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 Editor's
Corner
Medicaid
enrollments
by
Charleta Guillory, MD
Assistant Professor of Pediatrics-Neonatology
Baylor College of Medicine
Texas legislators’ efforts that simplified the state
Medicaid enrollment process, increased enrollment in the Children’s
Health Insurance Program, and increased Medicaid reimbursement
rates are to be commended. These efforts were a tremendous step
toward reforming Texas’ “broken” Medicaid system; however, unless
the Medicare/Medicaid reimbursement disparity is eliminated, barriers
to access will continue to hinder physician enrollment in the
program.
The
future of Texas will be greatly influenced by the choices we make
today about our children. In May 1998, the Institutes of Medicine,
Committee on Children, Health Insurance, and Access to Care reported,
“When compared with insured children, uninsured children are more
likely to be sick as newborns and less likely to be immunized
at appropriate ages. Having analyzed the available evidence on
financial and non-financial barriers to care, the committee concluded
that childrens’ health insurance status is the single most important
influence in determining whether healthcare is accessible to children
when they need it.” In the United States, Texas has the highest
or next to highest percentage of uninsured children—about 1.4
million children. Also, approximately 1.1 million children are
eligible either for Medicaid or Children’s Health Insurance Program
(CHIP) but are not enrolled.
Physicians
who presently accept Medicaid reimbursement have lost the ability
to cost-shift due to increased numbers of Medicaid patients and
low Medicaid reimbursement. Medicaid
reimbursement is now 70% of Medicare reimbursement and 50% of
commercial reimbursement.
Medicaid
reimbursement rates for children’s healthcare must be increased
to at least the same rate as Medicare or the Medicaid program
in Texas will cease to be meaningful for 2 million low-income
Texans.
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