this. Am I misinformed?