States getting arms around Medicaid expansion, challenges in own Medicaid programs

Published on December 15, 2012 at 1:38 AM · No Comments

The health law's treatment of using Medicaid to expand coverage to more Americans is examined in Georgia -- where a doctor pay raise in the program has stirred discontent -- and in Oregon, where 200,000 stand to qualify under the program's expansion.

Georgia Health News: Doctor Pay Raise Encounters Controversy
Reimbursing underpaid doctors more for treating Medicaid patients, with the additional money coming from the federal government instead of state coffers, might appear to be an easy thing for a health agency board to approve. But the idea was not greeted enthusiastically by the state Department of Community Health board. There were expressions of dissatisfaction and a dissenting vote at Thursday's board meeting. The discontent appeared to stem from the pay raise's link to the Affordable Care Act, a federal law that has survived legal and political challenges but remains highly unpopular with many Georgians (Miller, 12/13).

The Lund Report: Medicaid Expansion Offers Richer Benefits To 200,000 Oregonians
The 200,000 Oregonians expected to qualify for Medicaid coverage in 2014 will receive more robust benefits if the Oregon Health Policy Board approves a recommendation from the Medicaid Advisory Committee. Now many low-income adults lack the dental, rehabilitative and optical care required by the Affordable Care Act, which expands Medicaid coverage to 133 percent of the poverty line. Those newcomers would receive care in the Oregon Health Plan Plus that's already offered to children, pregnant women and people with certain disabilities. "The Oregon Health Plan Plus is slightly richer than the average commercial plan," said Rhonda Busek, who chairs the advisory committee, adding that people wouldn't have to pay deductibles or co-payments to access care. Up until 2017, the federal government will absorb 100 percent of the cost for the expansion (Gray, 12/13).

In other state Medicaid news --

The Seattle Times: Two Health Plans Sue State Over Allocation Of Medicaid Patients
Two health plans that have contracted with the state to administer managed-care health services to Medicaid enrollees have sued the state, saying its allocation formula will penalize them by assigning too many new patients to other plans. In a lawsuit filed in Thurston County Superior Court, Molina and Community Health Plan of Washington (CHPW) contend that the state has breached its contract with them, penalizing the plans that have served the state's Medicaid patients for many years. The two plans maintain that three new plans have been given an unfair advantage by a reworked formula the state wants to use to assign patients (Ostrom, 12/13).

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