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The Actuarial Report of the Fiscal Status of Medicaid projects the enrollment of patients to reach 78 million in 2019, with an average annual increase of 4.5 percent. In 2012, 54.8 people will be enrolled in Medicaid with a total expenditure of $456.4 billion. The state portion of payments will be $196.5 billion.
In 2014, the enrollment will jump to 67 million patients at a cost of $564 billion, $224 billion of which will be state payments. And by 2019, the 78 million enrollees will cost a total of $840 billion. The states’ share will be $327.6 billion.
The cost breakdown, as calculated in the Actuarial Report listed the following breakdown of where the bulk of the Medicaid money is spent: 40.6 percent for nursing home care, 34.7 percent for home health care, 17.1 percent for hospitals, and 8.3 percent for drugs.
A letter to governors from Secretary Kathleen Sebelius of the Department of Health and Human Service Feb. 3 attempted to wipe salve on the worried brows of governors. The letter contained recommendations and pieces of advice. But it was even more an effort to tell the governors how lucky they were to have the benefits of all the technical provisions of the law to make paying Medicaid costs easier if not much fun.
“States may add or increase cost sharing,” she said, adding the words so favored by bureaucrats relishing their power: “within reason.” Sebelius also wrote: “We also are working with states to ensure they have accurate information about drug costs in order to make prudent purchasing decisions—as if governors couldn’t make “prudent” decisions by themselves.
She acknowledged the “error rate for Medicaid is 9.4 percent,” some $33.7 billion “paid inappropriately.” Maybe “scandalously” is a better description. She said reassuringly, however, that the President “is committed to cutting the error rate in half” in 2012.
What a relief.
Sebelius also said her Department plans to reduce health costs by improving patient safety not only in Medicaid and Medicare but “throughout the private health care system”—obviously further fiddling with our private health care.
In an article last year, Reason Magazine said: “Imagine a government-run health care program” with severely limited access, uncontrollably rising costs, and often worse health outcomes than having no insurance at all; “it already exists, and it’s called Medicaid.”
Medicaid, the article explained, was originally intended “as a bulwark against further government intervention” in health care. But instead of heading off added government intervention, it became a vehicle for expansion. Medicaid outspends all other welfare programs combined.
Soon, it may overtake even out-of-control Medicare.
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