Under an Arizona Plan, Smokers and the Obese Would Pay Medicaid Fee
By TIMOTHY WILLIAMS
NYT
Arizona, like many other states, says it is no longer able to finance its Medicaid program adequately. As part of a plan to cut costs, the state has proposed imposing a $50 fee on childless adults on Medicaid who are either obese or who smoke. In Arizona, almost half of all Medicaid recipients smoke; while the number of obese people is unclear, about one in four Arizonans is overweight, according to the Centers for Disease Control and Prevention. The state’s plan must ultimately be approved by the federal government. Monica Coury, spokeswoman for Arizona’s Medicaid program, discusses.
Q. What is the current status of the state’s Medicaid program?
A. In Arizona, there has been an increase of 30 percent in the number of people on Medicaid and a 34 percent decrease in general fund revenue since 2007. We are one of just a few states that cover childless adults in Medicaid. We want to change the nature of eligibility for that program from an open-ended entitlement program to one that the state manages based on available funding, which means we can freeze the program and then open the program back up for enrollment should we come into additional funds. But that is just one of the things we are seeking to do. We also want to reform the payment system for Medicaid. Currently, Medicaid is structured such that we are a purchaser of ‘widgets,’ if you will. So, providers are incentivized to do more — since they get paid for quantity. There is no financial incentive for a provider to reduce the number of hospital admissions, for instance, because that drives down the bottom line. We want Medicaid to move away from that concept to one that supports and financially rewards health plans and providers for supporting quality.
Q. Why is it a good idea to charge people a fee for being overweight or for smoking?
(More here.)
NYT
Arizona, like many other states, says it is no longer able to finance its Medicaid program adequately. As part of a plan to cut costs, the state has proposed imposing a $50 fee on childless adults on Medicaid who are either obese or who smoke. In Arizona, almost half of all Medicaid recipients smoke; while the number of obese people is unclear, about one in four Arizonans is overweight, according to the Centers for Disease Control and Prevention. The state’s plan must ultimately be approved by the federal government. Monica Coury, spokeswoman for Arizona’s Medicaid program, discusses.
Q. What is the current status of the state’s Medicaid program?
A. In Arizona, there has been an increase of 30 percent in the number of people on Medicaid and a 34 percent decrease in general fund revenue since 2007. We are one of just a few states that cover childless adults in Medicaid. We want to change the nature of eligibility for that program from an open-ended entitlement program to one that the state manages based on available funding, which means we can freeze the program and then open the program back up for enrollment should we come into additional funds. But that is just one of the things we are seeking to do. We also want to reform the payment system for Medicaid. Currently, Medicaid is structured such that we are a purchaser of ‘widgets,’ if you will. So, providers are incentivized to do more — since they get paid for quantity. There is no financial incentive for a provider to reduce the number of hospital admissions, for instance, because that drives down the bottom line. We want Medicaid to move away from that concept to one that supports and financially rewards health plans and providers for supporting quality.
Q. Why is it a good idea to charge people a fee for being overweight or for smoking?
(More here.)
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